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Failures of US Health Care System for Pregnant Asylum Seekers

Migrant Clinicians Network's white paper, “Failures of US Health Care System for Pregnant Asylum Seekers,” outlines how pregnant asylum seekers who have been released into the US to await their asylum hearing face extreme obstacles to secure prenatal care, despite their legal presence within the country.

Without prenatal care, infants will not have the benefit of early screening and treatment for potentially life-threatening diseases and screening for congenital abnormalities, while in utero. Additionally, pregnancies without prenatal care may result in excess utilization of emergency services which produces unforeseen strain on the health care system.

Knowledge of prenatal care needs, cost, lack of insurance, transportation, refusal by health centers, and fear are delineated as key barriers for pregnant asylum seekers from accessing the care they need during their pregnancy.

Press contact: Claire Hutkins Seda, cseda@migrantclinician.org. 

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"Abstract: Unathorized (undocumented) immigrants are less likely than other residents of the United States to have health insurance. The American College of Obstetricians and Gynecologists has long supported a basic health care package for all women living within the United States without regard to their country of origin or documentation. Providing access to qualify health care for unauthorized immigrants and their children, who often were born in the United States and have U.S. citizenship, is essential to improving the nation's publc health."

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Sara A. Quandt, PhD, Kristen L. Kucera, PhD, Courtney Haynes, MS, Bradley G. Klein, PhD, Ricky Langley, MD, Michael Agnew, PhD, Jeffrey L. Levin, MD, Timothy Howard, PhD, and Maury A. Nussbaum, PhD

Background Workers in the Agriculture, Forestry, and Fisheries (AgFF) sector experience exposures directly related to the work itself, as well as the physical environment in which the work occurs. Health outcomes vary from immediate to delayed, and from acute to chronic.

Methods We reviewed existing literature on the health outcomes of work in the AgFF sector and identified areas where further research is needed to understand the impact of these exposures on immigrant Latino workers in the southeastern US.

Results Outcomes related to specific body systems (e.g., musculoskeletal, respiratory) as well as particular exposure sources (e.g., pesticides, noise) were reviewed. The most extensive evidence exists for agriculture, with a particular focus on chemical exposures. Little research in the southeastern US has examined health outcomes of exposures of immigrant workers in forestry or fisheries.

Conclusion As the AgFF labor force includes a growing number of Latino immigrants, more research is needed to characterize a broad range of exposures and health outcomes experienced by this population, particularly in forestry and fisheries.

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Arthur L. Frank, MD, PhD, Amy K. Liebman, MPH, MA, Bobbi Ryder, BA, Maria Weir, MAA, MPH, and Thomas A. Arcury, PhD

 

 

Background The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the
US is comprised primarily of Latino immigrants. Health care access for these workers
is limited and increases health disparities.

Background The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in theUS is comprised primarily of Latino immigrants. Health care access for these workersis limited and increases health disparities.

 

Methods This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers.

 

Contents Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers.C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US. Am. J. Ind. Med.

 

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By Amy K. Liebman, MPA, MA, Melinda F. Wiggins, MTS, Clermont Fraser, JD, Jeffrey Levin, MD, MSPH, Jill Sidebottom, PhD, and Thomas A. Arcury, PhD

Background Immigrant workers make up an important portion of the hired workforce inthe Agricultural, Forestry and Fishing (AgFF) sector, one of the most hazardous industrysectors in the US. Despite the inherent dangers associated with this sector, workerprotection is limited.

Methods This article describes the current occupational health and safety policies andregulatory standards in theAgFF sector and underscores the regulatory exceptions and limitationsin worker protections. Immigration policies and their effects on worker health and safety arealso discussed. Emphasis is placed on policies and practices in the Southeastern US.

Results Worker protection in the AgFF sector is limited. Regulatory protections are generallyweaker than other industrial sectors and enforcement of existing regulations is woefullyinadequate. The vulnerability of the AgFF workforce is magnified by worker immigrationstatus. Agricultural workers in particular are affected by a long history of “exceptionalism”under the law as many regulatory protections specifically exclude this workforce.

Conclusions A vulnerable workforce and high-hazard industries require regulatoryprotections that, at a minimum, are provided to workers in other industries. A systematicpolicy approach to strengthen occupational safety and health in the AgFF sector mustaddress both immigration policy and worker protection regulations.

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The Applied Research Center released this report offering the first national data available on the perilous intersection of immigration enforcement and the child welfare system. ARC's Investigative Research package includes a poignant video and Colorlines.com articles which bring to life the story of one family trying desperately to stay together.

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Issue Brief Co-Authored by Health Outreach Partners and the Kaiser Family Foundation
Information provided by the Kaiser Commission on Medicaid and the Uninsured
Publication Number: 8249
Publish Date: 2011-10-27

This brief examines how the Affordable Care Act (ACA) may impact immigrant families based on data collected from Outreach/Eligibility Workers in four regions of the country and supported by needs data from several health outreach programs around the country.  You will note that the pivotal role of Community Health Centers (CHCs)  to connect immigrant families to coverage and care is highlighted.  Migrant Health Centers and Homeless Health Centers are specifically cited because of their history of pioneering and strengthening many of the models and strategies that will be needed to connect immigrant families to health coverage and care come 2014.

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Background Briefing Prepared for Task Force on Immigration and America's Future.
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The figures show that immigration trends are forming a unique generational divide: those immigrants over 40 are largely white, while those under 40 are increasingly Hispanic, Asian and from other minority groups.

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This report focuses on the health and well-being of young children under 6 in immigrant families, those with at least one parent born outside the United States. Eight key themes emerge from the research.
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