The Bhutanese American Organization-Philadelphia and Dr. Kate Yun, of CHOP, have recently concluded a longitudinal, qualitative investigation to understand health care navigation among Bhutanese immigrants in Philadelphia.
Key Findings:
1) Refugees learning the US health system navigate both extremely complex systems-based issues (e.g., insurance appeals) and basic life skills (e.g., learning to use the telephone and take the bus)
2) When they first arrive in the US, refugees go through a learning process that starts with proxies (people who do things for you), progresses through modeling/coaching (peers demonstrate key skills), and finally arrives at self-sufficiency.
3) This process is longer for older individuals and those with memory and other cognitive challenges. Those with the greatest difficulty mastering new skills may never become independent. Those with higher literacy levels and better mental health may become independent within a few months.
4) In the Bhutanese community, refugees who have difficulty mastering new skills are supported by a network of peers who “know the system.” Building capacity amongst community members who “know the system” is beneficial for the community at large and should be a priority for funders seeking to support comparable refugee groups.
