Background/Purpose:
With the growing immigrant
and refugee population in the United States, the landscape of medicine is
constantly changing.  In order to provide quality healthcare, it is crucial
that we investigate disease patterns and continue to monitor the quantity and
quality of resources available.
Somali immigrants live in many areas of the United States with the largest
number in the Minneapolis-St Paul area. There are no data available to define
rheumatologic disease or attendance with rheumatology specialists in this
population in the United States. To better characterize the disease patterns
for an emergent immigrant community, we investigated the clinical
characteristics of Somali patients referred to the principal rheumatology
clinic serving this population over a 5-year period.  We evaluated the
rheumatologic and non-rheumatologic diagnoses made after referral in this
cohort as well as follow-up. 

Methods:
A retrospective chart review from 2010-2014 for patients of Somali origin
presenting to Hennepin County Medical Center (HCMC) rheumatology clinic in
Minneapolis, MN. We collected data from one hundred consecutive Somali patients
seen in clinic, including population characteristics, diagnoses and follow up
(see table 1).

Results:
Over a 5-year period, 100 patients of Somali origin were referred to the
clinic. 81% were female. 1/3 (33/100) did not have a rheumatologic syndrome.
1/3 (32/100) had OA or myofascial pain. 1/3 (35/100) had an inflammatory or
immunologic CVD.  Coexisting mental health disorders were present in 44%
of those with OA or myofascial pain.  In addition, an average of 90% of
patients had low vitamin D levels.  Of all 100 patients, 64% were asked to
return to clinic for follow up and over half did not. See tables 1-3. 

Conclusion:
Of 100 Somali patients referred to our rheumatology clinic, 1/3 had no
rheumatologic disease.  Additionally, 1/3 had non-inflammatory conditions
(OA and myofascial pain). These also had a high incidence of mental health
diagnoses (44%). Hypovitaminosis D was highly prevalent. The no-show rate for
return visits was more than 50%. More effort is needed in education of
primary care physicians regarding non-rheumatological disease, OA and
myofascial pain as well as hypovitaminosis D in this population. Awareness of
mental health issues and provision of such services as well as working with the
community to improve attendance at clinic is important