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Immigrant/Migrant Health

The DEI Shift

In 2018, the United States had an estimated 44 million immigrants living within its borders, and this number has increased in the last 4 years. Unfortunately, the migrant population is not always taken into consideration when health strategies and policies are put into place. The determinants of health are clearly on display when taking into consideration the social, economic, cultural, and political factors that surround migration: housing, access to water and sanitation, education, living and working conditions, health care services, etc. Join the DEI Shift as they examine what physicians should be aware of, the factors that influence the health of immigrants they may see in their clinics and hospitals and the importance of cultural sensitivity, language appropriateness communication, and developing trust.

First, listen to the podcast. After listening, ACP members can take the CME/MOC quiz for free.

CME/MOC:

Up to 0.5 AMA PRA Category 1 Credits ™ and MOC Points
Expires September 16, 2025   active

Cost:

Free to Members

Format:

Podcasts and Audio Content

Product:

The DEI Shift

The DEI Shift's mission is to create a podcast series on diversity, equity, and inclusion (D.E.I.) in medicine that sparks discussion and provides practice-changing data and stories for a physician, student, allied health professional, and health care leader audience. Listeners will be able to gain useful information to improve their practices and environments, to gain empathy, cultural competency, and humility, and to learn more about emerging D.E.I. concepts. The DEI Shift will discuss issues related to gender, race, sexuality, religion, ability, socioeconomics, and so much more.

Co-Hosts: Dr. Brittäne Valles, Dr. Ricardo Correa

The DEI Shift Guest: Dr. Lorena Bonilla

Editor/Assistant Producer: Clara Baek

Production Assistants: Ann Truong

 

Episode Description:

Migration across the globe has increased. Health care professionals are likely to encounter immigrant populations who have unique needs. Join us in learning with Dr. Lorena Bonilla (Internal Medicine Hospitalist and Assistant Professor at Florida University/Herbert Wertheim College of Medicine) about factors that influence the health care of immigrants, how to approach patients with cultural sensitivity, and ways physicians can incorporate advocacy into their practice to help support immigrants.

Definition of Terms:

In this podcast, we use the terms migrants, immigrants, refugees and asylum. Here we wanted to define these terms. A migrant is an individual who migrates from one location to another usually seeking employment or education. An immigrant is an individual who seeks to live in another country permanently. A refugee is an individual who is forced to flee their home because of violence or persecution. Additionally, someone who applies for asylum is seeking protection from dangers in their home country and is awaiting their claim for refugee status to be legally determined. For further reference, rescue.org has an article outlining these terms. https://www.rescue.org/article/migrants-asylum-seekers-refugees-and-immigrants-whats-difference.

Learning objectives:

1. Identify key social determinants of health that affect immigrant populations.

2. Recognize factors that influence the health care of immigrants and refugees.

3. Summarize a situation from your own clinical experience in which understanding the culture of a patient enhanced your ability to care for them. Identify how you can be consistent in ensuring that you consider the role that culture plays in the lives of your patients.

[00:00] Welcome and Introductions

[00:51] Introducing Guest Dr. Bonilla Del Pilar Bonilla

[02:25] “A Step in Your Shoes” Segment

[03:32] Introduction on Immigrant Health

[04:28] Dr. Bonilla’s Story of Inspiration

  • Dr. Bonilla discusses barriers in communication with language discordance between patients and physicians
  • The importance of translators to prevent the lack of communication and good delivery of care

[07:11] Dr. Bonilla Highlights her Advocacy work

  • Doctors for Camp Closure
  • Collaboration with other organizations who focus on the humanitarian care of patients
  • Social determinants of health
  • Investing in understanding the lives of your patients
    • Curiosity and the fuel to discover more about the patients one serves
    • The importance of self education and asking questions to partner with patients

[10:45-16:27] Suggestions on Best Practices in Immigrant Health

  • Ways to improve health care delivery to immigrants
    • Focusing on patient centered and intercultural approaches
    • Understanding the nature of your patient’s needs and barriers that might exist (financial, cultural, etc)
    • Learning from success and failures of others who have worked in this area
  • Community organization/clinics can help to provide resources to patients who may be worried about their legal status
  • Education for immigrant populations on available resources

[16:27-18:57] Language Used Surrounding Immigrants

  • Dr. Bonilla describes Title 42
  • Biases and the media
  • The contributions of immigrant

