Immigrant and refugee health: medical evaluation.

Overseas medical screening by panel physicians for conditions that might jeopardize US public health is required for admission to the United States by immigrant visa or refugee status. According to protocols established by the Centers for Disease Control and Prevention, conditions such as active tuberculosis and substance dependence, when detected, prohibit entry to the United States, whereas close medical follow-up after arrival is required for individuals with other conditions. Refugees and asylees should undergo further medical assessment by a US civil surgeon as soon as possible after arrival. Applicants for legal permanent residence in the United States, whether by immigrant visa or adjustment of status, must receive vaccinations comparable to those recommended for citizens. When immigrants and refugees present to a primary care physician, the vaccination process may not be complete, and documentation of the extent to which it is complete might be lacking. Immigrants and refugees may have a variety of unrecognized or untreated musculoskeletal conditions, mental health conditions, infectious diseases, and chronic conditions. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.