Running head: IMMIGRATION POLICIES ON HEALTH OF IMMIGRANTS 1

Affects of U.S. Immigration Policies on Health Of Immigrants

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IMMIGRATION POLICIES ON HEALTH OF IMMIGRANTS 2

Affects of U.S. Immigration Policies on Health Of Immigrants

Introduction

In the United States, there is a striking tension that exists between public health, which

ought to provide essential health services to the citizens. The systems are meant to ensure that

every American, including the needy persons, have access to primary health care. There are also

stipulations that criminals, the undocumented immigrants, should access the health services.

However, there exist challenges that prevent immigrants from accessing health care in the United

States. Because of the large number of immigrants in the United States, rigorous research is

required to determine the effects of immigration policies on the health of the immigrants. Some

of the established procedures in the U.S are meant to punish the undocumented immigrants when

they seek health services. Some deliberately exclude the undocumented immigrants from the

health service programs, which in areas such as the emergency department, and even in the labor

wards where they cannot access the services. Currently, there is a high influx of immigrants into

the U.S presents a significant challenge to western bio-medical practice.

Due to significant differences in living standards between developed and developing

countries, people have been moving to stable and developed regions throughout history. Between

1990 and 2015, the number of immigrants to the United States of America increases from 19.8

million to 43.2 million. In 2016, these immigrants comprised 13.5% (43.7 million) of the U.S.

population and moved from Asia, Africa, Europe, Latin America, and other world regions

(Pereira & Pedroza, 2019). An immigrant is a term used to describe foreign nationals who enter a

country with the purpose of settling permanently. Immigration laws in most states, including the

United States, do not classify ‘temporary workers’ as immigrants. Philbin et al. (2016) assert

that, though, when temporary workers decide to settle permanently in their new country, they are
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categorized as immigrants. Generally, immigrants are classified into three broad categories. The

first category is voluntary immigrants: those people who come to live with their relatives already

settled in the host nation or to fill particular jobs for which the host nation lacks expertise.

Secondly, our refugee and asylum seekers: people who enter another country to avoid

persecution, violence, and war in their home countries. Lastly are the undocumented immigrants:

People who enter another country illegally. Although there are potential issues for every citizen

to access health services, people of foreign-born backgrounds face peculiar challenges in their

attempt to access essential services from the health centers. Hall and Cuellar (2016) claim that

some of these problems include communication barriers due to their language, their beliefs about

health, lack of cultural awareness concerning the service providers. While there are cultural

issues in access to health care, the government has also posted significant barriers to the access

of health services to the immigrants. This paper aims to provide a research proposal on the

impacts of the United States immigration policies on the health of the immigrants. The paper is

divided into the following sections: Literature Review, Theory, Research Design, Expected

Analysis, and Conclusion.

Literature Review

In the United States, immigrants face the challenge of adjusting to a new life in a new

country that has different social norms, culture, and social institutions. These social institutions

include a range of federal, state, and local laws that can either assist or hinder the adaptation of

immigrants to the United States. These laws and policies explicitly provide or limit access to

health services. Some rules or policies restrict or prohibit immigrants from accessing essential

health services, including emergency care. Access to health services is identified into three
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categories. First are the Laws and policies that restrict rights associated with health services.

Secondly, are the Laws and policies permitting minimum rights to immigrants. Third, are the

Laws and policies permitting more than minimum rights to immigrants. The findings of Philbin

et al. (2016) indicate that in the United States, the immigration laws and policies are more rigid

towards undocumented immigrants than legal immigrants. There are several factors, such as

political, economic, racial, and terrorism, that has resulted in the implementation of immigration

policies aimed at curbing legal or undocumented immigrants. Fabio & Saloner (2016) found that

the economic crisis can lead governments to respond with stricter immigration laws, and often

undocumented immigrants are attacked for these financial crises. Hall and Cuellar (2016) note

that although the world has seen a significant financial crisis and the Great Depression (1929 –

1933), these economic crises did not result in the harsh immigration policies. However, the

contemporary financial crisis all over the world encourages states to react to migration upsurge

by targeting illegal immigrants through stringent laws and policies. These strict immigration

laws and policies deeply impacted immigrants’ access to health services and health outcomes in

America.

