Social History

SOCIAL SITUATION

The patient should be asked about his/her current family and housing situation. Newly arrived refugees and refugee claimants often have socioeconomic concerns (financial problems, food insecurity, poor housing, etc.), but will not always spontaneously mention them.

 

INTIMATE PARTNER VIOLENCE AND CHILD ABUSE

In the 2011 CMAJ guidelines, Pottie et al. recommended to not routinely screen for intimate partner violence (IPV) or child abuse. The current evidence at the time did not demonstrate clear benefits and showed that screening could even cause harm. In contrast, in a recent review (Curry et al., 2018), the U.S. Preventive Services Task Force now recommends that clinicians should screen for IPV in women of reproductive age. This recommendation is however not specific to refugee patients.

Our consensus is to at least screen all our prenatal refugee patients for IPV. We do not perform routine screening for child abuse. Even if routine screening for IPV or child abuse is not performed, physicians should always be alert to any sign or symptom that could be related to these issues.