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Feature: September 2018

Implications for Health Care and Service Providers from Possible Immigration Legal Changes

The Protecting Immigrant Families (PIF) Campaign and other organizations are organizing around the possibility of federal changes to public charge rules that would impact many immigrant families.  Reports continue to circulate that many immigrants are turning down programs such as WIC and other nutrition programs out of fear that accessing this federal aid will make them ineligible for a green card if new rules are put into place.  


The change being considered would expand the categories of public benefits that could be held against an individual seeking legal status.  These categories might include nutrition programs like WIC or lunch programs, CHIP (Children's Health Insurance Program), educational assistance, child care services. If these changes are implemented it could mean the government could deny admission to the U.S. or refuse an application for lawful permanent residency if it is determined the applicant is likely to become a public chargeā€”in other words, likely to use certain types of government assistance. These rule changes have not been publicly released to date, but the threat of policy change is already creating fear in immigrant and refugee communities who may put off health care visits or not enroll in services for children and families. It is critical that providers are aware of the potential impact and be ready to address these issues if new rules are proposed. Below are some resources with additional information:


Media Reports

Current Immigration Issues and Legal Challenges:
The following talk was given by Maggie Chen, JD from the Northwest Immigrant Rights Project to practitioners at Harborview Medical Center and provides an overview of the immigration and legal challenges that NWIRP has been responding to. 


Additional Resources:
Under A Trump Proposal, Lawful Immigrants Might Shun Medical Care, NPR, May 10, 2018 

Recent Features 

Discussing Measles and MMR Vaccine with Your Somali Patients

Measles Infographic CDC
Image source:

Although techniques regarding how to discuss vaccines with vaccine hesitant parents as described in the literature remain relevant, there are additional considerations in the Somali community. Understanding what has led the Somali community to be wary of the MMR vaccine is critical to knowing how to approach the conversation in the clinic setting.

Dr. Anisa Ibrahim provides background information regarding concerns that arose in the Somali community about autism, and specific recommendations for providers regarding how to approach the conversation about measles and MMR vaccine with patients. 

Includes link to factsheet about measles in Somali language from Public Health-Seattle & King County

Read more... 


Community House Calls Program Videos

New videos highlight the work of Harborview's patient navigator program and caseworker / cultural mediator staff helping LEP patients from other cultures navigate the health care system.

See videos... 

Summer Safety

sun imageSummer safety issues include heat-related illnesses, sun exposure, water safety concerns, and use of fireworks or concern about fire.  Extremely hot weather can cause sickness or even death.

Who is at highest risk for heat-related illness:

  • Older adults
  • Young children
  • People with mental illness and chronic diseases
  • Athletes who exercise outdoors
  • Outdoor workers
  • People experiencing homelessness 

During very hot weather:

  • Check on at-risk friends, family and neighbors twice a day
  • Stay cool and avoid direct contact with the sun
  • Stay hydrated. Drink plenty of water and don't wait until you're thirsty to drink more
  • NEVER LEAVE INFANTS, children or pets in a parked car
  • Watch for signs of heat exhaustion or heat stroke.  Seek medical care immediately 

Below are a few sites that provide information on this topic in other languages or audio/visual formats:

Health Reach: 
"Heat Waves" (Arabic, Bosnian, Somali, Spanish) and "Heat Exhaustion" (Creole, Spanish)

Health Information Translations: "Sun Safety Tips", (Arabic, Chinese, French, Hindi, Japanese, Korean, Russian, Somali, Spanish)

MedlinePlus:   "Sun Exposure" (Arabic, Chinese, French, Hindi, Japanese, Korean, Russian, Somali, Spanish)

Public Health: Seattle & King County:  "Hot Weather and How To Stay Cool", (Chinese, Korean, Russian, Spanish and Vietnamese)

Children's Hospital & Medical Center, Seattle: Safety and Injury Prevention materials, some other languages.  

Washington State Department of Health:   "Hot Weather Safety", (Chinese, Korean, Russian, Somali, Spanish, Ukranian, Vietnamese, and large type)

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EthnoMed contains information about cultural beliefs, medical issues and related topics pertinent to the health care of immigrants to Seattle or the US, many of whom are refugees fleeing war-torn parts of the world.

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Refugee Health Weekly Roundup

This summary is compiled by the Washington State Department of Health Refugee Health Program. The Weekly Roundup highlights upcoming events and opportunities, resources and news relevant to refugee health. Some information is local to WA, but also what's on the national agenda. Read the latest edition of the Refugee Health Roundup.

Migrant Children and Health

The Migrant Children and Health Campaign has created a video featuring leaders in immigrant and refugee health advocacy introducing the facts about migrant children health and the continued history of racial and ethnic disease scaremongering in the U.S. For more information about this Campaign and to view the video "Migrant Children and Health: Borders, Boundaries, and Bigotry" click here.

Torture Resources

Resources for clinicians and advocates around issues of torture, often related to warfare and political repression.  Includes information about Northwest Health and Human Rights (NWHHR) coalition serving refugees, asylum seekers, and immigrants in Washington State.  Visit Caring for Survivors of Torture page for additional information.