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Community Corner

Dearborn Arabs Facing Health Care Crisis (Part 1 in a Series)

While Dearborn Arabs suffer from abnormally high rates of respiratory disorders and cardiovascular disease, one-third have no health care.

The way Dr. Adnan Hammad sees it, the most pressing crisis facing Dearborn’s Arab-American community today is one over which leaders in Washington continue to battle: health insurance.

Hammad is director of the Community Health & Research Center at the , one of the largest primary care providers for Dearborn’s uninsured Arabs. And during his time at the organization’s health clinic–the largest community-based medical facility for Arab Americans in the country–he has seen Dearborn Arabs’ health care situation only get worse.

The Michigan Department of Community Health reported that 31 percent of Arab Americans living in the Detroit Tri-County area had no health insurance in 2009–three times more than their non-Arab white counterparts.

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That rate has grown 10 percentage points in the last decade, Hammad said. But that’s not the worst of it.

“Eighty-five percent of children who come to (the ACCESS) clinic do not have insurance,” he said. “If we’re not here, who is going to see those children?”

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Illness Depletes Familes' Funds

Lacking health insurance poses particularly large problems for Dearborn’s Arabs, as the large immigrant community suffers from abnormally high rates of , diabetes and cardiovascular disease. What’s more is that many in the community are low income and don’t have the means to pay for treatment in times of need.

“You don’t know how many families I’ve talked to who lost everything because somebody got sick and they didn’t have any way to deal with it,” said Ismael Ahmed, former executive director of ACCESS.

Ahmed and other community experts agree that the main culprit behind the crisis is a lack of money. Many Dearborn Arabs–especially newly arrived immigrants–either work low-paying jobs that don’t provide health benefits, or aren’t employed at all.

The latter side of the problem has gotten even worse since the economic downturn, as many manufacturing workers and unskilled laborers have lost their jobs, benefits, or both. The ensuing lack of coverage has forced many Dearborn Arabs to live without one of the health care industry’s most valuable medical and economic strategies: preventive medicine.

Prevention Key in Preventing Disease

“In terms of family stability, economic stability and health care, prevention is really important,” said Ahmed, also the former head of the Michigan Department of Human Services. “They don’t do prevention if you can’t pay for it.”

The lack of health coverage–and resulting lack of regular check-ups and other preventive care–is so great that more than half of Dearborn Arabs who suffer from diabetes have no knowledge of their condition, according to a 2010 Michigan Department of Community Health report.

Complicating the situation even further is the fact that Arab immigrants in Dearborn who have yet to obtain their citizenship are ineligible for government aid–even if they work and pay taxes.

Culture Plays a Role

But conservative health care policies aren’t the only reason for the crisis. Part of it is also the Dearborn Arab community’s own doing–whether they know it or not.

The cause is an unconscious cultural one, according to Dr. Mouahanad Hammami, president of the National Arab American Medical Association. And it contrasts directly with the prevailing medical theories in the American health care system.

“The idea of prevention does not exist in the countries (Arab Americans) come from,” Hammami said. “The idea of regular check-ups, of screenings, of lifestyle modification isn’t in the back of their minds. They only address (health problems) when they happen.”

Many incoming Arab immigrants lack the basic health education commonly taught in American schools, such as lessons in healthy eating and exercise, Hammami said. And when individuals in the community experience certain health problems, such as behavioral and mental health disorders, they’re less likely to turn to health care providers for help.

“The Arab community believes they can solve their worries socially, versus seeking professional help,” Hammami said. “The major factor is the lack of awareness or the lack of education.”

Hammad, whose ACCESS research focuses on environmental health issues, said Arab immigrants are actually healthier when they arrive in Dearborn than five years later. Economic hardship leads to unhealthy living in many cases. Acculturative stress and are additional risk factors, he added.

Outreach, Education Show Progress

Nevertheless, strides are being made. Slowly but surely, health outreach to the Arab community is increasing. Educators in both schools and community organizations such as ACCESS are emphasizing healthy eating and exercise to incoming immigrants.

Health care providers, meanwhile, are slowly becoming more culturally competent toward Arab needs, Hammad said. And this is extremely important for a community that is unfamiliar with the American health care system.

“There are excellent health care services in southeast Michigan area and a population that needs these health care services, but there are no strong bridges between the population and the health care services,” Hammad said. “(Health services) need to be accessible and they need to be acceptable.”

But organizations like ACCESS can’t pull this extra weight alone, Hammad said, adding that the health care crisis holding back Dearborn’s Arab community is only hurting Dearborn as a whole.

“You need to reach out to this community,” Hammad said. “This is a growing community … and it has some specific cultural needs. We need to actually address them.”

Check Dearborn Patch Thursday, Oct. 13, for the second installment in this series.

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