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Somali immigrant women and the American health care system: Discordant beliefs, divergent expectations, and silent worries

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  • Pavlish, Carol Lynn
  • Noor, Sahra
  • Brandt, Joan

Abstract

The civil war in Somalia resulted in massive resettlement of Somali refugees. The largest diaspora of Somali refugees in the United States currently reside in Minnesota. Partnering with three community organizations in 2007-8, we implemented the Community Connections and Collaboration Project to address health disparities that Somali refugees experienced. Specifically, we examined factors that influenced Somali women's health experiences. Utilizing a socio-ecological perspective and a social action research design, we conducted six community-based focus groups with 57 Somali women and interviewed 11 key informants including Somali healthcare professionals. Inductively coding, sorting and reducing data into categories, we analyzed each category for specific patterns. The categorical findings on healthcare experiences are reported here. We found that Somali women's health beliefs related closely to situational factors and contrasted sharply with the biological model that drives Western medicine. These discordant health beliefs resulted in divergent expectations regarding treatment and healthcare interactions. Experiencing unmet expectations, Somali women and their healthcare providers reported multiple frustrations which often diminished perceived quality of health care. Moreover, silent worries about mental health and reproductive decision making surfaced. To provide high quality, transcultural health care, providers must encourage patients to voice their own health explanations, expectations, and worries.

Suggested Citation

  • Pavlish, Carol Lynn & Noor, Sahra & Brandt, Joan, 2010. "Somali immigrant women and the American health care system: Discordant beliefs, divergent expectations, and silent worries," Social Science & Medicine, Elsevier, vol. 71(2), pages 353-361, July.
  • Handle: RePEc:eee:socmed:v:71:y:2010:i:2:p:353-361
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    References listed on IDEAS

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    1. Guillermina Jasso & Douglas S. Massey & Mark R. Rosenzweig & James P. Smith, 2004. "Immigrant Health--Selectivity and Acculturation," Labor and Demography 0412002, EconWPA.
    2. Heather Antecol & Kelly Bedard, 2006. "Unhealthy assimilation: Why do immigrants converge to American health status levels?," Demography, Springer;Population Association of America (PAA), vol. 43(2), pages 337-360, May.
    3. Kokanovic, Renata & Dowrick, Christopher & Butler, Ella & Herrman, Helen & Gunn, Jane, 2008. "Lay accounts of depression amongst Anglo-Australian residents and East African refugees," Social Science & Medicine, Elsevier, vol. 66(2), pages 454-466, January.
    4. repec:aph:ajpbhl:2004:94:5:866-869_4 is not listed on IDEAS
    5. Meadows, Lynn M. & Thurston, Wilfreda E. & Melton, Christina, 2001. "Immigrant women's health," Social Science & Medicine, Elsevier, vol. 52(9), pages 1451-1458, May.
    6. McDonald, James Ted & Kennedy, Steven, 2004. "Insights into the 'healthy immigrant effect': health status and health service use of immigrants to Canada," Social Science & Medicine, Elsevier, vol. 59(8), pages 1613-1627, October.
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    Cited by:

    1. Binder, Pauline & Johnsdotter, Sara & Essén, Birgitta, 2012. "Conceptualising the prevention of adverse obstetric outcomes among immigrants using the ‘three delays’ framework in a high-income context," Social Science & Medicine, Elsevier, vol. 75(11), pages 2028-2036.
    2. Viladrich, Anahí, 2012. "Beyond welfare reform: Reframing undocumented immigrants’ entitlement to health care in the United States, a critical review," Social Science & Medicine, Elsevier, vol. 74(6), pages 822-829.
    3. Yao, Jing & Murray, Alan T. & Agadjanian, Victor, 2013. "A geographical perspective on access to sexual and reproductive health care for women in rural Africa," Social Science & Medicine, Elsevier, vol. 96(C), pages 60-68.
    4. Lum, Irene D. & Swartz, Rebecca H. & Kwan, Matthew Y.W., 2016. "Accessibility and use of primary healthcare for immigrants living in the Niagara Region," Social Science & Medicine, Elsevier, vol. 156(C), pages 73-79.
    5. Parkinson, Sarah E. & Behrouzan, Orkideh, 2015. "Negotiating health and life: Syrian refugees and the politics of access in Lebanon," Social Science & Medicine, Elsevier, vol. 146(C), pages 324-331.

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