Immigration and Health Disparities

by

Kofi Danso

• LAST MODIFIED: 12 January 2022
• DOI: 10.1093/obo/9780195389678-0311

Introduction

Migration continues to be an important component of globalization. With global movement comes migrants’ vulnerability, and the consequent intersection with health and health disparities. The immigrant population in the United States is expected to increase to about eighty-one million by 2050. This ongoing demographic transformation suggests that the health status, health risk behaviors, and health disparities of immigrants and their offspring may play a significant role in shaping the health outcomes of the American population. Immigrants are particularly considered a vulnerable population because of insufficient access to and utilization of health care, limited English proficiency, low socioeconomic status, immigrant status, stigmatization, marginalization, and increased risk for poor physical, psychological, and social health outcomes, especially among the working poor. These factors undoubtedly have detrimental effects on the health and health disparities of immigrants and their children. These social, environmental, and behavioral occurrences or life experiences accumulate over time to improve or jeopardize an individual’s health. Similarly, immigration policies have a tremendous impact on immigrant health disparities, especially during periods of strict and intense enforcement in the United States. Nativity has become a prominent domain in health disparities research. Given that nativity, racial, and ethnic health disparities continue to be a major public health concern, social work scholars and practitioners continue to work toward eliminating health disparities among population subgroups, including immigrants. Included in these discussions are immigrant health service use, immigrant health effects, salmon bias, and determinants of immigrant health. Also important in working with immigrants are problems with accessibility to health services.

General Overviews

This section of the article discusses literature on a broad spectrum of topics, ranging from immigration to immigrant health disparities to healthy-immigrant advantage, including predictors of immigrant health and health disparities. In this section, several books are identified as useful in providing discussions about immigration, immigrant health, and immigrant well-being. These books or references generally reflect on immigrant experiences and the extent to which certain characteristics influence their health and well-being. Findley and Matos 2015 discusses the role of community health workers in promoting better health among immigrants. Fernández-Kelly and Portes 2013 explore the factors that improve or diminish immigrant health. Deeper discussions on health and mental health of immigrants are provided in Hall 2020 and Walker and Barnett 2007. Illingworth and Parmet 2017 and Hilado and Lundy 2018 provide some details about work with immigrant and refugee mental health through collaborative efforts. A detailed understanding of the struggles of immigrants and their health, using case studies from several countries, is found in Park 2011. Other authors have examined the challenges of undocumented immigrants, including immigrants and refugee health (Kemp and Rasbridge 2004). Kolker 2011 also provides a detailed examination of the immigrant health advantage. Furthermore, Raphael 2016 investigates the intersection of public policy, immigrant experience, and health in seven immigrant-receiving nations.

• Fernández-Kelly, P., and A. Portes. 2013. Health care and immigration: Understanding the connections. New York: Routledge.

  DOI: 10.4324/9781315868622

  This edited book investigates the relationship between health care and immigration in the United States. It demonstrates the extent to which medical institutions provide for the needs of the poor and most vulnerable in society. The authors portray how differences in federal, state, and local governance influence the health-care system and consequently the health and well-being of individuals living in those communities. It also explores health-care provisions, immigration policy, and other factors that contribute to the health of immigrants.

• Findley, S. E., and S. Matos. 2015. Bridging the gap: How community health workers promote the health of immigrants. Oxford: Oxford Univ. Press.

  DOI: 10.1093/med/9780199364329.001.0001

  Discusses the inequitable access to health care that contributes to the risk of chronic disease, stress, and lifestyle change of immigrants. It highlights that for community health programs to be effective, programs must be community driven and community oriented. Immigrants’ experiences are captured as case studies. Community health workers’ assistance in navigating the health system helps in making health care accessible for immigrant population and to overcome obstacles in the US health-care system through education, advocacy, and culturally competent practice.

• Hall, N. G., ed. 2020. Mental and behavioral health of immigrants in the United States: Cultural, environmental, and structural factors. London: Academic Press.

