Disparities in Immigrant Health
When considering immigrants, it is important to remember that immigrants from different countries and backgrounds are not all alike and in fact have some very different characteristics. Nonetheless, while immigrants from different countries face different challenges, there are some common causes of health disparities among immigrants from many parts of the world.
Immigrants to the United States from non-English speaking countries often face a language barrier upon arrival. This language barrier can interfere with health and health care in a variety of ways. First of all, the language barrier can interfere with information about how to access health care in a new health care system. It can also make people feel intimidated or afraid of accessing health care if they feel that are not able to effectively communicate. Finally, if the health care provider does not provide adequate interpretation services, the quality of the health care can be compromised and the services provided may not address the needs of the patient, or possibly even endanger the patient.
Cultural differences in the understanding of health and illness can also affect the health and health care access of immigrants. In the context of health care services, immigrants may feel uncomfortable or threatened by the procedures or recommendations that are practiced in Western medical practice. If clinicians are not prepared to interact humbly with people of differing cultural backgrounds, the quality of care is likely to be negatively affected, and the experience may discourage immigrants from returning to seek needed care.
Ethnic and racial discrimination also play a part in the health of immigrants. Just as discrimination affects native-born members of ethnic and racial minority groups, immigrants, many of whom identify as non-white, are also vulnerable to discrimination. This discrimination affects them at many levels. Day-to-day discrimination can increase stress levels, which has been shown to have long-term negative health effects (McClure, et al 2011). Furthermore, discrimination at the point of health care can worsen health outcomes and discourage future health care access.
Another factor that especially influences the health of immigrants is a lack of health insurance. Because of legal restrictions, immigrants are not eligible for public health insurance (Medicaid and Medicare) programs for the first five years after immigration. This means that immigrants only have access to health insurance if they receive it through their jobs or if they pay extremely high rates for individual insurance. Many employers are trying to exclude health insurance from their labor contracts, and many immigrants are especially vulnerable to this kind of exploitation because of limited financial and social resources. The result is an overall lower rate of health insurance among immigrants in the United States. Logically, a person with no health insurance is less likely to access preventative health care and health care deemed “unnecessary” and the cost of health care if this person does need to access care will be much higher.
These are only a few of the factors that affect the health of immigrants in the United States. For further reading, see the following:
UCLA Center for Health Policy Research
Health Disparities and Children in Immigrant Families: A Research Agenda
Fernando S. Mendoza, MD, MPH
Kaiser Family Foundation Disparities Policy page
American Psychological Association
Fact Sheet: Health Disparities and Stress
Immigrant Health and Cancer Disparities (IHCD) Service
National Conference of State Legislatures