Several pieces of research have been conducted on the access of immigrants to health

services in the United States. In the United States, undocumented immigrants cannot benefit

from the national insurance plan. Statistics show that around 60% of the undocumented

immigrants do not have health insurance, which implies that 15% of the uninsured persons in

the U.S are the immigrants. This is a large number of persons because the immigrants represent

3% of the total population in the U.S (Monga, Keller & Venters, 2014). The most significant

barrier to accessing health care services lies in the legal frameworks that have been established in

various health departments aimed at excluding undocumented immigrants into the United States.
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Traditionally, some of the laws were favorable to the immigrants, such as the 1986 Emergency

Medical Treatment and Active Labor, which ensured that every person in the United States

received emergency medical attention. The emergency department is currently dealing with the

45miliion of the persons without insurance (Monga, Keller & Venters, 2014). Other programs,

such as the Affordable Care Act, also exclude undocumented persons from accessing primary

health care. Numerous health policies affect the immigration’s health care in the U.S. For

instance, Pereira and Pedroza (2019) explained the full range of systems from state to local and

immigration enforcement activities to analyze the impact on their health and participation in

public programs. The authors find that it includes both inclusive and exclusive policies that

either facilitate immigrant's adaptation or restrict immigrant access to federal programs,

education, and economic opportunities. Furthermore, the authors also provide steps that can be

undertaken to improve the health of immigrants.

Hall and Cuellar (2016) have discussed the negative impact of immigration policies on

the health of immigrants. They point out that despite the enactment of the Patient Protection and

Affordable Act, the health disparities remain. Their results further show that the inequalities due

to ethnicity, immigration status, and country of origin affect immigrant health and provide

opportunities to improve health outcomes among immigrants. It means that most of the

immigrants are struggling to access health care in the United States.

Some of the barriers presented by the health policies are either direct, which includes

using health settings as places for detention. It means that some immigrants are detained when

they visit the hospitals, yet all they need is access to health services. Morey (2018) notes that it is

a practice that discourages most immigrants because they risk being taken to court, especially

those that are undocumented. Velasco-Mondragon et al. (2016) found that the same aspect may
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even affect documented immigrants. The latter might feel they have not met all the minimum

requirements set by the increasing immigration policies. There are other issues, such as

criminalizing the possession of condoms that have adverse effects on the ability of the

immigrants to seek medical care. Although the practice may not be targeting the immigrants, it

has psychological impacts on them. For example, in the state of Arizona, some policies have

been established to check the immigration status of the patient. Although this bill may not

supersede the Emergency Medical Treatment and Active Labor Act (EMTALA), it will scare

away the immigrants, and they may not be comfortable when seeking medical attention. It is a

practice that is also meant to punish the hospitals that provide health services to immigrants.

According to Torres et al. (2018), the impacts of these policies may even be fatal as there are

high rates of deaths among the immigrants, especially those crossing through the US-Mexican

border. Because of the rising concerns of the ends of the immigrants, people have established

movements and campaigns aimed at preventing the unnecessary deaths of immigrants, such as

the "No More Deaths." Pedraza, Nichols, and LeBron (2017) share the sentiments as they claim

that this campaign is aimed at providing emergency medical supplies, blankets, water, and other

essentials to the persons crossing the border. However, the government has further undermined

the efforts of such groups through numerous arrests and obstruction of justice when they attempt

to go the court.

However, there are circumstances where the federal governments are promoting the

health outcomes of the immigrants. The research by Pedraza, Nichols, and LeBron (2017)

indicates that these new approaches have been significant in ensuring that criminal justice takes

its course and considers the health of the people as a priority ahead of other issues. For instance,

the federal government is ins support of around 150 migrant health centers across the United
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States. These clinics have been monumental in improving the lives of the immigrants, especially

those that are undocumented. The target is the undocumented persons, and thus they are mostly

found in areas around the roads where they erect mobile clinics.

Another policy that has adverse impacts on the health outcomes of the immigrants is the

widespread adoption of local ordinances which prevent the provision of housing or safe harbor to

the immigrants. In their research, Stimpson, Wilson, and Us (2013) found that some of the states

that have developed this system include the Hazelton PA and other states, which include

Georgia, Arizona, Alabama. The same method is also beneficial to the victims of domestic

violence, which is another challenge that the United States must deal with to ensure a more

cohesive and stable society. The immigrants will continue experiencing problems if there are no

improvements in the policies that have been established to provide that their health outcomes are

improved. The current plans have adverse impacts on the health of the immigrants because they

are unable to access the necessary services effectively.

