Family medicine
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During the 1990s, African refugees from the southern Sudan were resettled in Minnesota. This research characterizes the health care utilization of a small sample of these recently arrived refugees and describes their health histories. ⋯ Information about this sample's demographic variables, health behavior, health histories, and communication difficulties are documented. Some descriptors of the Nuer ethnic group are provided, and issues are raised that may help health care workers provide more culturally competent care to this Sudanese refugee population.
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More than 9 million Latino children currently live in the United States. Latinos will soon be the largest minority group in the country, but little is known about access barriers to health care faced by Latino children. We reviewed the literature to define specific barriers to care for Latino children, identify methodologic problems, and highlight the clinical and research implications of the identified barriers. ⋯ Lack of health insurance and lack of a regular source of care are major access barriers for Latino children, but many other barriers were identified that also can have a substantial effect on health care. In addition, the behaviors and practices of both health care providers and parents can affect access to care. Too little is known about what parents perceive to be the major barriers, access differences among Latino subpopulations, the roles of language and culture, and the causes of obstacles resulting from the actions of providers.
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Despite advances in medical approaches to the management of chronic illnesses, relatively little is known about how older members of ethnic minority groups view their chronic illnesses or how they manage them in daily life. ⋯ Our findings showed that although major chronic illnesses were, for the most part, the same for all three groups, each group differed in its response to and management of its illnesses. These findings have implications for the education of physicians in training.
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There are now more than 100,000 Hmong (Southeast Asian) refugees in the United States. This study examined interactions between Hmong patients and their health care providers and identified specific factors that either enable or obstruct health care delivery. ⋯ Many basic issues in relations between clinicians and Hmong patients must be addressed to improve health care communication.
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This study examines differences in breast cancer survival between African-American and white women to determine whether there is a racial difference in survival after accounting for established influences on outcome, such as stage of cancer, health status, health behavior, utilization patterns, access to care, quality of care, and the doctor-patient relationship. ⋯ Missed appointments was a determinant of both advanced stage and shorter survival. This measure is an important component of how race affects survival. Compliance with appointment keeping and alleviating reasons for noncompliance must be considered as factors in breast cancer survival.