Barriers to Health Care for Undocumented Immigrants: A Literature Review

Abstract

• International migration has increased, and many countries limit health care access for undocumented immigrants.
• Barriers include financial, discrimination, and fear of deportation.
• The review included 66 articles identifying barriers and strategies to address these barriers.
• Policy barriers relate to law and type of care available.
• Health system barriers include bureaucracy and limited alternative care.
• Individual barriers involve fear, stigma, and lack of resources.
• Recommendations include policy change, insurance options, and education for both providers and immigrants.

Background

• Rise in international migration due to conflict, discrimination, and lack of opportunities.
• Countries use border control and policies to deter immigration, impacting health care access.
• Policies in places like the US and EU limit undocumented immigrants' access.
• Undocumented immigrants underuse health services, risking their and public health.

Methods

• Literature review using PubMed covering immigrants, undocumented, and health care access.
• Search was limited to English articles from the past decade.
• Screening process included title, abstract, and full-text reviews, resulting in 66 articles.

Results

Barriers

• Policy Arena: Legal barriers denying insurance access and requiring documentation.
• Health System: Bureaucratic obstacles, limited capacity, and discrimination.
• Individual Level: Fear of deportation, communication barriers, financial constraints, and stigma.

Recommendations

• Policy Advocacy: Change laws to expand access regardless of status.
• Insurance Options: Provide state-funded or subsidized insurance.
• Safety Net Expansion: Enhance capacity of clinics and hospitals.
• Provider Training: Cultural competency and legal knowledge.
• Immigrant Education: Navigating health systems and understanding rights.

Discussion

• Barriers are extensive and vary by country.
• Legal barriers are significant, but bureaucratic and individual challenges also play a role.
• Fear of deportation is a major deterrent.

Recommendations for Improvement

• Policy Changes: Full access or limited coverage based on health needs.
• Insurance and Safety Nets: Develop new insurance strategies and expand safety nets.
• Provider and Immigrant Education: Train providers and educate immigrants about their rights.

Conclusion

• Barriers encompass legal, social, and financial challenges.
• Research is needed on the impact of health policies on undocumented immigrants.

Limitations

• Limited to English articles from PubMed over 10 years.
• Excluded non-English or articles from other databases.
• Focused on barriers, not a separate review of solutions.