[18:57-20:43] Categories That Influence Care: 3 C’s

[20:43-21:56] Importance of Understanding Culture in Patient Care

[21:56-23:29] Educating Ourselves as Physicians

[23:29-27:04] Dr. Bonilla’s work with Doctors for Camp Closure

  • National work in Washington DC
  • Local advocacy in detention centers
  • The importance of developing good relationships with many professionals

[27:04-28:44] Take-Home Points & Closing

[28:44-29:55] Outro

Twitter and Instagram @TheDEIshift, email at thedeishift@gmail.com, and our website www.thedeishift.com

References:

Doctors for Camp Closure - a non-partisan organization of physicians and healthcare professionals from all specialties who oppose the inhumane detention of migrant populations and refugees arriving to the United States of America.

https://d4cc.squarespace.com/

Additional Reading:

  1. A short summary on the work of Doctors For Camp Closure as part of Shutdown Glades Coalition. https://www.aclufl.org/en/press-releases/shut-down-glades-coalition-update-five-wins-and-road-ahead
  2. WHO. Promoting migrant health – striving for peace and decent life for all. In: Promoting migrant health – striving for peace and decent life for all. Geneva: WHO. p. 2017.
  3. Brandenberger, J., Tylleskär, T., Sontag, K. et al. A systematic literature review of reported challenges in health care delivery to migrants and refugees in high-income countries - the 3C model. BMC Public Health 19, 755 (2019). https://doi.org/10.1186/s12889-019-7049-x

Resources for physicians:

  1. AMA Center for Health Equity - https://www.ama-assn.org/topics/ama-center-health-equity
  2. Resources for Supporting Immigrant and Refugee Communities: Here are links to resources highlighting education, employment, health, housing and resettlement, legal advice and safety. https://www.onlinemswprograms.com/resources/support-resources-immigrants-refugees/

Credits:

Guest: Dr. Lorena Bonilla

Co-hosts/Producers:  Dr. Brittäne Valles, Dr. Ricardo Correa

Executive Producer: Dr. Tammy Lin 

Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung

Senior Producers: Dr. Maggie Kozman, Dr. DJ Gaines

Editor/Assistant Producer: Clara Baek

Production Assistants: Ann Truong

Website/Art Design: Ann Truong

Music: Chris Dingman

Disclaimer: The DEI Shift podcast and its guests provide general information and entertainment, but not medical advice. Before making any changes to your medical treatment or execution of your treatment plan, please consult with your doctor or personal medical team. Reference to any specific product or entity does not constitute an endorsement or recommendation by The DEI Shift. The views expressed by guests are their own, and their appearance on the podcast does not imply an endorsement of them or any entity they represent. Views and opinions expressed by The DEI Shift team are those of each individual, and do not necessarily reflect the views or opinions of The DEI Shift team and its guests, employers, sponsors, or organizations we are affiliated with.

The DEI Shift podcast is proudly sponsored by the American College of Physicians Southern California Region III Chapter

The DEI Shift theme music is by Chris Dingman. Learn more at www.chrisdingman.com.

Contact us: thedeishift@gmail.com, @thedeishift, thedeishift.com

Contributors

Brittane Valles, MD, FACP – Co-host

Ricardo Correa, MD, FACP – Co-host

Lorena Bonilla, MD, ACP Member – Guest

Tammy Lin, MD, MPH, FACP – Executive Producer

Pooja Jaeel, MD, ACP Member – Co-Executive Producer

Tiffany Leung, MD, MPH, FACP, FAMIA, FEFIM – Co-Executive Producer

Maggie Kozman, MD, ACP Member – Senior Producer

DJ Gaines, MD, ACP Member – Senior Producer

Clara Baek – Editor/ Assistant Producer

Ann Truong – Production Assistant

Reviewers

Tiffany Leung, MD, MPH, FACP, FAMIA, FEFIM

DJ Gaines, MD, ACP Member – Senior Producer

None of the contributors or reviewers for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Release Date: September 16, 2022

Expiration Date: September 16, 2025

CME Credit

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Physicians and the DEI Shift.  The American College of Physicians is accredited by the ACCME to provide continuing medical education for physicians.

The American College of Physicians designates each enduring material (podcast) for 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM Maintenance of Certification (MOC) Points

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to .5 medical knowledge MOC Point in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program.  Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

How to Claim CME Credit and MOC Points

After listening to the podcast, complete a brief multiple-choice question quiz. To claim CME credit and MOC points you must achieve a minimum passing score of 66%.  You may take the quiz multiple times to achieve a passing score.