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Failures of US Health Care System for Pregnant Asylum Seekers

Migrant Clinicians Network's white paper, “Failures of US Health Care System for Pregnant Asylum Seekers,” outlines how pregnant asylum seekers who have been released into the US to await their asylum hearing face extreme obstacles to secure prenatal care, despite their legal presence within the country.

Without prenatal care, infants will not have the benefit of early screening and treatment for potentially life-threatening diseases and screening for congenital abnormalities, while in utero. Additionally, pregnancies without prenatal care may result in excess utilization of emergency services which produces unforeseen strain on the health care system.

Knowledge of prenatal care needs, cost, lack of insurance, transportation, refusal by health centers, and fear are delineated as key barriers for pregnant asylum seekers from accessing the care they need during their pregnancy.

Press contact: Claire Hutkins Seda, cseda@migrantclinician.org

Failures of US Health Care System for Pregnant Asylum Seekers

Migrant Clinicians Network's white paper, “Failures of US Health Care System for Pregnant Asylum Seekers,” outlines how pregnant asylum seekers who have been released into the US to await their asylum hearing face extreme obstacles to secure prenatal care, despite their legal presence within the country.

Without prenatal care, infants will not have the benefit of early screening and treatment for potentially life-threatening diseases and screening for congenital abnormalities, while in utero. Additionally, pregnancies without prenatal care may result in excess utilization of emergency services which produces unforeseen strain on the health care system.

Knowledge of prenatal care needs, cost, lack of insurance, transportation, refusal by health centers, and fear are delineated as key barriers for pregnant asylum seekers from accessing the care they need during their pregnancy.

Press contact: Claire Hutkins Seda, cseda@migrantclinician.org

Questions for staff to address current organizational tensions

This publication was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $ 1,310,460 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

Questions for staff to address current organizational tensions

This publication was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $ 1,310,460 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

"The Global Report on Internal Displacement presents the latest information on internal displacement worldwide caused by conflict, violence and disasters."

This 90-minute webinar was created for physicians, nurses, and other health professionals who treat and case manage patients with active TB.  The webinar introduced the 2016 Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.  This training highlighted the guidelines development process, the key changes in recommendations, and discussed the evidence supporting the changes.  The webinar was originally presented on November 4, 2016. This training was jointly sponsored by all 5 RTMCCs.

The 1999–2013 United States Cancer Statistics (USCS): Incidence and Mortality Web-based Report includes the official federal statistics on cancer incidence from registries that have high-quality data, and cancer mortality statistics. It is produced by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI). This report shows that in 2013, 1,536,119 Americans received a new diagnosis of invasive cancer, and 584,872 Americans died of this disease (these counts do not include in situ cancers or the more than 1 million cases of basal and squamous cell skin cancers diagnosed each year).

This year’s report features information on invasive cancer cases diagnosed during 2013, the most recent year of incidence data available, among residents of 49 states, six metropolitan areas, and the District of Columbia—geographic areas in which about 99% of the U.S. population resides. Incidence data are from CDC’s National Program of Cancer Registries (NPCR) and NCI’s Surveillance, Epidemiology, and End Results (SEER) Program. Data from population-based central cancer registries in these states and metropolitan areas meet the criteria for inclusion in this report.

The report also provides cancer mortality data collected and processed by CDC’s National Center for Health Statistics. Mortality statistics, based on records of deaths that occurred during 2013, are available for all 50 states and the District of Columbia.

The report also includes incidence rates and counts for Puerto Rico for 2009 through 2013 by sex and age, as well brain tumor and childhood cancer data.

USCS data are presented in the following applications—

 

The 1999–2013 United States Cancer Statistics (USCS): Incidence and Mortality Web-based Report includes the official federal statistics on cancer incidence from registries that have high-quality data, and cancer mortality statistics. It is produced by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI). This report shows that in 2013, 1,536,119 Americans received a new diagnosis of invasive cancer, and 584,872 Americans died of this disease (these counts do not include in situ cancers or the more than 1 million cases of basal and squamous cell skin cancers diagnosed each year).

This year’s report features information on invasive cancer cases diagnosed during 2013, the most recent year of incidence data available, among residents of 49 states, six metropolitan areas, and the District of Columbia—geographic areas in which about 99% of the U.S. population resides. Incidence data are from CDC’s National Program of Cancer Registries (NPCR) and NCI’s Surveillance, Epidemiology, and End Results (SEER) Program. Data from population-based central cancer registries in these states and metropolitan areas meet the criteria for inclusion in this report.

The report also provides cancer mortality data collected and processed by CDC’s National Center for Health Statistics. Mortality statistics, based on records of deaths that occurred during 2013, are available for all 50 states and the District of Columbia.

