Healthcare among Immigrant Families

The U.S. healthcare system is very complex, incorporating both public and private programs. Healthcare is extremely costly due to the high cost of drugs, and there is no universal healthcare initiative. Citizens pay for their medical insurance expenses except for federal programs such as Medicaid and Medicare for the poor and elderly. Health insurance is necessary as the primary care providers require a medical cover. The availability and cost of healthcare depend on the individual’s income status; thus, different populations have different medical coverage.

Population Chosen

The population I choose to work for my course project is Immigrants. I feel close to this population because I am from Puerto Rico. Although I have been a U.S. citizen as Puerto Rico is a free associated state of the U.S., I have had my share of negative experiences due to being Hispanic. I want to help them as much as possible, especially when they don’t speak the language or are afraid to request help because of their immigration status or circumstances. I work as a case manager assistant; thus, I am already helping them as many immigrants come to the clinic as they need help with translation, assistance in coordinating appointments. This is due to the low number of Spanish speaking persons available, or they don’t understand the referral process.

I am based in Florida, where the demographical statistics of immigrants into the U.S is more than one person in five Florida residents. In 2018, more than 44 million immigrants resided in the U.S, and is estimated that one in seven U.S residents being foreign-born (Norlander and Sørensen, 2018). The number of undocumented immigrants ranges from 10 to 12 million, and in Florida, more than 425,000 U.S. citizens live with at least one undocumented family member.

 

Developmental Milestones

Hispanic immigrant’s assimilation into the U.S. system has seen some developmental milestones being achieved through infusion into American society’s political, economic, and social paradigm. The population has been instrumental in social, cultural diversification through the influence of cultures such as the learning of bilateral languages, Spanish, and English. Hispanic families often teach their children Spanish as a cultural heritage but learn English to integrate with the rest of the population who widely speak the English language. In terms of behaviorism, the community has had a significant influence on American cuisines. The integration of Spanish and American delicacies have led to the development of unique cuisines such as tortilla chips, which is one of the highest-selling snacks in the U.S.

Their mistrust of the system illustrates psychosocial development due to their illegal immigrant status (Suárez-Orozco, 2017). The U.S. government recently expanded the powers of Immigration and Customs Enforcement (ICE), giving them powers to deport illegal immigrants without going to court. In 2019, there was an average of 50,000 immigrants in ICE custody. The population is wary of the threat the policy poses, as it can be misused to target naturalized immigrants, thus keep their immigration status confidential. The developmental milestones in healthcare have been limited due to cost and linguistic barriers, as shown in the case study.

Case Study

The patient is a 27-year-old stay at home mom who has been living in the U.S. for a few years now. She is originally from Guatemala and does not speak any English. Her husband works full time to provide for the family. Her family moved here for a better life. They have four children, all under the age of 12 years old. They are all uninsured. She was referred to my clinic and eventually to me through another immigrant based organization. She has been having some health issues but her attempts to see a doctor have been hindered by the English language barrier, lack of insurance cover, and unfamiliarity with the U.S. healthcare system. I contacted the patient, and after reassuring her to remain calm and composed, she explained her medical condition; tired and sad diagnosis.

I explained our clinic offers primary care for all ages, behavioral health, dental, maternity services, and pharmacy services for the uninsured based on income and family size.  She was happy about that but worried because they were still in the naturalization process as U.S. citizens, thus afraid of getting deported. The process has been put on hold, and therefore wanted her information kept confidential. An appointment was scheduled with one of our Spanish speaking doctors who was mailed all the appointment information and my contact information.

After she saw the doctor, she has referred again regarding exploring options for a radiology office for a mammogram. A place was found for the client, and an appointment was scheduled for her. She was also referred to see a Spanish Speaking License Clinical Social Worker regarding her state of sadness. The prescribed medications were filled at our pharmacy at a low cost. Recent conversations with the patient suggest she is recuperating and is grateful for the assistance we could provide for her and her family. Now her children are also seen at the clinic for their primary and dental care.

Case Study Analysis

Guatemala is among the countries with the highest poverty index in Latin America and the Caribbean. According to the Human Development Index (HDI), Guatemala is classified as a medium human development level country. Guatemala has been among the countries with the highest socioeconomic inequality levels in the world, where extreme poverty continues in both its urban and rural settings. Migration has been a survival tactic in search of better opportunities; thus, choose the U.S as the best viable market for. This is why people from different countries risk everything for a better life in the USA. My client and her family did just that. Now I am here to help them as much as I can. But now we can understand a little better about their fear of being deported and why they hesitate to ask for help. The reasons vary from cultural competency, language barrier, and accessibility of health information.

Cultural competency refers to healthcare providers’ ability to meet their patients’ social, cultural, and linguistic needs. The patient was nervous at first but grew more comfortable after being engaged in Spanish. Cultural competency is paramount in healthcare provision, especially among the immigrant population, such as Hispanic patients. It helps reduce disparities and improve patient outcomes when there is no language barrier (Henderson, Horne, Hills and Kendall, 2018). Hispanic patients are likely to disclose medical conditions to providers who speak the same dialect as they feel respected regarding beliefs, customs, and values, thus communicate freely. The language barrier is a significant contributor to health disparity; therefore, assistance is required in terms of interpretation. Understanding the dialect of the patient proved key in treating the patient in the case study. Health information is nonexistent in the immigrant population as most lack health insurance covers. They lack the necessary information on how PCPs operate, thus shun the idea of seeking medical attention. PCPs are responsible for all the medical complications and can be involved in the whole family’s care.

Conclusion

Most immigrants lack access to quality health care due to language barriers and lack of health information. Referrals are widely used when in need of medical assistance as they tend to trust physicians who understand their culture. Thus, poor communication with English-speaking nurses is limited by referring the patients to a Spanish-speaking doctor.  Sensitization of the health information should be done to enable the immigrants to know the type of services offered by different health care programs. In turn, this will help them choose the appropriate medical insurance cover or register for federal programs. With the number of immigrants expected to rise, the government should consider policies that enable the purchasing of health covers for immigrants awaiting citizenship certification.

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