By Michael Poirier

The healthcare crises experienced by undocumented immigrants in the United States constitute a significant concern that is chronically under-addressed. Further exploration of this issue promises to expand our understanding of societal ramifications within a context where healthcare is not universally accessible. By intensifying the scrutiny of such healthcare concerns, there is potential to foster enlightening discussions and effectually drive policy development, thereby promoting the establishment of a more inclusive healthcare system for all.

As immigration rates have begun increasing over the past decade, a rising concern is why a country, with a wide array of options for insurance and medical care, sees disproportionate health statuses for its citizens. This disparity can be traced back to a variety of

health-related and societal factors, a key factor being that roughly one-third of immigrants in the United States are below 200 percent of the federal poverty line. Factors contributing to these health disparities include decreased access to affordable health care, differences in cultural practices, especially medicinally, and other factors, such as language barriers, that may discourage them from seeking care. Steps must be taken in order to rectify national disparities in health outcomes and access to care.

Factors of dissuasion for immigrants

The United States has policies that limit access to health services for undocumented immigrants, as outlined in the Affordable Care Act, also known as Obamacare, a law enacted in 2010 that aims to improve access to affordable health insurance for all Americans and reduce the overall cost of healthcare. However, the underutilization of health care by immigrants puts their health at risk of infectious diseases and poses a larger risk to the health of the general public.

A number of factors not affecting natural-born citizens can dissuade undocumented immigrants from accessing health care. First, a lack of documentation can bar them from accessing services that require documentation. Next, discrimination on the basis of documentation, the stigma surrounding seeking services, and fear of deportation can lead undocumented immigrants to avoid seeking care for their medical needs. Also, the lack of financial resources, due to inequitable employment opportunities, lack of education surrounding health care, and/or the inability to properly communicate with medical providers can decrease confidence in seeking medical attention.

Foreign successes and examples

Across the world, many countries aspire to reach a level in which all inhabitants have equal access to quality health care. Some struggle to establish this programming but others excel in providing this care to marginalized groups such as undocumented immigrants.

In Thailand, rates of immigration have been rapidly increasing. The current population of immigrants is constituted primarily of workers from neighboring countries, increasing the non-Thai population to an estimated 4.9 million in 2019, a 1.2 million increase over the previous five years. With this sharp increase, assurance that these individuals have

access to public services was at the forefront of Thai policy development. Its use of public and non-profit organizations have helped increase healthcare coverage for undocumented immigrants. While utilization remains low in comparison to its counterparts, 64% of immigrants in Thailand are enrolled in public health insurance, filling gaps that aid migrants regardless of legal status. Thailand is internationally recognized for its healthcare coverage for migrants and immigrants as each individual is entitled to healthcare driven by legal status.

In 2016, Thailand started to limit rates of immigration as natives were fearing that jobs were being stolen, contributing to the fear that anti-immigrant sentiments were rising among the general population. Much of this fear arises from economic concerns. Natives feel they have to “fight” immigrants for jobs and economic stability. Other challenges to this programming include sustainability in staffing, financial structuring, geographic or location logistics, and/or the current health status of their patients. However, these efforts show promising structures that can be modeled and improved upon to help the 46% of uninsured, undocumented immigrants gain greater access to public subsidized health care, compared to the 8% of uninsured, natural-born citizens in the United States.

Accountability and dual improvements

In order to rectify health disparities in the United States among undocumented immigrants, challenges need to be recognized and changes need to be made. Five major steps can be taken to start this process. First, changes in the structure of insurance in the United States can allow undocumented immigrants to have access to state-funded programming. Secondly, expanding safety net features in health care, such as services and capacity in public or non-profit clinics and support through religious or non-profit organizations, can overcome geographic and insurance-related barriers. Thirdly, education for health care providers and undocumented immigrants needs to increase. Healthcare providers need to be well-versed in the barriers and issues that undocumented immigrants face and how best to provide them with care. Undocumented immigrants need to be educated on the current legal system and their rights to health care, helping them navigate a complex system. Finally, legal change and advocacy efforts will continue to push individuals to notice disparities in health status and increase support for these vital changes.

Moving forward: programming and political action

Undocumented immigrants face increasing quantities of barriers to accessing quality health care. Solutions and possibilities exist but increased political awareness is needed to drive change. By addressing the health-related issues experienced by immigrants, the U.S. can more effectively uphold the human rights principles that it prides itself on, leading to a stronger, more immune population. Given the increasing number of immigrants entering the United States, more comprehensive and inclusive health-related programming must be established to ensure that all inhabitants can contribute and participate fully in society regardless of social status.

Michael Poirier is a Public Health and Criminology student at the College for Public Health and Social Justice at Saint Louis University in St. Louis, Missouri.

To quote this article, please use the following reference: Michael Poirier (2023), “A Damaging Healthcare Crisis in the United States” https://crisesobservatory.es/A-Damaging-Healthcare-Crisis-in-the-United-States

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