The report also includes incidence rates and counts for Puerto Rico for 2009 through 2013 by sex and age, as well brain tumor and childhood cancer data.

USCS data are presented in the following applications—

 

The National LGBT Health Education Center provides educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual, and transgender (LGBT) people.

This is a resource dedicated to researching educational opportunities within public health to help make the decision to get your degree, go back to get your degree, or further your education with a master's or doctoral degree in public health. With over 150 schools and over 2,000 public health degrees in this database, this is a comprehensive resource for you to utilize when figuring out which public health program is best for you.

http://www.asbestosdiseaseawareness.org/

ADAO is the largest independent nonprofit in the U.S. dedicated to preventing asbestos exposure, eliminating asbestos-related diseases, and protecting asbestos victims' civil rights through education, advocacy, and community initiatives. 

The Inter-professional Oral Health Faculty Toolkit, developed by the Oral Health Nursing Education and Practice program, is now available.The toolkit is an innovative web-based open source product intended to facilitate integration of oral-systemic health content and clinical competencies into nurse practitioner and midwifery curricula. 

National Health Service Corps released the 2015 Application and Program Guidance for the HHSC Scholarship Program. The application cycle will close on May 7, 2015, at 7:30 p.m. ET."The NHSC Scholarship Program awards scholarship to health professions students who want to pursue their passion and work as a primary care provider without the burden of overwhelming debt."

"Abstract: Unathorized (undocumented) immigrants are less likely than other residents of the United States to have health insurance. The American College of Obstetricians and Gynecologists has long supported a basic health care package for all women living within the United States without regard to their country of origin or documentation. Providing access to qualify health care for unauthorized immigrants and their children, who often were born in the United States and have U.S. citizenship, is essential to improving the nation's publc health."

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Recently in the UK, there has been research supporting midwifery care. Due to this research, the UK has made some policy changes in regards to maternity. Midwifery care has been shown to be more safe for women with uncomplicated pregnancies and because of these new policies, the United States may follow in their footsteps.

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Public Health Online includes expert-driven data and information about careers in the field, online learning options, and how students can gain valuable professional experience even before graduation. Some key features include:


-          An in-depth look at public health issues and the importance of public health education

-          A detailed examination of high-quality, available online public health degrees and specializations

-          Tips for choosing a high-quality, affordable online program that meets the student’s education and career goal

-          A public health career fit quiz

 

http://www.publichealthonline.org/degree-programs/masters/

 


The National Nework for Oral Health Access has developed a user’s guide that provides a structure, options, and suggestions to help Health Centers develop programs to implement oral health competencies that integrate oral health care into primary care practice, which increases access to oral health care and improves the oral health status of the populations Health Centers serve.

This report captures important happenings in occupational health and safety from August 2013 through July 2014. Authoured by researchers from the George Washington University Milken Institute School Of Public Health, this resource focuses on workplace injury and illness statistics each spring and documents successes, challenges, and areas ripe for improvement in occupational health and safety.  

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Part 5 of the 6 webinar series: Essential Clinical Issues in Migration Health

DATE RECORDED: June 5, 2014
PRESENTED BY: Katherine Brieger, RD and Elizabeth Magenheimer

View Recorded Webinar

Participant Evaluation  

Presentation Slides (PDF)

To receive CME* or CNE credit after viewing any of these webinars you must do the following:
  • Complete the Participant Evaluation associated with each webinar
  • Send an email with your first and last name stating which webinar you completed to contedu@migrantclinician.org

Diabetes continues to be one of the most common and challenging health condition confronting migrants and other underserved populations. It is clear that a healthy lifestyle is critical to mitigating the impact of diabetes on individuals and the population, however effective and appropriate interventions can be difficult to design. Fairhaven Community Health Center in Connecticut and Hudson River Healthcare in New York, are two health centers that have long led the way in creating culturally appropriate lifestyle programs for migrants and other underserved patients. In this session the presenters will discuss lessons learned from the development of a variety of programs for diabetics and other patients including a community garden, nutrition classes, cooking classes, weight management and strategies to encourage exercise. The session will address the clinical core measures related to nutrition and BMI and will also discuss current research test second line drug effectiveness in Type 2 DM. Available in English

Learning Objectives:

  1. Describe culturally appropriate diabetes intervention strategies
  2. Identify strategies to address clinical core competencies related to nutrition and BMI to improve quality care.
  3. Receive “take home” examples of how to incorporate effective nutrition, weight loss, exercise and other health lifestyle strategies.