Theory

Scholars use some models which analyze the delivery of health services to the people,

especially the immigrants in the United States. Theories act as guidance to the development,

identification, and implementation of interventions that are necessary for the improvement of

health outcomes to the people. One of the models that can be used in explaining the situation of

health services in the United States is the Transtheoretical Model, which is also known as the

stages of the change model. Some of these stages include the pre-contemplation whereby there

lacks the intention of action, while the second stage is the contemplation where there are
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intentions or plans. In this case, there are little actions for the government to promote the health

outcomes of the immigrants. Venkatraman et al. (2018) note that although there are policies that

hinder access to health care among the immigrants, there some practices that show that the health

of immigrants my improve if the government moves to the next stage of preparation. The third

stage is the preparation where the governments should take some measures to ensure that the

immigrants should benefit from medical care. The fourth step is the action, which entails the

implementation of the policies meant to improve the health outcomes of the citizens. The next

stage is maintenance, which monitors the progress of the systems and the rectification of any

error or weakness that may have been identified in the model (Stimpson, Wilson & Us, 2013).

The last step is termination, which happens if the model did not achieve its desired goal. Using

this model and considering the health outcomes of the immigrants, this research proposal will be

guided by the hypothesis that.

Ho: The immigration policies have no significant impacts on the health of immigrants.

H1: The immigration policies have significant impacts on the health of the immigrants.

Research Design

i. Methodology

The quantitative research method will be used to study how policies in the United States

affect the health outcomes of the immigrants, To analyze the impact of immigrant's integration

policies on the health outcomes the immigrants by considering various factors. It is a strategy

that uses data and applies statistical associations between the statue of the citizen, policies, and

the health outcomes of the participants. The qualitative approach can utilize state and their

aspects concerning immigration. It will also consider immigrants and their families to understand
IMMIGRATION POLICIES ON HEALTH OF IMMIGRANTS 9

how immigration laws and policies related to workplace raids and deportation shape the daily life

experience of immigrants and their families and their impact on mental health.

ii. Data description

The data required for the implementation of the policies can be measured by considering

their effects on the variables that have direct impacts on the health of the citizens. For instance, it

can be retrieved through the consideration of the reforms on health insurance and their

implications on the rate of the number of immigrants visiting the hospitals. Data from the U.S

Department of Homeland Security to determine the effects of the policies on such programs as

Medicaid and WIC participation of foreign-born citizens. The coding will also consider the

aspect that some states use a mixture of both inclusive and exclusive policies; therefore, this will

help in ensuring that the different ranges are taken into consideration

iii. Data Collection

The study will consider the causal effects of the policies, which implies that statistical

analysis will be run to determine the relationships between the policies and the health outcomes

of the immigrants. This research will consider questionnaires as the method of collecting data.

The questionnaire will improve the reliability of the results because the participants will get the

chance to give their direct opinions about the policies established by the United States

government (Bell, Bryman & Harley, 2018). Some of the questions will be open-ended, while

others will be closed-ended, and they will help in the analysis of the data. In this light, the

research will consider around 100 participants, of which demographic and their response to the

policies will be analyzed. The questionnaires will also be appropriate in analyzing data using

software such as SPSS. For instance, it may compare the health of the immigrants before and

after the implementation of the immigrant policies. In this light, another comparison that can
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inspire this study is the health outcomes of foreign nationals and American born citizens. The

comparison will give a practical framework to determine whether the policies have significant

impacts on foreign nationals.

iv. Operationalization

The other aspect that will be considered for this study may also find such data as educational

levels, income, occupation, and the residents of the immigrants. These factors can help in

predicting health outcome levels for the immigrants. This information can be combined with

other information concerning the degree of worry, stress, or fear, which results from the full

implementation of the immigration policies. Such a survey will help in analyzing the causal

effects on immigration on the lives and the behavior of the immigrants, which results from their

response to the established laws. This will also determine their attitudes towards their nationality

and whether they feel that the government cares for their stay.

Some of the variables that would be considered include the age of the participants, their

country of origin, income levels, among others. The participants will also be required to give

their opinions on variables such as whether the polices are strict and whether they believe they

affect their health adversely. They may also respond to such questions, such as their direct

impacts following the regulations of immigration. These questions will be fundamental in

determining the relationship between the health outcomes and the policies that have been

imposed. The proportion of the documented and the undocumented participants will also assess

the effectiveness of the immigration policies to impeded the health outcomes.

Expected/Analysis and Results

IMMIGRATION POLICIES ON HEALTH OF IMMIGRANTS 11

After the analysis of the data collected in the previous section, this research expects to

find a significant relationship between immigration policies and the health of the immigrants. As

the number of international migrants put pressure in the United States, the federal and the states

establish laws that discourage the entry of immigrants into the country. Some policies, such as

detention in the attempt to seek medical care, have adverse impacts on the health outcome of the

immigrants. These laws place the immigrants at a higher chance of isolation, discrimination, and

prosecutions, which can be distressing and can have adverse psychological effects. The

immigration policies will show that they bar members of LGBT, especially from those in the

immigration groups, are more susceptible to HIV infections, and because of the strict measures.

