jewish russian immigrants in the us and around the world. health needs
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Jewish Russian Immigrants in the US and around the world. Health Needs. Part 2: Health challenges Olga Greg and the Supercourse team University of Pittsburgh. Somatic problems:. Acute physical illness Chronic diseases Disabilities. Jewish Genetic Disorders. - PowerPoint PPT PresentationTRANSCRIPT
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Jewish Russian Immigrants in the US
and around the world. Health Needs. Part 2: Health challenges
Olga Greg and the Supercourse team
University of Pittsburgh
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Somatic problems:
Acute physical illness Chronic diseases Disabilities
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Jewish Genetic Disorders
Mendelian Disorders are the direct result of mutated genes
Disease Predisposition Genes are disorders which result from the combination of specific genes
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Mendelian Disorders Bloom Syndrom Canavan Disease Crohn's Disease Factor XI Deficiency Familial Dysautonomia (Riley-Day syndrome) Fanconi Anemia Gaucher Disease Mucolipidosis IV Niemann-Pick Disease Non-Classical Adrenal Hyperplasia Nonsyndromic Hearing Loss Tay-Sachs Disease Torsion Dystonia
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Disease Predisposition Genes
Breast Cancer (BRCA1 and BRCA2) Familial Colon Cancer and BRCA2)
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Common diseases seen in immigrants from Russia include:
diabetes hypertension coronary disease gastrointestinal problems tuberculosis alcohol and substance abuse
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Alcohol Problems:
The alcohol dehydrogenase (ADH2) gene relates to alcohol dependence, alcohol consumption, and reported alcohol-related symptoms. However, the association of ADH2 with alcohol-related behavior is not well characterized in Ashkenazic Jews*.
Although alcoholism is a tremendous problem in Russia, the incidents of alcohol abuse in Russian immigrants is very low.**
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Cultural beliefs influencing health behaviors Some immigrants believe that disability or
illness is caused by something the individual did not do right, such as not eating well or not dressing warmly enough.
Good health is equated with absence of pain. Illnesses that do not cause pain often go undiagnosed and under-treated, such as Type 2 diabetes, hypertension, and high cholesterol.
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Non-somatic problems:
Stress / Distress Intergenerational
conflict Language barrier Social isolation
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Demoralization
Depression resulting from an undermining of morale
Upset or destruction of normal function
A state of disorder and confusion
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Symptoms of demoralization:* loss of control loss of hope anger/bitterness sense of failure feeling life was a burden loss of meaning and a belief that life's
meaning is dependent on health
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Stigma around mental illness
Mental illness is often regarded as disgraceful.
Immigrants often do not disclose a family history of mental illness or past treatment.
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Acculturation challenges Acculturation to both American and Jewish
cultures is related to psychological adaptation, peer relations, and school and family outcomes. Both acculturations reduce loneliness and increase perceived support from parents. Different dimensions of acculturation, such as language and identity, are differentially related to adaptation.
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Language Problems
Refugees and migrants from non-English speaking cultures have little preparation for their new English speaking environment
Their limited English language skills exacerbate resettlement problems regardless of previous economic and social status
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Communication challenges
No ability to discuss health promotion issues such as smoking, diet, physical activity, vitamins and medication intake with their physician.
Lack of knowledge of medical terminology Relying on relatives with lack of medical
knowledge to translate medical documents Lack of knowledge about preventive behaviors
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Cultural difficulties
Lack of understanding of US health care etiquette
Expect more compassion and emotional closeness with their physician
Rather than appreciating the privacy and autonomy of the American medical culture, patients may complain about the quality of medical treatment they receive
Question the physician’s ability to understand their problems.
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Home remedies use
Often doctor’s health recommendations are rejected or substituted by home remedies and treatments
Home remedies are often used prior to seeking medical attention
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Conclusions and patient care implications
It is important to understand patients’ background and cultural norms. Russian Jewish immigrants might have needs and cultural norms that are different from other population groups
Address the physical, emotional, and spiritual health of individuals and families
Ensure effective patient-provider communication
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Recommendations?
Get to know your patients on an individual level.
Not all patients from diverse populations conform to commonly known culture-specific behaviors, beliefs, and actions.
Failing to support and foster culturally competent health care for racial and ethnic minorities can increase costs for individuals and society through increased hospitalizations and complications.
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Conclusions Russian Jewish immigrants have unique educational,
cultural, and health background Several genetic mutations (such as breast cancer
associated BRCA) are more prevalent in Jewish populations
While public health programs have been tailored to different ethnic, racial, and cultural minorities, they rarely addressed the needs of this population group
This lecture provides a short summary about this group that would be helpful in guiding public health interventions and educational programs