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You Have to Pay to Live: Somali Young Adult Experiences With the US Health Care System

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Since there is increasing documentation that refugees face experiences of interpersonal or structural discrimination in health care and employment, this study examined how Somali refugees understand various forms of discrimination in employment and health care related to their health, utilization of, and engagement with the health care system in the United States.



The study drew on semi-structured qualitative interviews (N = 35) with Somali young adults in three U.S. states—Minnesota, Massachusetts, and Maine. Using modified grounded theory analysis, the study explored how experiences of discrimination in employment and health-care settings impact health-care access, utilization, and perceptions of health among Somali young adults. Discrimination was identified as a major barrier to using health services and securing employment with employer-sponsored insurance coverage. These findings highlight how interpersonal and structural discrimination in employment and health care are mutually reinforcing in their production of barriers to health-care utilization among Somali refugees. (Publisher Abstract)


Date Published: January 1, 2021