They are unable to implement proper prevention measures. The results will also show that

immigration policies discourage some immigrants from accessing such services as prenatal care

because they feel that they will be discriminated against, and this puts their lives into risk. Lack

of prenatal health care may be detrimental not only to the mother but also to the child. The

immigration policies will indicate that there is a significant effect of the laws on the mental

health of the immigrants. Mental disorders are among the leading causes of reduced human

production and social dysfunctionality, which means that they will adversely impact immigrants.

Because of the conditions in which they are subjected, the immigrants may live uncertain lives,

which say they can be affected grossly by nature the policies. Mostly the immigrants usually

struggle with issues as torture, war, hardship, loss of relatives among others from their original

countries. When they come into the country, some may live in the camps while others may be

living in squalid conditions, which may affect their health.

The attitude that the policies may instill among the Americans and the health officials

may lead to stress. For instance, because they are limited in accessing education and other
IMMIGRATION POLICIES ON HEALTH OF IMMIGRANTS 12

essential aspects such as income, then they cannot afford quality health services. If they are not

economically empowered, they cannot afford insurance. The negative stereotype can even push

some of the immigrants into activities such as drugs and substance abuse that may threaten their

lives.

Conclusion

The main argument of the study is that the imposition of immigrant policies has a

negative impact on the health of the immigrants. Some of these policies are meant to deny the

immigrant's essential health services can affect their health. Again, some of these policies

promote discrimination against immigrants, and it encourages health care to ignore or even

report some of the immigrants, especially if they do not have the legal documents. The result is

that the immigrants feel targeted, and because of the fear of arrest and prosecution, they prefer

not to seek medical attention.

However, more research is required to investigate the economic and social integration of

immigrants into the United States. This research will determine where immigrants have been left

out in the social and economic development of the United States.

The study recommends that to reduce the barriers to accessing health care in the United

States, it is essential to incorporate all stakeholders and ensure that they immigrants also have

access to medical care because the life of a person is more important than the policies

established. Americans should also adopt the culture of togetherness and help the immigrants to

live peacefully in the country.

References

Bell, E., Bryman, A., & Harley, B. (2018). Business research methods. Oxford university press.
IMMIGRATION POLICIES ON HEALTH OF IMMIGRANTS 13

Fabi, R., & Saloner, B. (2016). Covering undocumented immigrants—state innovation in

California. New England Journal of Medicine, 375(20), 1913-1915.

Monga, P., Keller, A., & Venters, H. (2014). Prevention and punishment: barriers to accessing

health services for undocumented immigrants in the United States. Laws, 3(1), 50-60.

Morey, B. N. (2018). Mechanisms by which anti-immigrant stigma exacerbates racial/ethnic

health disparities. American journal of public health, 108(4), 460-463.

Pedraza, F. I., Nichols, V. C., & LeBrón, A. M. (2017). Cautious citizenship: the deterring effect

of immigration issue salience on health care use and bureaucratic interactions among

Latino US citizens. Journal of health politics, policy, and law, 42(5), 925-960.

Philbin, M. M., Flake, M., Hatzenbuehler, M. L., & Hirsch, J. S. (2018). State-level immigration

and immigrant-focused policies as drivers of Latino health disparities in the United

States. Social Science & Medicine, 199, 29-38.

Stimpson, J. P., Wilson, F. A., & Su, D. (2013). Unauthorized immigrants spend less than other

immigrants and US natives on health care. Health Affairs, 32(7), 1313-1318.

Torres, S. A., Santiago, C. D., Walts, K. K., & Richards, M. H. (2018). Immigration policy,

practices, and procedures: The impact on the mental health of Mexican and Central

American youth and families. American Psychologist, 73(7), 843.

Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A. G., Davis, D., & Escamilla-Cejudo, J.

A. (2016). Hispanic health in the USA: a scoping review of the literature. Public health

reviews, 37(1), 31.

Venkataramani, A. S., Shah, S. J., O'Brien, R., Kawachi, I., & Tsai, A. C. (2017). Health

consequences of the US Deferred Action for Childhood Arrivals (DACA) immigration

program: a quasi-experimental study. The Lancet Public Health, 2(4), e175-e181.

IMMIGRATION POLICIES ON HEALTH OF IMMIGRANTS 14