Immigrant, Refugee, and Migrant Health

What's the Problem?

The United States is a diverse country with diverse public health problems. Since standards of care, access to health care and treatment, and exposure to infectious diseases vary by country, newly arriving immigrants and refugees may experience different health problems than US-born populations. Some of these diseases include tuberculosis, mumps, measles, rubella, and viral hepatitis. Refugees who arrive in the United States come from different regions of the world where health conditions are often poor and there is greater risk for infection. This presents a burden on state and local health systems that work to promote the health of refugees while protecting the health of US communities.

Who's at Risk?

Each year, up to half a million immigrants and 80,000 refugees come to the US from around the world. Over the last ten years, refugees have primarily come from Asian and African countries.

Can It Be Prevented?

Yes – the Centers for Disease Control and Prevention (CDC) has specific screening and treatment protocols that prevent the importation of certain infectious diseases. All immigrants and refugees must have a medical examination to check for inadmissible health-related conditions before they can enter the United States. The Division of Global Migration and Quarantine (DGMQ) at the CDC helps lessen the burden of preventable and treatable diseases in newly arriving immigrants and refugees who are beginning their lives in the United States. CDC provides requirements for disease screening and treatment and mandates the vaccination of immigrants. It also works closely with physicians around the world to respond to disease outbreaks among refugees and help provide vaccinations to refugees. CDC additionally works with state and local health departments in the United States to help coordinate the follow-up care for immigrants and refugees once they arrive in America. Preventing and treating these diseases in newly-arriving populations helps protect the health of all Americans.

The Bottom Line

• Up to 80,000 refugees and half a million immigrants relocate to the United States each year. They come from diverse regions of the world and bring with them health risks unique to specific populations.
• Immigrants and refugees can have health problems that are not common among the US-born population, such as leprosy, tuberculosis, and polio.
• CDC works with physicians around the world to ensure that immigrants and refugees are screened and treated for diseases that pose a public health risk to the US population, such as tuberculosis
• CDC works to ensure that refugees have access to vaccinations for vaccine-preventable diseases, such as measles and mumps
• If an immigrant or refugee is found to have an inadmissible health-related condition, he or she must be treated prior to arrival in the United States
• The main goal of CDC’s Division of Global Migration and Quarantine is to keep infectious diseases and other diseases of public health significance from coming into and spreading in the United States

Case Example

Mae Rae, his wife, and their 3 children are refugees from Myanmar (Burma) and have been living in the Mae Sot refugee camp in Thailand for ten years. They are in the process of being resettled to St. Paul, Minnesota as refugees. All immigrants and refugees are required to undergo a medical examination before they can enter the United States. Mae Rae and his family go to a physician in Thailand who is trained to perform the medical examinations using the CDC medical screening requirements for immigrants and refugees who want to live in the United States. Unfortunately, Mae Rae tests positive for tuberculosis and will need to be treated for 6 months before he can travel to America. After the 6 months of treatment Mae Rae feels much better, has gained weight, and is found to be fully treated for tuberculosis. He is ready to travel to his new home in St. Paul. Once Mae Rae and his family arrive in St. Paul, they go to the local health department and are helped by physicians and staff who are familiar with the language and customs of Burmese refugees. His follow-up tests show that he remains free of tuberculosis, and he is given other health care that further improves his health. The medical examination in Thailand and the health department staff in St. Paul help ensure that Mae Rae, his wife, and their 3 children are healthy in their new American home.