SFS has been a champion in addressing gaps in healthcare in the San Diego East African refugee community, frequently collaborating with other community stakeholders and residents. Despite over a decade of settlement in San Diego, until recently there was no data on the demographics and health status of the Somali community, making it difficult for community groups and health care providers to adequately address health needs and concerns. The lack of qualitative information about this population makes it more difficult to engage East Africans in existing health promotion programs. These programs are designed to convey key preventative health messages, such as the importance of a healthy diet and exercise, to a general population and so are typically linguistically inaccessible to most Somalis. Because such programs are “one size fits all,” they cannot be expected to address or serve the needs of a specific immigrant population, whose health issues must be addressed in terms of culture, as well as the physical and mental health ramifications of the refugee experience.
Our Health Services program is based on a comprehensive Health Needs Assessment of 150 Somali individuals, conducted by other Somali refugees, conducted in 2008 and funded through the California Endowment. This assessment allowed the direct involvement of the community in the program, a feature that distinguishes this program from similar needs assessment and health promotion programs. The surveys were completed in fall 2008, and the Institute for Public Health (IPH) at San Diego State University compiled and analyzed the data.
Summary of the Health Assessment
• The key health issues facing the community are hypertension, diabetes, mental health/trauma, heart disease/stroke, and access to health care.
• Hypertension: close to 90% of the males and 40% of the females had or knew someone with hypertension, yet only roughly 50% of the males and 20% of the female were familiar with the symptoms of hypertension. Only 25% knew the cause of hypertension, and only 10% of the male and 40% of the females were familiar with the treatment of hypertension.
• Diabetes: almost 90% of the men indicated that they had or knew somebody who had diabetes; almost 50% of the women responded similarly. 90% of the men believed that the community was at risk for diabetes. Approximately 46% of the men and 62% of the women reported that they did not know what diabetes was and 69% of the women did not know the symptoms. The majority of the respondents (84% of men and 70% of women) did not know how diabetes can be prevented.
• Mental Health/Trauma: The participants were asked about their experience with metal health and emotional well-being. The study revealed that almost 90% of men keep thinking about the war in Somalia and just over 40% of men expressed that they feel rested when waking up in the morning. Interestingly, the ratio significantly differed among female respondents; while only one-quarter keep thinking about the war and almost 70% feel rested in the morning.
• Heart Disease/Stroke: over 90% of the men and more than 80% of the women did not know how heart problems and stroke can be prevented and 65% of men and more than 75% of women reported they did not know the causes of heart problems and strokes.
• Access to health care: while 75% of respondents had health insurance (largely thought to be MediCal), only 35% knew what it covered, and only 12% knew whom to contact if they had questions. 60% reported that no one at their doctor’s office spoke their language, and when asked further, 64% reported taking a family member or friend with them to translate.
To review the SFS Health Assessment please click here.
Our Health Services program is currently centered on improving access to quality health care for senior underserved population suffering from language and cultural barriers, transportation and other challenges.
• Case management – two Health Educators provide outreach activities in the community, navigate individual clients through the health care system, provide transportation and translation services.
• Ongoing education of Somali Health Ambassadors – a year-long program educating senior members of the community on the healthy lifestyle and prevention. The program consists of monthly educational workshops.
• Cultural presentation for organizations working with East African community.
• Yearly Health Fair – in 2009 and 2010 SFS organized Health Fair in Honor of World Refugee Day, which served both as a promotion of healthy lifestyle and presentation of community 30 health care providers and a community get-together. The event also serves as a educational opportunity for the health care providers to get familiar with East African community. In 2010 the event was attended by almost 400 people. For more information on SFS Health Fairs click here
• 240 members of the East African community per year receive basic health care services such as transportation, translation and navigation through the health care system.
• 10-15 community members a year receive education to serve as health care leaders. The graduates of this program will have the knowledge and information on the major health issues faced by the East African community as well as the US health care system and leadership skills.
• 10 bilingual community volunteers are recruited and trained as interpreters. This will also provide marketable job skills for the volunteers, who it is hoped will pursue careers in the health field, thereby increasing access for the Somali community.