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PubMed2004

Different subjects: the health care system's participation in the differential construction of the cultural citizenship of Cuban refugees and Mexican immigrants.

This paper explores the public health system's differential construction of Mexican and Cuban immigrants' "deservingness" of citizenship benefits and its preparation of them for different roles in U.S. society. Civic institutions such as the public health care system are charged with inculcating normative behavior in immigrants and instilling in them different conceptions about their rights and responsibilities. Faced with limited resources under the implementation of Medicaid managed care, hospital administrators created new categories of "deserving" and "undeserving" immigrants based on neoliberal standards of individual responsibility and self-discipline. As a result, hospital policies construct different types of "cultural citizenship" for Cuban and Mexican immigrants, preparing the former to be active citizens and discouraging the latter from pressing demands on American civil institutions. I show that this negative construction of Mexican immigrants' moral worth leads to unmet health needs and poor health outcomes.

Cuba↗
PubMedDate not supplied

Cost-effectiveness of serotesting compared with universal immunization for varicella in refugee children from six geographic regions.

BACKGROUND: It is unknown whether it is more cost-effective to test for varicella antibody or to immunize without testing in immigrant populations. The reliability of history of varicella disease is also unclear. METHODS: The prevalences of varicella antibody in immigrant children from six regions of the world were used in a cost-effectiveness model to calculate the antibody prevalence above which it is more cost-effective to test rather than to immunize. History of varicella disease was obtained from chart review. We calculated the positive and negative predictive values of varicella history by age group and region. RESULTS: The prevalence of varicella antibody above which it is more cost-effective to test than to immunize was 34% for children less than 13 years old and 17% for those aged 13 years and older. Overall, the positive predictive value of varicella history was 93-100% and the negative predictive value of varicella history was 28-66% among the six geographic regions. CONCLUSION: Immunization without serotesting was cost-effective in children <5 years of age. Testing prior to immunization was cost-effective in children 5 years of age and older. History of varicella was a good predictor of the presence of antibody to varicella, whereas a negative history was a poor predictor of the absence of antibody to varicella.

Adolescent↗
PubMed1993

Somatisation as a presentation in depression and post-traumatic stress disorder among Cambodian refugees.

Three Cambodian patients with Depression and Post-traumatic Stress Disorder (PTSD) presenting with somatic complaints are described. Their case histories support previous observations that somatisation is the most common presentation of Cambodian patients with Depression and PTSD. The probable reasons why depressed, traumatised Cambodian patients somatise their psychiatric problems are discussed. These cases illustrate the difficulties involved in engaging such patients in Western style psychotherapy, but show the effectiveness of small doses of antidepressants in treating the depressive and post-traumatic stress symptoms.

Adult↗
PubMed1997

Comparative levels of psychological distress in a pre-migratory refugee population.

OBJECTIVE: This study compares levels of psychological distress in a pre-migratory sample of Vietnamese Amerasians with those in a like-aged, non-migratory sample of Vietnamese living in Ho Chi Minh City, Vietnam. METHOD: Subjects were assessed using two measures developed and validated for Vietnamese clinical populations in the United States: the Hopkins Symptom Checklist-25 and the Vietnamese Depression Scale. RESULTS: Amerasians had significantly higher symptom levels on the depression scale of the Hopkins Symptom Checklist-25, but not on the other measures utilised. CONCLUSIONS: Amerasians' higher levels of depressive symptoms are probably a result of their traumatic lives in Vietnam, but may also reflect acute situational factors or selection bias.

Acculturation↗