  This edited volume reviews research on immigrant health and mental health, acculturation, and multicultural psychology. It has three sections; the first discusses the complex intersection between geography and social context of immigration, including acculturation and cultural orientations. Section 2 discusses mental health issues, and issues of LGBTQ+ individuals and their relationship with Latinx, Asian, and Middle East immigrant populations. Also, the book explores other topics such as alcohol abuse, sleep, and other disorders across various immigrant groups.

• Hilado, A., and M. Lundy. 2018. Models for practice with immigrants and refugees collaboration, cultural awareness and integrative theory. Thousand Oaks, CA: SAGE.

  DOI: 10.4135/9781506300214

  This book provides best practices specifically for working with trauma-exposed immigrants and refugees, and how to promote their mental health. It discusses best practices, and how to support the adjustment, acculturation, and empowerment of immigrants and refugees. It highlights ethical considerations across global settings and employs an ecological framework, Western theories, and integrative strategies to inform immigrants and refugees. The book discusses the role of social work in transnational work, and the need for a collaborative approach in working with immigrants and refugees.

• Illingworth, P. M., and W. E. Parmet. 2017. The health of newcomers: Immigration, health policy, and the case for global solidarity. New York: New York Univ. Press.

  DOI: 10.18574/nyu/9780814789216.001.0001

  Discusses immigrant health and access to health care. The authors explain the dangers of developing health policy based on ethnocentrism and xenophobia on immigrant and native populations. Challenges associated with extending health care to immigrants have consequently led to chronic diseases and premature death. The authors draw on rigorous legal and ethical arguments as well as empirical studies, including case studies. They highlight the need for global challenges such as poverty and climate change, among others, to inform health policy both for immigrants and natives.

• Kemp, C., and L. A. Rasbridge. 2004. Refugee and immigrant health: A handbook for health professionals. Cambridge, UK: Cambridge Univ. Press.

  This handbook discusses physical health, including infectious disease risks, mental health, and spiritual issues of immigrants and refugees. The text discusses the characteristic differences between immigrants and refugees and the specific health and mental-health-care needs of each group, including women’s health. It also overviews the cultural traditions of various immigrants and refugees and their countries of origin, and the different health beliefs. The book is intended to build an understanding of cross-cultural health and cultural competence.

• Kolker, C. 2011. The immigrant advantage: What we can learn from newcomers to America about health, happiness, and hope. New York: Free Press.

  There is growing evidence that immigrants tend to have better physical and mental health than most native-born Americans. The author writes about her research of second- and third-generation immigrants’ physical and mental health. The author gets into immigrant communities such as in Mexico, Jamaica, India, and Vietnam and introduces some fascinating details about cultures and customs that may promote health advantage. The rich details also include personal stories as case studies.

• Park, L. S. 2011. Entitled to nothing: The struggle for immigrant health care in the age of welfare reform. New York: New York Univ. Press.

  DOI: 10.18574/nyu/9780814768013.001.0001

  Lisa Sun-Hee Park writes about how immigration policies, health care, and welfare intertwine in the immigrant experience. She discusses how women of reproductive age were targeted for deportation as a part of “disciplining” immigrants. She provides a first-person account or case studies of the struggles of immigration, and how policies can better protect immigrant populations.

• Raphael, D., ed. 2016. Immigration, public policy, and health: Newcomer experience in developed nations. Toronto: Canadian Scholars.

  This text observes how public policy affects the health of immigrants. It discusses welfare, along with political systems that shape health-care policy. The authors of this edited book use Canadian and international case studies to demonstrate the differential impact of public policy and the welfare state on the experience and outcomes of immigrant health. This is because these policies influence the quality of the distribution of the social determinants of health and its eventual health outcomes.

• Walker, P. F., and E. D. Barnett, eds. 2007. Immigrant medicine. St. Louis, MO: Saunders Elsevier.

  Given the increasing wave of immigrants, this edited book provides a comprehensive guide about immigrant populations within the US health-care system in understanding the complexity of immigrant experiences for proper diagnoses, prevention, and treatment of diseases and disorders. The book is divided into several sections that tackle health topics ranging from medical screening and immunization to epidemiology of diseases, chronic illness, and mental health and illness as they relate specifically to immigrants and refugees.