About one in seven residents of the US is an immigrant, and about fifteen million individuals stay inside 100 kilometers of the US-Mexico border. Disparities in well being standing exist between individuals born within the US and people who have immigrated. Immigration coverage has been contentious all through US historical past, and present insurance policies within the US and Mexico have important results on the well being and well-being of tens of thousands and thousands of individuals. This thematic situation of Well being Affairs focuses on immigrants and borders. The overview article by Arturo Vargas Bustamante and coauthors describes a spread of well being coverage points raised by the constantly shifting demography of US immigrants.
Alongside The Border
Keith Gennuso and colleagues calculate life expectancy for counties on the US facet of the US-Mexico border. They discover that Black, White, and Asian residents of border counties expertise longer lives than their counterparts elsewhere within the US, however Hispanic and American Indian/Alaska Native residents in these counties have decrease life expectancy than in the remainder of the US.
Rodrigo Dominguez-Villegas and Bustamante look at the medical health insurance protection of individuals born in Mexico who left that nation and returned both voluntarily or as a result of they have been deported. In the course of the first two years after their return, each teams have decrease medical health insurance protection charges than Mexican-born residents who by no means left, with deportees faring worse than different returnees.
Sharon Borja and coauthors discover that 53.6 p.c of US citizen migrant youngsters residing in Mexico lack medical health insurance. Underinsurance charges are 80.4 p.c in city areas and 65.2 p.c amongst those that stay in Mexican states close to the US border.
Reaching The US Border
The US has agreements with El Salvador, Guatemala, and Honduras allowing the expedited elimination of asylum seekers from the US, claiming that these nations present safety in opposition to persecution. C. Nicholas Cuneo and coauthors look at knowledge from individuals from this area who have been searching for asylum within the US and who offered to a medical clinic in Boston, Massachusetts. Amongst them, 91.2 p.c of individuals reported repeated trauma exposures, most frequently threats of violence, sexual assault, and violence perpetrated in opposition to household or pals.
Ietza Bojorquez-Chapela and coauthors analyze official well being coverage paperwork in Mexico to review the extent to which the nation considers the wants of in-transit migrants and asylum seekers in its response to the COVID-19 pandemic. The authors discover main gaps relating to who can entry care and who is remitted to offer care, suggesting the necessity for extra consideration to those extremely susceptible teams.
Meghan Benton and Demetrios Papademetriou take into account how COVID-19 is reshaping border and immigration administration within the US and draw parallels with coverage adjustments made after September 11, 2001. They analyze the pandemic’s impression on migrants, migration flows, and migration insurance policies and argue that COVID-19 gives each dangers and alternatives for future protected journey and migration coverage.
Immigrants In The US
Abigail Friedman and Atheendar Venkataramani discover that elevated enforcement of deportation insurance policies is negatively correlated with having a daily well being care supplier and an annual checkup amongst Hispanic adults. This unfavourable relationship holds “even amongst diabetic respondents, for whom biannual check-ups are the usual of care.”
In 2018 a change to the “public cost” rule was proposed that threatened the power of noncitizens who use some public packages to change into residents. Sharon Touw and coauthors estimate that 25 p.c of all at-risk immigrant important employees and their family members prevented in public packages due to the proposed rule change, leading to about 1.3 million and a couple of.1 million of them forgoing SNAP and Medicaid, respectively.
About sixteen million individuals stay in mixed-status households the place just some members are legally current within the US. Mariellen Jewers and Leighton Ku report that when residing in the identical family, 42 p.c of noncitizen youngsters are uninsured in contrast with 12 p.c of citizen youngsters, primarily due to Medicaid and CHIP.
Dolores Acevedo-Garcia and coauthors talk about authorized standing as a social determinant of well being, evaluation how immigrant exclusions have an effect on US citizen youngsters in mixed-status households by specializing in entry to safety-net packages, and description coverage suggestions to lower restrictions that hurt youngsters.
Well being Affairs thanks Arturo Vargas Bustamante, UCLA Fielding College of Public Well being, our theme situation adviser. We have been terribly saddened to study of the loss of life in November 2020 of Leah Zallman, from Harvard Medical College and Cambridge Well being Alliance, who participated in our situation planning assembly and is a coauthor of two articles. We thank the California Well being Care Basis, The California Endowment, and Con Alma Well being Basis for his or her monetary help of this situation.