Medical Care for Undocumented Immigrants: National and International Issues

Abstract

• Global presence of undocumented immigrants (UIs), primarily in the U.S.
• Over 12 million UIs in the U.S. face unique healthcare challenges.
• Most UIs are uninsured, relying on safety-net health systems.
• UIs are generally younger and healthier but with specific health risks.

Key Points

• Estimated 30 to 40 million UIs worldwide, with significant numbers in the U.S.
• Barriers to healthcare: language, cost, fear of deportation.
• Limited provisions for health needs, mostly uninsured with restricted access.
• Specific conditions: infectious diseases, mental health issues, inadequate prenatal care.

Introduction

• U.S. definition of UIs: non-legal residents, visa overstayers, unresolved immigrant status.
• UIs constitute about 4% of the U.S. population, mainly of Hispanic origin.
• International estimates: 30 to 40 million UIs, with significant shares in Europe.
• Health challenges and solutions for UIs in the U.S. and Europe discussed.

Challenges in Healthcare

• Health advantage diminishes over time in the U.S.
• Factors: socioeconomic status, deportation fear, language barriers.
• Limited English proficiency leads to decreased healthcare access.
• UIs face shame, discrimination, and financial barriers globally.
• Europe: Only 22% of UIs had access to health coverage.

Access to Healthcare

• ACA excluded UIs, though they can receive emergency care under EMTALA.
• Limited federal provisions for prenatal and children's care.
• Federally Qualified Health Centers offer sliding-scale services.
• Europe: Various countries offer different levels of healthcare access to UIs.

Table 1: Healthcare Access in European Countries

• Comparison of healthcare access for UIs in the UK, France, Germany, Italy, Netherlands, Spain, and Switzerland.

National Debate on Medical Care for UIs

• Ethical and practical arguments for and against providing UIs healthcare.
• Professional societies advocate for healthcare access for all residents.

Common Medical Conditions

• UIs report lower levels of chronic diseases but face maternal and acute injury challenges.
• Fear of deportation and stressors lead to faster health decline.
• Public health concerns over infectious diseases brought by UIs.
• Mental health issues: anxiety, adjustment disorders, stress.

European Experience

• High prevalence of mental health, infectious diseases, and reproductive health issues.
• Human trafficking concerns.

Potential Solutions

• Strengthening primary care to improve outcomes and reduce costs.
• U.S. cities and states offer models for providing comprehensive care.
• Proposed advocacy, insurance reform, expansion of safety nets, provider training, and UI education.

Summary

• UI healthcare is complex with multiple barriers.
• U.S. cities and European countries offer models of care.
• Interest in developing solutions to meet UIs' healthcare needs.