Analysis of an Immigrant Problem (1)

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Nadine Driver ANALYSIS OF A PROBLEM FACING IMMIGRANT COMMUNITES

Part I Immigrants in the United States battle systemic xenophobia despite their documentation status (Wilson & Stimpson, 2020) . Chang-Muy and Congress stress the fact that this maltreatment at the micro, mezzo, and macro levels of society significantly increases the risks of poor physical and mental health for immigrants and their families (Chang-Muy & Congress, 2015) . A combination of prejudice and racial personal beliefs and discriminatory laws and policies create almost impossible barriers for immigrants to access healthcare and other public assistance programs (Castañeda, Ponce, & Wilson, 2018) . Immigrants, specifically undocumented immigrants, have been documented as being a vulnerable population due to cultural barriers, language barriers, etc. Montgomery County, MD is considered a “sanctuary” jurisdiction, which means that this county has a policy of not inquiring about immigration status, nor does this county conduct any immigration investigations (American Immigration Council, 2020) . A sanctuary jurisdiction is any jurisdiction that limits its cooperation with federal immigration authorities. Montgomery County’s immigration population has grown from 5% in 1960 to over 35% in 2023 making Montgomery County one of the most diverse counties in America (American Immigration Council, 2020) . There are an estimated 44 million immigrants living in the United States, with approximately 11.4 million being undocumented immigrants (Fazel-Zarandi, 2018) . For the analysis of this issue, the focus will be on undocumented Hispanic individuals in Montgomery County, MD. Undocumented immigrants are defined as those who have migrated to the United States without legal immigration status (Yu, Kelley, & Morgan, 2020) . Hispanic countries such as Mexico, Chile, or Cuba report less than 10% of their populations being denied adequate access to health services (Alacon, 2022) . Most Latin American countries provide free and high-quality healthcare services where available (Alacon, 2022) . In 2021, Mexico held the highest overall

Global Health Security Index Score, which assesses a country’s resiliency in their public health systems ability to protect and prevent the population from microbial threats (Alacon, 2022) . However, these individuals migrate to the United States of America with hopes of a better life, but do not always get that experience. Part II It is very surprising that the United States of America is one of the only developed countries without a universal healthcare system accessible to its entire population. Health care is only accessible through government-funded healthcare programs and private insurance (Yu, Kelley, & Morgan, 2020) . Unfortunately, federal and state-funded healthcare programs are heavily means- tested, where the participants have to meet very specific requirements to be eligible for coverage (Alacon, 2022) . Documented immigrants have to fit into one of seventeen categories to qualify for either Medicaid or Medicare (Yu, Kelley, & Morgan, 2020) . However, undocumented immigrants do not have access to federal public health care (Yu, Kelley, & Morgan, 2020) . Undocumented immigrants are much more likely to be uninsured due to lack of affordability, restrictions within the Affordable Care Act Health Insurance Marketplace, and inability to apply to federally & state-funded programs (Alacon, 2022) . Because of the barriers presented in accessing healthcare for undocumented immigrants, these individuals may not have all of their healthcare needs met (Castañeda, Ponce, & Wilson, 2018) . Some of these barriers include limited options for health insurance programs, inability to afford private insurance, language barriers, racial/ cultural prejudice, and fear of deportation (Castañeda, Ponce, & Wilson, 2018) . Valerie Lacarte reported that a child’s access to health care can create long-term impacts on the child’s life and development (Lacarte, 2022) . CHIP, or Children’s Health Insurance

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Program is a federally funded health care program aimed at providing health care services to children and pregnant women (Lacarte, 2022) . This federal program provides funding to support the state in offering health care coverage to low-income and uninsured eligible pregnant women and children who otherwise would not qualify for Medicaid. In 2002, there was a federal mandate that allowed states to receive funding to provide coverage to immigrants regardless of their citizen status (Lacarte, 2022) . However, this is short gap prenatal service that only extends from 60 days to one year of benefits depending on which state is being discussed (Lacarte, 2022) . However, the CHIP benefits are able to be extended to the unborn child (Lacarte, 2022) . As mentioned before, Montgomery County, Maryland has been identified as a sanctuary jurisdiction, which means that the county limits its cooperation with federal immigration officials such as ICE (American Immigration Council, 2020) . Nonetheless, the sanctuary policies in place are unable to extend immigrant legal rights and access to public assistance (Perez & Fortuna, 2019) . Thus a sanctuary jurisdiction provides a safe place for undocumented immigrants to come and settle but does not allow for the support that this vulnerable population would depend on (Perez & Fortuna, 2019) . This creates additional issues with undocumented immigrants seeking refuge in these sanctuary jurisdictions, but still face limitations such as the inability to find profitable employment, affordable health care, housing, and other needed resources due to the restrictive legislation (Perez & Fortuna, 2019) . The Ecological systems theory will be used to examine the issue being discussed. The Ecological System Theory was developed by Urie Bronfenbrenner (Paat, 2013) . This theory proposes that biopsychosocial development is influenced by the individual’s environment. Bronfenbrenner asserts that there are five social environments that directly affect the individual’s development, which are microsystems, mesosystems, exosystems, macrosystems, and

