Health screening of newly arrived refugees

What it is and when it is done

A full history and physical examination are indicated for all refugees within 30 days of arrival in the United States, with a professional medical interpreter if needed. That is the timing: within 30 days of arrival, and the visit is a full one, not a short one.

The interpreter is part of what is asked for and not an aside. A family member who speaks English is not the appropriate choice as the interpreter; it should be a professional medical one.

In addition to addressing medical needs, the focus should be on emotional support and barriers to health care access.

What to screen for

All refugees should be screened for depression, anxiety, and posttraumatic stress disorder.

They should also be screened for anemia, hypertension, impaired fasting glucose, nutritional deficiencies, tuberculosis, and COPD.

So the list has two parts: depression, anxiety and posttraumatic stress disorder on one side, and anemia, hypertension, impaired fasting glucose, nutritional deficiencies, tuberculosis and COPD on the other. The first of the two is not an extra. In the case built on this material, a 32-year-old female refugee relocated 2 weeks ago, screening for posttraumatic stress disorder is what the first visit is for.

Each of these lines carries SOR C on the page, the timing, the focus, the screening on both sides and the vaccination rule alike.