Ukrainian immigrants in rural America: A community-based study of health, system navigation, and perceptions of healthcare providers after the 2022 invasion of Ukraine by Russia

This study investigates the health status, healthcare navigation experiences, and perceptions of healthcare providers among Ukrainian immigrants resettled in rural Iowa following the 2022 Russian invasion of Ukraine. A bilingual online survey was distributed via a community group in spring 2024. Participants included 37 adults (ages 18+), predominantly female (62.16%), averaging 38 years. Among participants, 62.16% reported chronic conditions, most commonly high cholesterol (24.32%) and hypertension (18.92%). While 91.89% had insurance, 29.73% reported unmet healthcare needs, and 21.62% screened positive for possible major depressive disorder. Since arriving, 83.78% have engaged with the healthcare system. Provider descriptions were largely positive (65.91%), including ‘friendly', ‘professional', and ‘understanding'. Negative descriptions (27.27%) included ‘not helpful' and ‘arrogant’; 6.81% were neutral. Only 54.0% would seek emergency care for heart attack symptoms, and 35.13% would seek professional help when depressed or hopeless. Despite high insurance coverage and healthcare engagement, findings highlight challenges with system navigation, mental health, and willingness to seek mental healthcare, alongside some negative provider perceptions. Findings are consistent with those observed in other settings, suggesting that rural resettlement did not necessarily place Ukrainian immigrants at a disadvantage in accessing and navigating the healthcare system.