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- Creators: School of Life Sciences
Understanding the Connection Between Iraqi Culture & Iraqi American Women's Health Seeking Behaviors
The term “Iraqi American” defines any person of Iraqi origin who is residing in the United States. From 1960 until 2014, Iraq experienced numerous armed conflicts and international sanctions. As a result, a great surge of Iraqis migrated out of the country to seek refuge elsewhere. The United States alone currently houses about 400,000+ persons of Iraqi descent, many of whom identify as its citizens. Despite that, Iraqi Americans remain severely understudied. Therefore, this study aims to understand the cultural barriers Iraqi American women face while seeking healthcare in the United States, and how these barriers can impact their behaviors. I collected data via semi-structured interviews with eight Iraqi American women. In this study, I identified five major themes that contributed to women’s healthcare seeking behaviors: societal/familial pressures, staying “pure,” shame associated with performing medical procedures, taboo surrounding discussions of female health conditions, and issues regarding being in the presence of male doctors. Many of these themes involved cultural stigmas and pointed to potential pathways to destigmatize women’s healthcare in the community. This study acts as an initiative to understanding Iraqi Americans better and lays groundwork for further research.
This venture is unique in that it is an interdisciplinary fusion between students, health professionals, and non-profit organizations empowering underserved refugees. A refugee is an individual forced to leave their country because of persecution, war, or violence. Once they arrive in the United States, they are forced to restart their lives, often with little to no financial assets, minimal English literacy, and a lack of transferable skills from their previous occupations in their home countries. In addition to these socioeconomic disparities, it is common for refugees to face health disparities. Consequently, refugees are one of the most vulnerable populations in our society.
Our organization provides value to the refugee community through our three key services. These are made up of supplemental resources, educational workshops, and clinical services. Our supplemental materials include resources that our clients will use after they have left our care to further improve their health and quality of life. These items include personal hygiene kits, informational pamphlets, and nutritional foods.
The educational workshops we provide specifically address identified knowledge gaps that impede the autonomy of our clients’ health and wellbeing. Several of the topics that we cover (but are not limited to) are diabetes, postpartum depression, nutrition, dental hygiene, AHCCCS, and nutrition. The clinical services that the clinic will provide will be supplementary primary care services that will encompass basic physical exams, A1C blood pressure checks, and vaccinations. These services all are aimed at alleviating the barriers to health that refugees face and ultimately improve their quality of life.
Our venture seeks to maintain positive and sustained relationships with our client segments through continuous community engagement. In conjunction with providing educational workshops and clinical care in the future, REACT continually engages the community by planning formal and informal programming with the refugees based on the needs and wishes of individual communities.
REACT generates these services through the work of medical students from Mayo Clinic Alix School of Medicine and undergraduates from Arizona State University. Our team brings together the experience from hundreds of hours of work in the community, collaborations with refugee community leaders, and the insight of professionals in the healthcare/social-work industry.
Further, our members have had extensive experience working with refugees, training in culturally sensitive practices, and delivering care to those that need it most. With the cost of healthcare exponentially rising, there is little hope for refugees to find adequate culturally competent healthcare. This leads to an increase in chronic diseases, preventable health issues, and increased hospitalization costs. Supporting REACT is not only an investment in the health of the refugees but the health of our entire healthcare system.
receptor (RAR) and vitamin D receptor (VDR). The RXR/RAR dimer is activated by ligand all
trans retinoic acid (ATRA), which culminates in gut-specific effector T cell migration. Similarly,
the VDR/RXR dimer binds 1,25(OH)2D3 to cause skin-specific effector T cell migration.
Targeted migration is a potent addition to current vaccines, as it would induce activated T cell
trafficking to appropriate areas of the immune system and ensure optimal stimulation (40).
ATRA, while in use clinically, is limited by toxicity and chemical instability. Rexinoids
are stable, synthetically developed ligands specific for the RXR. We have previously shown that
select rexinoids can enhance upregulation of gut tropic CCR9 receptors on effector T cells.
However, it is important to establish whether these cells can actually migrate, to show the
potential of rexinoids as vaccine adjuvants that can cause gut specific T cell migration.
Additionally, since the RXR is a major contributor to VDR-mediated transcription and
epidermotropism (15), it is worth investigating whether these compounds can also function as
adjuvants that promote migration by increasing expression of skin tropic CCR10 receptors on T
cells.
Prior experiments have demonstrated that select rexinoids can induce gut tropic migration
of CD8+ T cells in an in vitro assay and are comparable in effectiveness to ATRA (7). The effect
of rexinoids on CD4+ T cells is unknown however, so the aim of this project was to determine if
rexinoids can cause gut tropic migration in CD4+ T cells to a similar extent. A secondary aim
was to investigate whether varying concentrations in 1,25-Dihydroxyvitamin D3 can be linked to
increasing CCR10 upregulation on Jurkat CD4+ T cells, with the future aim to combine 1,25
Dihydroxyvitamin D3 with rexinoids.
These hypotheses were tested using murine splenocytes for the migration experiment, and
human Jurkat CD4+ T cells for the vitamin D experiment. Migration was assessed using a
Transwell chemotaxis assay. Our findings support the potential of rexinoids as compounds
capable of causing gut-tropic migration in murine CD4+ T cells in vitro, like ATRA. We did not
observe conclusive evidence that vitamin D3 causes upregulated CCR10 expression, but this
experiment must be repeated with a human primary T cell line.