New Haven Clinic Focuses on Refugee Health


January 5, 2015

Dr. Katherin Yun accepts the Myra M. Oliver Award on behalf of the Pediatric and Adult Refugee Clinics at the Yale-New Haven Hospital Primary Care Center. Photo: CWS

Dr. Katherin Yun accepts the Myra M. Oliver Award on behalf of the Pediatric and Adult Refugee Clinics at the Yale-New Haven Hospital Primary Care Center. Photo: CWS

The American health system is not intuitive. Health insurance is required. Under an individual’s plan, some doctors are covered, while some treatments are not. Some plans provide coverage for alternative medicine and chiropractics, but mental health coverage might be limited. Even for those who grew up in the US, the system can be a labyrinth of deductibles, co-pays, and referrals.

“It’s really hard for people. The US health system is so confusing,” says Dr. Katherine Yun.

Dr. Yun did her residency and post-doctoral work at Yale University in the Yale-New Haven Hospital Refugee Clinic, a partnership of the university and hospital, with engagement from community organizations like Integrated Refugee and Immigrant Services (IRIS), the CWS affiliate in New Haven CT.

For many refugees, learning how to access the health system is a challenge. “It’s very stressful for people when they don’t know how to access health care. To stand outside the system, to not only worry about your health but to worry about how to access care – it’s stressful…It’s an important part of resettlement to have someone help you through this process.”

Through their Health and Wellness Program, IRIS works to ensure all refugees resettled through their office not only receive an initial health assessment but follow-up visits, treatment, and medication. In addition, refugees learn how to get to and from the clinic, how to make appointments, and how to request an interpreter. They learn how to advocate for themselves within the health system.

“Refugees might give feedback that other immigrant groups wouldn’t,” says Dr. Yun. She suspects this is due to the advice, encouragement, and training provided by volunteers and case managers.

These kinds of interactions are good, not just for the refugees, but for the community. “It’s not just the refugees who change,” says Dr. Yun. “Clinics like the one in New Haven help train health care professionals. This is good for the health system.”

At a clinic focused on refugee health, doctors are more sensitive to health problems that might not be common in the United States. They also tend to ask questions several different ways in an effort to ensure that they understand the patient correctly. “There is a lot more detective work,” said Dr. Yun in a previous article.

Dr. Yun stresses the importance of educating refugees about the state and federal insurance exchanges that resulted from the Affordable Care Act. While they initially receive Medicaid, those benefits expire after eight months.

She also encourages resettlement agencies and communities to train and educate members of the refugee community. Build capacity, so that they can help people find insurance through the exchanges or plan a future doctor’s visit.

“We see a lot of proxy action. People do things for other people because it takes less time to do it than to train someone how to do it for themselves,” says Dr. Yun. But the benefits to the individual and the community are much greater when people know how to use the system themselves.

It is this emphasis on self-sufficiency and capacity building that Dr. Yun appreciates about IRIS. “I’m very impressed with IRIS’ holistic approach to refugee work.”

Dr. Katherine Young currently serves as an attending physician in the Division of General Pediatrics and the Refugee Health Program at The Children’s Hospital of Philadelphia and is an assistant professor of pediatrics at the University of Pennsylvania, School of Medicine.