Health Care Access and Wellness Needs of Resettled Rohingyan Refugees

Background and Purpose: Newly arrived refugees face numerous challenges navigating the complex U.S. health care system and struggling to understand the cost of medical treatment or insurance rules and regulations. Fear about the cost of medical treatment, lack of adequate transportation, and general apprehension can lead to delays in treatment (Asaduzzaman, 2019). The Rohingya, an ethnic hill tribe from Burma, who have been arriving in the U.S. as resettled refugees since about 2016, face unique obstacles due to the fact that the Rohingyan language does not have a written script, but exists entirely as an oral language. Language is a primary barrier between Rohingya refugees and the U.S. health care system, and can create unique challenges for this population in receiving timely and appropriate health and mental health treatment. The purpose of this study was to explore the lived experiences of resettled Rohingyan adults with regards to health and mental health needs and access to care.

Methods: Twenty-one recently resettled Rohingyans were interviewed by an emic Rohingyan researcher and member of the research team. A semi-structured interview guide asked questions about the experiences of participants related to health care access, and physical and mental health concerns, among a variety of other topics. Of the 21 participants in the study, the majority had some form of health insurance (85.7%), though 42.9% of the sample was currently unemployed and looking for work. Just over one-fourth of the sample reported speaking some English, through the majority of the sample (71.4%) spoke no English. The analysis of data was conducted using an independent categorical coding strategy, with the development of a taxonomic system that resulted in the development of central domains that were extracted into themes.

Results: Participants reported a myriad of chronic health problems in addition to the somatization of a number of mental health indicators such as headaches, fatigue, and body aches. Self-reported mental health concerns such as such as stress and anxiety attributed to a range of specific and abstract concerns about safety, health, financial instability, and worry about what the future would bring were common. Access to health care was negatively impacted by financial barriers, including lack of insurance and the inability to pay for treatment, which led to delays in seeking care for some participants. Other significant access barriers included language and literacy challenges and a lack of reliable transportation. Some participants in the study experienced no barriers accessing health care and reported positive experiences when receiving health care services.

Conclusions and Implications: The results of this study demonstrate a need for resettlement efforts and resources to eliminate barriers that prevent access to appropriate health and mental health care for Rohingyans. Providers should be equipped to address somaticized health complaints and must make efforts to address and rectify barriers resulting from low health literacy. Further research is needed to explore additional cultural considerations to enhance the acceptability and accessibility of care for this unique population.