This is a 40 -year old black man recently migrated from Africa. He is currently uninsured. To begin communicating with this individual, I would make sure he was able to speak English and that we under stand each other. If language is a barrier, I would get an interpreter on the interpretation Line. Communication techniques doesn’t always have to be spoken word, it can be pointing to an area of the body or using pictures. Communicating across language barriers is a challenge for clinicians and health systems. Federal law requires linguistic services for patients with LEP. Title VI of the US Civil Rights Act states that people cannot be discriminated against as a result of their national origin, race, or color, which has been extrapolated to include primary language by the US Office for Civil Rights and Department of Health and Human Services (Karliner, 2018). If the patient can speak some English the target would be to make sure our words mean the same thing and that’s where pointing to items and using hand gestures could come in handy. I would keep the questions fairly short with simple as possible terminology.
Being that this patient is newly immigrated to the U.S., I would want to give this patient resources that are free due to not having insurance but certainly would not deny treatment to the patient. I would focus on screening for any diseases that need immunizations, for one. Components of the health assessment for immigrants and refugees include addressing patient health concerns, screening for diseases associated with the country of origin and migration history, initiating age-appropriate immunizations, and routine health care maintenance (Walker, Barnett, & Stauffer, 2019). The question would be “have you had any illness, sicknesses, or hospitalizations that required any type of medications? Any immunizations? Any infections in your body or out breaks on your skin?” I would also ask about the living conditions and the nutritional conditions.
Other Potential Health Risks
Because of the ethnicity, the age and gender, I would certainly screen for any cardiac issue, hypertension, diabetes, and cancer. The acquisition of risk factors for chronic diseases such as coronary artery disease, hypertension, diabetes and cancer is poorly understood among African immigrants. More information must be gathered in the broad categories of chronic disease, health attitudes and health access to better promote the health of African immigrants (Venters & Gany, 2011).
Because of the area from which this patient came from. I would start by screening for infectious disease. I would focus on food and water exposure for things like Giardia or E. Coli, turn to the lungs and check for tuberculosis and so on. These screenings would require blood, urine, and fecal samples and a chest X-ray as most foreign folks get the Bacille Calmette-Guérin immunization and can cause a false positive when given the skin test.
5 Target Questions
I had mentioned some questions earlier but other questions would be
1. Have you had any coughing with bloody sputum,
2. Can you tell me about where you used to live in Africa?
3. Are you married? Are you sexually active with more than one partner?
4. Have you had any infections or illnesses?
5. Any diarrhea, nausea, or vomiting?
Karliner, L. S. (2018, April 2018). When Patients and Providers Speak Different Languages. AHRQ. Retrieved from https://psnet.ahrq.gov/webmm/case/440/when-patients-and-providers-speak-different-languagesVenters, H., & Gany, F. (2011, April 13, 2011). African immigrant health. US National Library of Medicine, 333-344. https://doi.org/doi: 10.1007/s10903-009-9243-xWalker, P. F., Barnett, E., & Stauffer, W. (2019). Medical screening of adult immigrants and refugees. Retrieved from https://www.uptodate.com/contents/medical-screening-of-adult-immigrants-and-refugees