Health Affairs’ July Issue: Borders, Immigrants, And Health – Health Affairs

The July issue of Health Affairs covers the intersection of borders, immigrants and health. The July issue of Health Affairs was supported by the California Health Care Foundation, The California Endowment, and Con Alma Health Foundation.

Featured articles highlighted and described below:

Immigration enforcement limits important health care for Hispanic adults.  

New analyses published in the July 2021 issue of Health Affairs link aggressive immigration detention and deportation activities to reduced use of health care services among Hispanic adults, despite undocumented people accounting for less than 14 percent of Hispanic residents in the United States. Such effects were evident among Hispanic adults with diabetes, for whom reduced care risks significant disease and early mortality.

Although the researchers used data from 2011–16, they noted that immigration detention and deportation activities grew substantially post-2016. That may help explain the high Hispanic mortality rates from COVID-19: delayed testing and treatment may have increased community spread. 

“Our results highlight the urgent need for health care systems, practitioners, and public health agencies to track immigration policies’ effects and develop inclusive methods to ensure care for people who may retreat into the shadows,” said study author Abigail S. Friedman of the Yale School of Public Health

Noncitizen children face long-term health challenges.

Researchers found that noncitizen children have far less health insurance and access to care than their siblings who are citizens, as reported in the new issue of Health Affairs. The authors argue that public health goals would be best served by providing health insurance access to all low-income children regardless of citizenship, as noncitizen children—who are predominantly Hispanic—trailed their citizen siblings in almost every health and economic category.

Census Bureau data indicate that many noncitizen children grow up to become citizens as adults, and excluding them from health insurance coverage as children can impair their adult health status.

“Exclusionary policies against noncitizen children effectively harm our future citizens,” pointed out study author Mariellen Jewers of George Washington University.

The authors recommend that eligibility for public insurance be offered to Deferred Action for Childhood Arrivals (DACA) recipients, as well as recommending the elimination of restrictions on Medicaid and the Children’s Health Insurance Program. 

Aging US immigrant population vexes state health care systems.

The US health care system is largely unprepared to deal with aging immigrants, particularly those who are uninsured and live in states where they cannot receive Medicaid, as well as undocumented immigrants who are ineligible for Medicare, according to research published in Health Affairs.

This shifts the need to care for this population to state and local safety-net providers.

Because comprehensive immigration reform in Congress is unlikely, researchers argue for more incremental approaches that increase coverage to underserved aging immigrants. One option could expand health care to aging undocumented immigrants, similar to California’s legislature considering expanding Medicaid coverage for low-income undocumented immigrants ages 65 and older. Another option is Illinois’s coverage of end-stage kidney disease for undocumented immigrants.

“Access to affordable health insurance would help protect immigrant household incomes and encourage optimal access to and use of health care,” said author Arturo Vargas Bustamante of the University of California, Los Angeles.

Other studies discussing related topics include:

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