There is increasing documentation that refugees face experiences of interpersonal or structural discrimination in health care and employment. This study examines how Somali refugees understand various forms of discrimination in employment and health care related to their health, utilization of, and engagement with the health care system in the United States. We draw on semistructured qualitative interviews (N = 35) with Somali young adults in three U.S. states—Minnesota, Massachusetts, and Maine. Using modified grounded theory analysis, we explore how experiences of discrimination in employment and health care settings impact health care access, utilization, and perceptions of health among Somali young adults. Discrimination was identified as a major barrier to using health services and securing employment with employer-sponsored insurance coverage. These findings highlight how interpersonal and structural discrimination in employment and health care are mutually reinforcing in their production of barriers to health care utilization among Somali refugees.

越来越多的文件表明，难民在医疗保健和就业方面面临人际或结构性歧视的经历。这项研究调查了索马里难民如何理解与他们的健康、利用和参与美国医疗保健系统有关的就业和医疗保健方面的各种形式的歧视。我们利用半结构化的定性访谈（N= 35）与美国三个州（明尼苏达州、马萨诸塞州和缅因州）的索马里年轻人。使用修正的扎根理论分析，我们探讨了就业和医疗保健环境中的歧视经历如何影响索马里年轻人的医疗保健获取、利用和健康观念。歧视被认为是使用医疗服务和通过雇主赞助的保险保障就业的主要障碍。这些调查结果突出了就业和医疗保健方面的人际歧视和结构性歧视如何在索马里难民中产生障碍以利用医疗保健。