About Immigrant, Refugee, and Migrant Health
CDC works to promote and improve the health of immigrants, refugees, and migrants and prevent the importation of infectious diseases and other conditions of public health significance into the U.S. by these groups. This work includes mandatory health screenings for all immigrants and refugees entering the United States. Public health interventions such as vaccination and parasitic treatment programs for refugees are also provided. These activities prevent the importation of infectious diseases, particularly tuberculosis, and provide relevant health information for healthcare providers continuing care after refugees arrive in the United States.
Most refugees resettled to the United States are referred by the United Nations High Commissioner for Refugees. Other refugees apply directly to the United States for resettlement and may be accepted under programs for specific populations.
An immigrant is an individual admitted to the United States as a lawful permanent resident. Permanent residents are also commonly referred to as immigrants; however, the Immigration and Nationality Act (INA) defines an immigrant as any person legally admitted for permanent residence in the United States, except for persons legally admitted under specific nonimmigrant categories (INA section 101(a)(15)).
A refugee is any person who is outside the country of such person’s nationality or, in the case of a person having no nationality, is outside any country in which such person last habitually resided. In addition, it is a person who is unable or unwilling to return to, and is unable or unwilling to avail himself or herself of the protection of, that country because of persecution, or a well-founded fear of persecution, on account of race, religion, nationality, membership in a particular social group, or political opinion. Refugees are required to apply for Legal Permanent Resident status 1 year after entry into and physical presence in the United States.
A migrant is a person who moves away from his or her place of usual residence, whether within a country or across an international border, temporarily or permanently, and for a variety of reasons as defined by the International Organization for Migrationexternal icon as an umbrella term, not defined under international law. The term, migrant, includes a number of well-defined legal categories of people, such as migrant workers; persons whose particular types of movements are legally-defined, such as smuggled migrants; as well as those whose status or means of movement are not specifically defined under international law, such as international students.
What We Do
The Division of Global Migration and Quarantine provides the Department of State (DOS) and the Department of Homeland Security U.S. Citizenship and Immigration Services (USCIS) with medical screening guidelines (referred to as Technical Instructions) for all physicians performing the overseas and U.S.-based medical screening examinations of refugees and immigrants.
These instructions are developed in accordance with Section 212(a)(1)(A) of the Immigration and Nationality Act (INA)external icon, which states those classes of aliens ineligible for visas or admission based on health-related grounds. The health-related grounds include those aliens who have a communicable disease of public health significance, who fail to present documentation of having received vaccination against vaccine-preventable diseases, who have or have had a physical or mental disorder with associated harmful behavior, and who are drug abusers or addicts.
A medical examination is mandatory for all applicants outside the U.S. applying for an immigrant visa and for all refugees coming to the United States. Outside the U.S., medical examinations are performed by approximately 600 physicians (called panel physicians) . Panel physicians are selected by the Department of State (DOS)external icon.
Aliens applying for nonimmigrant visas (temporary admission) may be required to undergo a medical examination at the discretion of the consular officer overseas or immigration officer at the U.S. port of entry, if there is reason to suspect that an inadmissible health-related condition exists.
Aliens in the United States who apply for adjustment of their immigration status to that of permanent resident are also required to be medically examined. In the U.S., medical examinations are performed by approximately 5,000 physicians (called civil surgeons). Civil surgeons are designated by District Directors of the U.S. Citizenship and Immigration Services (USCIS)external icon.
- Outside the U.S., medical examinations are performed by approximately 600 physicians (called panel physicians) selected by DOS consular officials. CDC does not maintain a listing of panel physicians since panel physicians are selected by the Department of State (DOS)external icon.
- CDC develops the technical instructions and provides guidance to physicians conducting the medical examination for immigration. The Technical Instructions consist of medical screening guidelines, which outline in detail the scope of the medical examination. The purpose of the medical examination is to identify, for the Department of State and the U.S. Citizenship and Immigration service, applicants with an inadmissible health-related condition.
- CDC also maintains an anonymous collection of surplus blood samples from overseas screenings called Migrant Serum Bank (MSB). the Scientists from around the world can request to use the samples for research projects.
The Domestic Refugee Health Program was established to facilitate collaboration between the Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, and its domestic partners, to: improve the healthcare of refugees after their arrival in the United States, initiate surveillance activities to monitor medical conditions identified post-arrival, work together to ensure adequate follow-up of refugees with medical conditions identified overseas, and strengthen the resources available for post-arrival health assessments and follow-up activities.
- CDC also maintains the Electronic Disease Notification System (EDN), which notifies states and local health departments of the arrival of refugees to their jurisdictions. EDN provides states with overseas medical screening results and treatment follow-up information for each refugee.
CDC works with partners in the United States and overseas to meet its refugee, immigrant and migrant health goals.
International partners include: The UN Refugee Agency (United Nations High Commissioner for Refugeesexternal icon), the World Health Organizationexternal icon, and The UN Migration Agency (International Organization for Migrationexternal icon) U.S. Department of State Bureau of Consular Affairs and Bureau of Population, Refugees and Migration.external icon
These partners each have a role in identifying persons with a valid claim for refugee status, support the public health response to humanitarian crises, implement the mandatory overseas medical examinations, provide vaccination and parasite treatment to refugees, transmit examination records to CDC and partner agencies and organizations in the United States and connect mobile populations with domestic resources to ensure a continuum of care. The U.S. Department of State sponsors the U.S. Refugee Admissions Program and adjudicates the visa applications for U.S. bound immigrants.
Stateside partners include: The U.S. state and local health departments, refugee resettlement agencies, the Association of Refugee Health Coordinators, and voluntary agencies.
Together with CDC, these partners monitor the health of refugee populations after their arrival in the United States.