LAUSR

Tuberculosis. Syphilis. HIV. Intestinal parasites. Physical or mental abnormality, disease, or disability. Vaccinations. Thirty-five years ago, when I began my career as a public health medical director, these were the concerns of immigrant and refugee health. Pre-internet, the questionnaires, screenings, recommended tests, treatments, and protocols fit nicely into a small reference book tucked neatly on a shelf above a desk in our communicable disease clinic. Thirty-five years ago, immigrant and refugee health were considered largely a matter of communicable disease control. Today, the CDC's immigrant and refugee health recommendations include screening patients for physical, mental, and other disabilities that might impair self-care, require extensive medical treatment, or lead to institutionalization in the future. But in actual practice, we have come so much further than all of that, with contemporary standards suggesting a more trauma-informed approach. Today a web search on immigrant and refugee health leads to words like crisis, commitment, and challenge; complex, emergency, and obstacles; and diverse, displaced, and yes, disease. We now recognize that immigrants and refugees have always brought both dreams and nightmares to this land of opportunity, and that integration and enculturation are ongoing processes that only began at the edge of Ellis Island – or the Rio Grande. This issue of the journal explores North Carolina's commitment and response to the complex crises, challenges, and obstacles we face in meeting the needs of our increasingly diverse immigrant and refugee residents and citizens.