Executive Summary

Dayton is known as an immigrant friendly city for its policies and programs to support immigrant integration and welcome newcomers. In 2017, Dayton became the first Certified Welcoming city in the United States for these practices. The foreign-born population in Dayton has continued to increase over the past decade. As more immigrants and refugees call Dayton home, institutions must be flexible and adapt their services to meet changing needs.

Many immigrants and refugees who are choosing to call Dayton home are from countries where there is a high rate of various diseases and low prevalence of screening, health education and treatment. In addition to this vulnerability, immigrants are stressed by the complexity of the US healthcare system. While many of them may be eligible to receive federal assistance, they find challenges accessing it due to language and cultural barriers. For example, a study in Dayton in 2011 revealed that refugees had difficulty accessing their Medicaid benefits due to language barriers. Immigrants have reported in community health assessments immigrants that they are unable to understand medical information provided to them by medical staff. Immigrants expressed they need to have these materials translated in their own languages. Furthermore, several studies in Dayton revealed that immigrants do not access preventative healthcare due to cultural barriers. Immigrants self-reported they only go to the doctor when they are seriously ill, and will then only go to the ER, which is more expensive for the entire system.

Another barrier to healthcare for immigrants is transportation. Yet, many of the sub-Saharan African immigrants come to the US as refugees and receive Medicaid as a benefit. Despite Medicaid covering transportation costs for medical appointments, local healthcare providers report “no-shows” with this population, citing lack of transportation or miscommunication between the client and transportation companies.

These challenges remain despite the fact that other surveys and studies have been conducted and have provided informed recommendations regarding improving healthcare education and removing language and cultural barriers. While organizations, such as Welcome Dayton, Five Rivers Health Clinic, the Public Health Department, Catholic Social Services, and Montgomery County Job and Family Services have all worked to improve the lives and health of immigrants and refugees, gaps have continued to exist.

A specific focus on health care access for sub-Saharan African immigrants has not been sustained and Ebenezer Healthcare Access seeks to address the gaps that these organizations have not been able to address due to capacity, funding, and/or cultural and linguistic constraints. Ebenezer Healthcare Access plans to address four social determinants of health for sub-Saharan African immigrants: access to care, language, transportation, and health education.

In carrying its project forward, Ebenezer Health Access intends to:

• Provide health education to immigrants using trained nurses and multilingual Community health workers;
• Train volunteers from the community (and local universities) and use them to provide quality language-related services (medical interpretation and medical translation);
• Provide medical scheduling services using a hotline where immigrants can call in their home language;
• Partner with Managed Care Plans to facilitate immigrants’ transportation to and from doctor’s office;
• Provide immigrants afterschool tutoring and computer literacy training.
• Eliminate or at least significantly mitigate language and cultural barriers to healthcare access by the provision of both medical interpretation and medical translation and the establishment of a hotline for all their medical-related queries;
• Improve immigrants’ access to healthcare by providing transportation to those unable to afford a vehicle of their own or are simply non-drivers, opening a driving school for those who cannot drive where information and all the teachings are delivered in a language that immigrants can comprehend;
• Recognizing that the use of computer is omnipresent in all facets of life, Ebenezer will equip immigrants with basic computer literacy skills that will enable them to easily navigate the healthcare system and be informed at the right time and from the right and trusted sources
• Providing healthcare information and training, particularly in relation to prenatal and postnatal care, which is key to the well-being of pregnant women, breastfeeding mothers and infants. Similarly, we intend to disseminate information relative to vaccination against, early screening and treatment of deadly female cancers: breast and cervical cancers.