Health Disparities among Travelers Visiting Friends and Relatives Abroad

4 January 2005 | Volume 142 Issue 1 | Pages 67-72

For an estimated 10 million trips abroad by U.S. residents in 2002, "visiting friends and relatives" (VFR) was a purpose for travel. Made up largely of foreign-born U.S. residents and their children, this population shows disparities in the number of reported cases of many preventable travel-related illnesses compared with people who travel for other purposes, such as tourism. High-risk illnesses in VFR travelers include childhood vaccine-preventable illnesses, hepatitis A and B, tuberculosis, malaria, and typhoid fever. Gaps in the prevalence of disease and access to care both between countries and within the United States uniquely influence disease risk in this population of travelers. We describe this population, a framework for understanding travel-related health disparities, and recommendations for improving the effective delivery of preventive travel-related care to VFR travelers. In addition to transnational efforts to control and eradicate disease, preventing illness in U.S. resident VFR travelers requires focused efforts to remove barriers to their care. In the United States, barriers exist at the systems level (for example, low insurance coverage), patient level (for example, misperception of disease risk), and provider level (for example, inadequate knowledge of travel medicine).

Author and Article Information

From the Robert Wood Johnson Clinical Scholars Program, Ann Arbor, Michigan, and Centers for Disease Control and Prevention, Atlanta, Georgia.

Note: This manuscript was completed while Dr. Angell was a fellow in the Robert Wood Johnson Clinical Scholars Program at the University of Michigan, Ann Arbor, Michigan.

Acknowledgments: The authors thank Sonya DeMonner, MPH, and Namrata Shah for their assistance with graphics and reference management and Ava Navin for critical review and editorial assistance.

Grant Support: By the Robert Wood Johnson Clinical Scholars Program.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Sonia Angell, MD, MPH, New York City Department of Health and Mental Hygiene, 2 Lafayette Street, CN-46, New York, NY 10007; e-mail, sangell{at}health.nyc.gov.

Current Author Addresses: Dr. Angell: New York City Department of Health and Mental Hygiene, 2 Lafayette Street, CN-46, New York, NY 10007.

Dr. Cetron: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333.