chronosystems. This social work theory allows an immigrant social worker to take a holistic view of the client’s experience by assessing how the client is affected by social, cultural, and political systems (Paat, 2013) . These systems are also helpful in identifying social determinants of health, which are the conditions that people are born, grow, and work in that ultimately influence health outcomes for the clients (Castañeda, Ponce, & Wilson, 2018) . Undocumented immigrants and their families incur several intense stressors that can negatively influence their health (Chang-Muy & Congress, 2015) . When the stressors of migration are compounded with the limited opportunities for undocumented individuals in employment, housing, healthcare access, and education negative outcomes of health can develop (Castañeda, Ponce, & Wilson, 2018) . Part III There are several definitions of what human rights mean. However, one common theme among the definitions is that human rights are inherent to all individuals (Live and Let Live: Health Care is a Fundamental Human Right, 2018) . The Universal Declaration of Human Rights is known as the first global catalog of human rights created in 1948 (United Nations, 2023) . A human rights violation is defined as any act that can deprive an individual of their civil liberties (Live and Let Live: Health Care is a Fundamental Human Right, 2018) . Universal health care access without prejudice is defined as a basic human right in the Universal Declaration of Human Rights as outlined in Article 25 (United Nations, 2023) . Article 25 explains that there is a standard of living adequate for health and wellbeing which includes medical care for all and specialized medical care for pregnant women and children (United Nations, 2023) . The United Nations reports healthcare as being an essential part of duty, however, the United States has historically failed to meet this obligation as a duty bearer. Rightsholders are individuals who have entitlements to specific duty bearers (Live and Let Live: Health Care is a Fundamental Human Right, 2018) . In this

case, the United States, or duty bearer, has demonstrated an inability to provide access to health care to everyone in the country, or the rights holders, without discrimination on the grounds of immigration status. For example, the explicit withholding of federal and state-funded insurance program enrollment for undocumented immigrants would be defined as a violation of human rights according to Article 25 (United Nations, 2023) . These individuals, although undocumented, are still humans entitled to basic human rights, one being access to health care (United Nations, 2023) . There are policies in place to support undocumented individuals with emergency short-gap services such as emergency room treatment. However, individuals living with chronic illnesses and disorders experience an inability to secure affordable and adequate treatment and medications, largely due to lack of affordability and accessibility (Alacon, 2022) . Part IV The immigrant population composes of approximately 14%-16% of the United States’ population (Fazel-Zarandi, 2018) . However, the focus on this analysis were undocumented immigrants’ lack of healthcare access, even despite residing in sanctuary jurisdictions (American Immigration Council, 2020) . Health care has been a very large issue in this community, and has been linked to lack of affordability, language barriers, cultural barriers, or disqualification due to immigration status (Castañeda, Ponce, & Wilson, 2018) . This has created negative implications for undocumented immigrants’ health status. There are some policies and provisions to protect the children of undocumented immigrants and temporarily protect pregnant immigrant women until they are able to give birth (Lacarte, 2022) . Additionally, emergency medical services are available to stabilize individuals in health crises (Alacon, 2022) . However, neither of these services extends to long-term treatment of chronic illnesses. Bronfenbrenner’s ecological systems theory has been

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helpful in understanding how determinants of health affect an individuals’ overall access to health (Paat, 2013) . The Universal Declaration of Human Rights documented was introduced seventy five years ago to outline the basic human rights every person is entitled to. Article 25 of the document outlines universal health care access without prejudice is defined as a basic human right in the Universal Declaration of Human Rights (United Nations, 2023) . Nonetheless this is a basic human right that the United States has failed to provide to its citizens with extreme prejudice.

References Alacon, F. (2022). The Migrant Crisis and Access to Health Care. Delaware Journal of Public Health , 20-25. American Immigration Council. (2020, October 30). Santuary Polices: Overview. Retrieved from www.americanimmigrationcouncil.org: https://www.americanimmigrationcouncil.org/research/sanctuary-policies- overview#:~:text=The%20common%20theme%20behind%20these,out%20their%20immigration %20enforcement%20duties. Castañeda, H., Ponce, N., & Wilson, A. (2018). Immigration and the Social Determinants of Health. Board on Population Health and Public Health Practice; Roundtable on the Promotion of Health Equity. Washington DC: National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division. Chang-Muy, F., & Congress, E. (2015). Social Work with Immigrants and Refugees: Legal Issues, Clinical Skills, and Advocacy. New York, New York: Springer Publishing Company. Fazel-Zarandi, M. (2018). The number of undocumented immigrants in the United States: Estimates based on demographic modeling with data from 1990 to 2016. PLOS One . Lacarte, V. (2022). Immigrant Children’s Medicaid and CHIP Access and Participation. Migration Policy Institute. Live and Let Live: Health Care is a Fundamental Human Right. (2018). Anita Pereira . Mann, J., Grunskin, S., & Lazarinni, Z. (2019). Health and Human Rights. Harvard University Press . Paat, Y. F. (2013). Working with Immigrant Children and Their Families: An Application of Bronfenbrenner's Ecological Systems Theory. Journal of Human Behavior in the Social Environment . Perez, C., & Fortuna, L. (2019). Psychosocial Stressors, Psychiatric Diagnoses and Utilization of Mental Health Services Among Undocumented Immigrant Latinos. Journal of Immigrant & Refugee Services. United Nations. (2023). Universal Declaration of Human Rights. Retrieved from United Nations: https://www.un.org/en/about-us/universal-declaration-of-human-rights Wilson, F., & Stimpson, J. (2020). US Policies Increase Vulnerability of Immigrant Communities to the COVID-19 Pandemic. Annals of Global Health . Yu, M., Kelley, T., & Morgan, A. (2020). Challenges for Adult Undocumented Immigrants in Accessing Primary Care: A Qualitative Study of Health Care Workers in Los Angeles County. Health Access .

Analysis of an Immigrant Problem (1)

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