Results & Conclusions:

Health Disparities Research Articles 

Results: Participants identified several barriers, including safety concerns, minimal culturally appropriate resources, and financial constraints. Strengths included public resources and a community support system. 

Conclusion: The findings laid the framework for subsequent program development and community engagement. 

                                      HeRISA’s Take on Health Disparities among Somali Americans

As described in “what is health disparity?” article, health disparities are viewed as multifactorial of environment, health access, health utilization, and particular health outcome of a group. The above extracts from few reports and scientific publications in health disparities among Somali-Americans show major health problems in this ethnic group. The distressing reality, according to the 2015 Health Equity of care report by Minnesota community measurement, is that Somali-Americans have performed the worst in five health areas measured. Similarly, the selected published articles revealed additional health disparities among Somali-Americans.

In the 2013 autism spectrum disorder (ASD) report by University of Minnesota, demonstrated that Somali and White children were more likely to be identified with ASD than Black and Hispanic children in Minneapolis. The study only focused on ASD prevalence in Minneapolis in 2010 for 7- to 9-year-old children identified with ASD and was not designed to answer questions such as “why Somali and white children had the highest ASD prevalence?”. However, it shows the need for additional research. One stark contrast, though, was that 20 of the 31 Somali children with ASD and with available IQ scores were more likely to have Intellectual Disability (ID) than children with ASD in all other racial and ethnic groups in Minneapolis. Children with ASD and ID were defined as those who had an IQ score of less than 70. Again, this shows the need for additional research as one can only postulate had the Somali children been identified early enough and placed under early intervention programs perhaps the rate of ID would have been lower.

Nevertheless, the question is: are we addressing these health disparities among Somali-Americans? The answer is yes, however more needs to be done and done in coordinated and cohesive manners between all stakeholders – federal and state health agencies, health maintenance organizations, Somali-American health professionals, and profit and non-profit Somali-American community organizations.

HeRISA and its team are willing to take part in our endeavors to reduce or eliminate the health disparities that Somali-Americans are facing.

There are numerous challenges faced by Somali Bantu and Bhutanese youths, as well as strengths and resources that promote resilience. Future steps include using culturally informed methods for identifying those in need of services and developing community-based prevention programs.

Disabled refugees resettled in the U.S.A. have many unmet needs associated with gaps in-service delivery stemming from disconnections between refugee and disability service systems.

There was a significantly higher prevalence of diabetes, pre-diabetes and obesity among Somali patients compared with non-Somali patients. Further research into the specific causes of these disparities and development of targeted effective and sustainable interventions to address them is needed.

We measured the efficacy of a natural-language-processing algorithm to identify a specific immigrant group. The algorithm demonstrated accuracy and precision in identifying Somali patients from the electronic medical records at a single institution. This technology holds promise to identify and track immigrants and refugees in the United States in local health care settings.

High Rates of Diabetes Mellitus, Pre-diabetes and Obesity Among Somali Immigrants and Refugees in Minnesota: A Retrospective Chart Review.
Njeru JW, Tan EM, St Sauver J, Jacobson DJ, Agunwamba AA, Wilson PM, Rutten LJ, Damodaran S, Wieland ML.
J Immigr Minor Health. 2015 Sep 28.
PMID: 26416285

Bosnian, Iraqi, and Somali Refugee Women Speak: A Comparative Qualitative Study of Refugee Health Beliefs on Preventive Health and Breast Cancer Screening.
Saadi A, Bond BE, Percac-Lima S.
Womens Health Issues. 2015 Sep-Oct;25(5):501-8.
PMID: 26219676

Somali Perspectives on Physical Activity: PhotoVoice to Address Barriers and Resources in San Diego.
Murray KE, Mohamed AS, Dawson DB, Syme M, Abdi S, Barnack-Taviaris J.

Prog Community Health Partnersh. 2015 Spring;9(1):83-90.
PMID: 25981428 Free PMC Article

Addressing health disparities in the mental health of refugee children and adolescents through community-based participatory research: a study in 2 communities.
Betancourt TS, Frounfelker R, Mishra T, Hussein A, Falzarano R.
Am J Public Health. 2015 Jul;105 Suppl 3:S475-82.
PMID: 25905818 

Barriers to care in an ethnically diverse publicly insured population: is health care reform enough?
Call KT, McAlpine DD, Garcia CM, Shippee N, Beebe T, Adeniyi TC, Shippee T.
Med Care. 2014 Aug;52(8):720-7.
PMID: 25023917 

Understanding cancer screening service utilization by Somali men in Minnesota.
Sewali B, Pratt R, Abdiwahab E, Fahia S, Call KT, Okuyemi KS.
J Immigr Minor Health. 2015 Jun;17(3):773-80.
PMID: 24817627

Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation.
Percac-Lima S, Ashburner JM, Bond B, Oo SA, Atlas SJ.
J Gen Intern Med. 2013 Nov;28(11):1463-8.
PMID: 23686510 [Free PMC Article 

Tracking health disparities through natural-language processing.

Wieland ML, Wu ST, Kaggal VC, Yawn BP.
Am J Public Health. 2013 Mar;103(3):448-9.
PMID: 23327237 Free PMC Article

Disparities in preventive health services among Somali immigrants and refugees.
Morrison TB, Wieland ML, Cha SS, Rahman AS, Chaudhry R.
J Immigr Minor Health. 2012 Dec;14(6):968-74.
PMID: 22585311

Diabetes care among Somali immigrants and refugees.
Wieland ML, Morrison TB, Cha SS, Rahman AS, Chaudhry R.
J Community Health. 2012 Jun;37(3):680-4.
PMID: 22075851

Service needs and service gaps among refugees with disabilities resettled in the United States.

Mirza M, Heinemann AW.
Disabil Rehabil. 2012;34(7):542-52.
PMID: 21981065

Taken together, duration of time in United States and prior exposure to Western medicine account for differences in refugee women's knowledge of preventive care. Understanding population-specific health beliefs, health information, and behavior are crucial for designing tailored prevention programs for refugee women.

There was a strong association between number of primary care visits during the study interval and achievement of all three diabetes care quality goals. This study demonstrates disparities in achievement of diabetes management quality goals among Somali patients compared with non-Somali patients, highlighting the need for additional system and practice changes to target this particularly vulnerable population.

Somali men commonly believe they are protected from cancer by religious beliefs. This belief, along with a lack of knowledge about screening, increased the likelihood to refrain from screening. Identifying the association between religion and health behaviors may lead to more targeted interventions to address existing disparities in cancer screening in the growing US immigrant population.

Many challenges to care persist for publicly insured adults, particularly minority racial and ethnic groups. The Affordable Care Act (ACA) expansion of Medicaid, although necessary, is not sufficient for achieving improved and equitable access to care.

Linguistically and culturally tailored PN decreased disparities over time in breast cancer screening among female refugees from Somalia, the Middle East and Bosnia.

There are significant discrepancies in the provision of preventive health services to Somali patients compared with that of non-Somali patients. These findings suggest the need to identify the root causes of these discrepancies so that interventions may be crafted to close the gap.

Health Disparities Research
Articles on Somali-Americans