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Refugee Health Clinical Topics

Topics related to the health care of refugees, including screening guidelines.

Clinical Pearls

Clinical Pearl:  Consider Lead and Other Heavy Metal Toxicities in the Evaluation of Nonspecific Symptoms
A short clinical pearl about the need to consider the prevalence of high lead levels among recently arrived Burmese. 

Other Related Websites with information about lead and caring for refugees:

  • Working with Refugees from Burma to Prevent Childhood Lead Poisoning Information presented by the New York State Department of Health on the prevalence of childhood lead poisoning among recent Burmese refugees, and prevention issues specific to this population. Includes a discussion of some of the cultural and health practices common among Burmese refugees.

Clinical Pearl: Pre-travel counseling for persons visiting friends and relatives (VFRs)
Useful tips and guidelines on pre-travel counseling for patients who are visiting friends and relatives internationally.

Refugee Health, Screening & Treatment

Pathways to Wellness Toolkit for Primary Care Providers Treating Refugees
This health screening toolkit was designed for King County, WA and includes information about medical assessments and interventions that occur as part of the refugee resettlement process.  Although specific to King County, WA, there are also some guidelines on adapting the toolkit for other areas.

New Arrival Refugees - Guidelines for Primary Care Providers in King County, WA
8-page PDF. These guidelines reflect current screening practice in King County, WA as of 10/1/2015. Please note that refugees screened prior to this date or outside of King County may have received a different screening.

Domestic Medical Screening Guidelines Checklist for Newly Arriving Refugees in WA State:

Washington State Department of Health's Domestic Medical Screening Guidelines Checklist for Newly Arriving Refugees. Based upon the CDC Guidelines for the US Domestic Medical Examination for Newly Arriving Refugees and the Office of Refugee Resettlement (ORR) Domestic Medical Screening Guidelines Checklist.  The purpose of this document is to provide guidance around screening asymptomatic refugees.

Approach to Medical Assessment and Screening for New Refugee and Immigrant Children
15-pages; Guidelines on how to approach health assessment and disease screening in immigrant children newly arrived to the US and/or new to our Child and Teen Clinic. Describes health assessments prior to immigration, and approaches to post-arrival domestic medical screening.

New Immigrant and Children: Screening and Treatment Guidelines
This 2-page document describes two components of medical screening of immigrant children new to the Harborview Child and Teen clinic: Preventive Health Interventions and Screening Lab Work.

Parasite Summary Tables
A 3-page table presenting information about parasites, consequence if left untreated, clinical diagnosis and treatment. Also includes a review of studies on parasite infections among immigrant /refugee children.

Refugee and Immigrant Healthcare
A general presentation addressing some specific issues related to health care for immigrants.


EthnoMed Resources Page with information geared to clinicians about caring for survivors of torture.

Working with Refugee Survivors of Torture
Article reprinted with permission from Western Journal of Medicine. By Barbara Chester, PhD and Neal Holton, MPH. West J Med, September 1992; 157:301-304. 

Related Websites

United Nations High Commissioner on Refugees (UNHCR) Resettlement Handbook 
July 2011 revised edition. This is an informative site on refugee resettlement though not specifically for health-related matters. There is a section of the U.S. guidelines for resettlement which outlines the criteria for resettlement and prioritization process; and a brief section on domestic services such as housing, language training, vocational training and financial assistance.

CDC Immigrant and Refugee Health
Provides information about medical examination, health guidelines, laws and regulations.

Minnesota Department of Health "Clinicians Corner"
The "Clinician's Corner" provides a collection of resources for providers working with refugee populations, including a quick guide for conducting initial refugee health assessments.

Harvard Public Health Review April 2016 issue on Refugee Health with six articles on various aspects of refugee health. EthnoMed is proud to be featured in"Healthcare Recommendations for Recently Arrived Refugees: Observations from EthnoMed". The Review can be freely accessed and is committed to the mission of advancing the public's health through learning and communication. 

Journal Articles

van Abeelen, Annet F.M., et al. (2012). Diabetes. Famine Exposure in the Young and the Risk of Type 2 Diabetes in Adulthood. doi: 10.2337/db11-1559.

     Note:  The full text of this article is available by subscription only, but the abstract is available.