Immigrant health care in the United States

[2] Existing studies have revealed strong correlation of these disparities with a combination of structural and social factors, including lack of insurance, high costs of care, restrictions associated with undocumented status, perceptions of discrimination, and language barriers.

[15] Since the enactment of the Personal Responsibility and Work Opportunity Act (PRWORA), colloquially known as "welfare reform," in 1996, the gap in health coverage between immigrants and citizens has grown considerably.

Generally, the provisions of PRWORA prevent immigrants from accessing federal benefits like the State Children's Health Insurance Program (SCHIP) until after they have held lawful permanent residency for five years (except in cases of emergency).

In contrast, undocumented immigrants are denied these subsidies and further prohibited from participating in federal or state health insurance exchanges, though their lawfully present children will be eligible.

[40] Further research indicates that this paradox exists only on some health measures; for example, Hispanic immigrants are healthier in terms of blood pressure and heart disease than non-immigrant non-Hispanic whites, but are more likely to be overweight or obese and have diabetes.

A study of Asian immigrants by Huabin Luo and Bei Wu found that longer residencies in the United States and English proficiency were correlated with more regular visits to dental clinics.

[49] Homer Venters and Francesca Gany found that cultural perceptions of disease models and illness can impede effective communications between African immigrants and health care providers.

Specifically, hypertension, diabetes, coronary artery disease, and other chronic conditions are considered to be less understood due to their relative greater prevalence in nations such as the United States.

[52] In a survey by Carol Pavlish, Sahra Noor, and Joan Brandt, Somali women in Minnesota reported encountering obstacles with unfamiliar healthcare systems, inefficiencies of diagnosis and treatment processes, and ineffective communication with medical professionals.

[61] A study by Russell Toomey and his colleagues similarly confirmed that Mexican-born teenagers and mothers decreased their usage of preventive health care and public assistance programs after the implementation of SB 1070 in Arizona.

[44][73] For example, a 1992 study of Southeast Asian refugees revealed that participants tended to be less forthcoming in seeking health care due to perceived relative urgencies of pain and discomfort.

[73] Additionally, in a 2016 study of Asian immigrants, Luo Huabin found that participants with higher levels of acculturation were more likely to seek routine oral health care.

[5] Immigration detention has been cited for repeated violations of human rights, including physical and sexual abuse, insufficient or denial of medical care, and substandard living conditions.

[6] A report from the Office of Inspector General at the Department of Homeland Security found that, out of five officially inspected detention facilities, four failed to meet proper standards for medical care and sanitary conditions.

[77] Patients in various detention centers stated that they were denied surgeries due to delays by ICE or other forms of care such as physical exams and biopsies, receiving only pain killers instead.

Laura Redman, the director of the Health Justice Program at New York Lawyers for the Public Interest, reported that numerous detained clients were never instructed on how they could make sick calls if needed.

[89] Charles Baily and his colleagues also found that negative experiences in detention centers, supplemented by difficulties encountered in migration, can increase children's risk for post-traumatic stress disorder (PTSD), anxiety, and depression.

[79] A review conducted by Kristen Ochoa found that detained immigrants with specific mental health needs were subjected to prolonged solitary confinement, restricted contact with family and friends, insufficient monitoring for detainees expressing suicidal ideation, and refusals to supply appropriately prescribed medications.

[92] Despite healthcare being a human right, immigrants being held at detention facilities within the United States face additional barriers to reproductive and sexual health access.

A report by the Southern Poverty Law Center indicated that immigrants at LaSalle Detention Facility in Louisiana received insufficient menstrual products, such as sanitary pads and tampons.

[96] In interviews conducted by the Human Rights Watch, participating immigrants within detention facilities stated that they had been denied forms of gynecological care such as Pap smears, hormonal contraceptives, and mammograms.

An article from The New York Times Magazine, describes the story of how detained immigrants located in a south Georgia detention center were able to devise and communicate a plan to protest against the facility and their officials during the COVID-19 pandemic.

An example includes a news article from The Guardian, which depicts the story of an immigrant woman who underwent a dilation and curettage (D&C) procedure after expressing to the doctor at the center her concerns about her menstrual health.

[100] It is through the efforts of whistleblowers that these kinds of injustices are brought to the attention of the public and because of their reports, the general masses are able to become more informed on the living conditions and health matters of immigrants within these detention centers which they do not have direct access to.

As such, minor health issues such as migraines—as opposed to emergencies like gunshot wounds and cardiac arrest—are included and hurt hospitals due to the lack of additional government compensation.

In 1986, theorists Kyriakos Markides and Jeannine Coreil developed the idea of the Healthy Migrant theory that thought of migration to include an inherent selection process due to the physical and psychological demands of travel, searching for employment, and adjusting to new cultural norm.

[105] In 2003, the federal government created a proposal to fund hospitals over a four-year period to cover emergency treatment for uninsured and undocumented immigrants, but required asking for patients' citizenship statuses.

[18] This proposal was ultimately withdrawn due to the belief that such a policy would delay immigrants from actively seeking care unless in extreme need, thereby contributing to overall higher incidences of medical problems in a community.

[18] Finally, policies to enhance insurance affordability for workers have been proposed to potentially reduce coverage disparities, given that a large proportion of immigrants are less likely to be covered than native-born citizens.

[107] Laura Uba proposes that culturally competent healthcare for immigrants can be delivered through improved provider education on communication patterns, others' perceptions of health and fatality, and traditional folk medicines.