Newly arrived refugees resettling in the United States face ending one long journey and embarking on another as they begin their new life here. But even after years of displacement, people who came to the U.S. as refugees still face significant obstacles to getting the healthcare they need.
As a social work scholar who studies refugee resettlement, mental health and access to care, I know well that many refugees experienced serious trauma before migrating. Adjusting to a new country can also be highly stressful, between language barriers, money woes and immigration-related bureaucracy. And the U.S. medical system is notoriously difficult to navigate.
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