 

FURTHER READING

Download the Spanish Toolkit Materials

National Diabetes Information Clearinghouse, http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram

Bright Bodies, http://brightbodies.org

Part 2 of the 6 webinar series: Essential Clinical Issues in Migration Health

DATE RECORDED: April 2, 2014
PRESENTED BY:  Hans Dethlefs, MD and Ed Zuroweste, MD

View Recorded Webinar  

 Participant Evaluation  

 Presentation Slides (PDF)

If you have any follow up questions for this webinar, feel free to contact Dr. Ed Zuroweste at kugelzur@migrantclinician.org or 512.579.4540 .

To receive CME* or CNE credit after viewing any of these webinars you must complete the Participant Evaluation associated with each webinar. If you have any questions, contact our Continuing Education Assistant at contedu@migrantclinician.org

At their best, clinical core measures serve as an important window to examine the impact and quality of care being delivered at health centers. However, without an effective system in place clinical core measures can require a great deal of time and effort without yielding important quality improvement. This session will examine both short and long term strategies health centers can employ to make the best use out of the clinical core measures to improve care for patients. Drs Zuroweste and Dethlefs will examine the building blocks health centers need for an effective quality improvement system. Through a series of case studies, this session will explore the role of clinical leadership, technology and strategies for building a short and long term quality infrastructure that works.

Learning Objectives:

  1. Identify common pitfalls health centers encounter related to the clinical core measures.
  2. Discuss strategies for assessing a health center’s current capacity to engage in meaningful quality improvement.
  3. Through case studies, evaluate different approaches to clinical quality improvement using the clinical core measures.

FURTHER READING

Approved Uniform Data System (UDS) Changes for Calendar Year 2014 Program Assistance Letter

New Clinical Measures 2014

Effective Data Management for the Pursuit of Quality Health Care: OneWorld Health Center. MCN's Streamline. Winter 2014 Issue 1.

330 Clinical Grant Requirements

Part 1 of the 6 webinar series: Essential Clinical Issues in Migration Health

DATE RECORDED: March 19, 2014
PRESENTED BY:  Deliana Garcia, MA, International Research and Development, Migrant Clinicians Network

View Recorded Webinar  

 Participant Evaluation  

 Presentation Slides (PDF)

To receive CME* or CNE credit after viewing any of these webinars you must do the following:
  • Complete the Participant Evaluation associated with each webinar
  • Send an email with your first and last name stating which webinar you completed to contedu@migrantclinician.org

**Note: Due to technical difficulities the first 7 minutes of the presentation are not recorded. Please refer to the pdf of the slides for the content that was covered in those 7 minutes.

Over the last 30 years, considerable attention has been paid in the clinical setting to cultural competency- the ability to mitigate against the effects of the sociocultural differences between clinicians and patients and to take into account how culture affects the symptoms presented or the patients’ attitude about health care.  More recently, scholars and clinicians have encouraged those in practice or health professions training to focus not only on the behaviors and beliefs of cultural groups but more importantly to consider the structural determinants, prejudices, injustices and blind spots, the “pathologies of social systems” that affect health outcomes and the stigma experienced by patients. The session will introduce participants to the broad framework of structural competency and the five core structural competencies.

Learning Objectives:

  1. Identify the structures that shape clinical interactions;
  2. Discuss the means of developing an extra-clinical language of structure;
  3. Rearticulate “cultural” formulations in structural terms;
  4. Explain the process of observing and imagining structural interventions; and
  5. Describe the concept of structural humility.

 

FURTHER READING

Farmer, Paul, Bruce Nizeye, Sara Stulac, Salmaan Keshavjee. 2006. Structural Violence and Clinical Medicine. PLoS Medicine 2006 (3): 1686-1691.

Holmes, Seth, Fresh Fruit Broken Bodies, 2013

Messac, Luke, Dan Ciccarone, Jeffrey Draine, Philippe Bourgois. 2013. The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies. Social Science & Medicine 99 (2013): 176-186

Quesada, James, Laurie Kain Hart, & Philippe Bourgois. 2011. Structural Vulnerability and Health: Latino Migrant Laborers in the United States. Medical Anthropology, Vol. 30, No. 4: 339- 362

Srivastava, Ranjana. Complicated Lives—Taking the Social History. New England Journal of Medicine 2011 (365): 587-589.

Willen, Sarah. 2012. How is Health-Related “Deservingness” Reckoned? Perspectives from Unauthorized Im/migrants in Tel Aviv. Social Science & Medicine 74 (2012): 812-821.

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Limited data document the multiple and repeated pesticide absorption experienced by farmworkers in an agricultural season or their risk factors.