Undocumented Immigrants and Barriers to Medical Care

Along with keeping its legal citizens healthy, countries must do their part to provide medical care for undocumented immigrants. With 30 to 40 million undocumented immigrants worldwide, including 12 million in the United States alone, this is an issue of increasing importance in terms of public and economic health.

Immigrants—particularly those who are undocumented—are pretty healthy, at least when they first arrive. They’re often young, and they have to be resilient in order to survive the often difficult journey to the United States. They typically report lower levels of cancer, heart disease, asthma, arthritis, and depression, and they use emergency healthcare mainly for childbirth and pregnancy complications. However, as they spend time in the United States, their health advantage declines due to several factors: difficulty accessing medical care, low income and low occupational status, and the stress associated with living without proper documentation. They may also face language barriers, and fear discrimination in a healthcare setting.

A group of physicians at the Emory Family Medicine Residency Program at the Emory School of Medicine in Atlanta have issued a report on the difficulties faced by undocumented immigrants when it comes to securing healthcare. According to the physicians, the health of pregnant women and children are of particular concern. Although undocumented immigrants who are expecting tend to engage in fewer risky behaviors than their American counterparts and have fewer low-birth weight or premature babies, those gains are offset by their comparative lack of prenatal care. Also, the stresses of being undocumented and living in fear of deportation may affect their offspring. One small study from The Urban Institute in Washington, DC found that in families that had at least one parent who had been arrested by immigration authorities, children experienced an increase in behavioral, speech, and development problems, and showed a decline in academic performance.

Although the country is currently divided when it comes to the efficiency of the Affordable Care Act, President Obama’s signature program that has provided coverage for millions of individuals, the report’s authors suggest that in the healthcare community there exists a consensus that primary care must be strengthened in order to keep individuals healthy and reduce healthcare costs overall. They cite a multitude of studies demonstrating that better primary care results in fewer emergency room visits, fewer hospitalizations, and lower rates of mortality, and they make the case that undocumented immigrants need to face far fewer obstacles when it comes to obtaining primary care.

Several cities and countries have proven to be good models of primary care to undocumented immigrants, say the study authors. New York City, home to the nation’s largest public-health system, has public hospitals and health centers that treat uninsured patients and rely on Medicaid and Medicare for reimbursement, as well as other funding. California has a low-cost healthcare plan for uninsured residents, which includes certain benefits extended to undocumented immigrants. Similarly, Houston has a financial-assistance program that all residents can take advantage of—documented or not—that provides discounted medical, dental, surgical, and dialysis care.

As important as expanding care options is for undocumented immigrants, it’s also key to train culturally sensitive healthcare providers to deal with the particular difficulties faced by this population as well as inform them of any legal updates that might affect them. Finally, it’s crucial to educate immigrants themselves on how to navigate what is often a complex system, specifically regarding what their rights are and how the law works.