RESUMO
BACKGROUND: Half a million immigrants enter the United States annually. Clinical providers generally lack training in immigrant health. DESCRIPTION: We developed a curriculum with didactic, clinical, and analytic components to advance residents' skills in immigrant and travel health. The curriculum focused on patients and their countries of origin and encompassed (a) societal, cultural, economical, and human rights profiles; (b) health system/ policies/resources/statistics, and environmental health; and (c) clinical manifestations, tropical and travel health. Residents evaluated sociocultural health beliefs and human rights abuses; performed history and physical examinations while precepted by faculty; developed specific care plans; and discussed patients in a dedicated immigrant health morning report. EVALUATION: We assessed resident satisfaction using questionnaires and focus groups. Residents (n=20) found clinical, sociocultural, and epidemiological components the most helpful. Morning reports reinforced peer education. CONCLUSION: The immigrant health curriculum was useful for residents. Multiple teaching modules, collaboration with grassroot organizations, and an ongoing clinical component were key features.
Assuntos
Competência Clínica , Competência Cultural/educação , Educação de Pós-Graduação em Medicina/organização & administração , Emigrantes e Imigrantes , Saúde Global/educação , Direitos Humanos/educação , Internato e Residência , Refugiados , Ensino/métodos , Currículo , Avaliação Educacional , Disparidades nos Níveis de Saúde , Humanos , Cidade de Nova Iorque , Inquéritos e QuestionáriosRESUMO
Varying dimensions of social, environmental, and economic vulnerability can lead to drastically different health outcomes. The novel coronavirus (SARS-CoV-19) pandemic exposes how the intersection of these vulnerabilities with individual behavior, healthcare access, and pre-existing conditions can lead to disproportionate risks of morbidity and mortality from the virus-induced illness, COVID-19. The available data shows that those who are black, indigenous, and people of color (BIPOC) bear the brunt of this risk; however, missing data on race/ethnicity from federal, state, and local agencies impedes nuanced understanding of health disparities. In this commentary, we summarize the link between racism and COVID-19 disparities and the extent of missing data on race/ethnicity in critical COVID-19 reporting. In addition, we provide an overview of the current literature on missing demographic data in the US and hypothesize how racism contributes to nonresponse in health reporting broadly. Finally, we argue that health departments and healthcare systems must engage communities of color to co-develop race/ethnicity data collection processes as part of a comprehensive strategy for achieving health equity.
Assuntos
COVID-19 , Etnicidade , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Pandemias , SARS-CoV-2 , Estados UnidosRESUMO
Liberation Medicine is the conscious, conscientious use of health to promote social justice and human dignity. The new United States of America government policy of separating children from their families at the border has galvanized action on the part of health professionals and their professional organizations. The impact of Hurricane Maria's devastation on 16 September 2017 in Puerto Rico has reverberated throughout the entire United States, and-like other examples globally-reminds us of our responsibility as clinicians to understand and influence social well-being in our patients' lives. Liberation Medicine recognizes the interrelatedness of healthy lives in all corners of the world and the responsibility of health professionals to incorporate social well-being in daily practice. Liberation Medicine affirms that all life is worthy of life, and encourages that vision as a metric within health policy and patient care global to local.