By Allison Hydzik
In his
State
of the Union address this week, President Obama called on Congress to send him an
immigration reform bill, saying, “Now let’s get this done. Send me a
comprehensive immigration reform bill in the next few months, and I will sign
it right away.”
Q: Why is immigration reform important to public health?
Dr. Macia: The most obvious answer is that access to health insurance
and, sometimes, certain medical services is directly impacted by the legal
framework in which immigrants exist. Not having a social security number makes
accessing some of these services much harder. Additionally, anxiety and
depression are often reported by immigrants as resulting from the experience of
migration. We also often hear from undocumented immigrants who refuse to engage
in social or sporting activities due to fear about their legal status, and this
becomes a barrier to living healthier lifestyles. Immigration reform could also
take many of these immigrants out of the “shadows,” allowing them to claim
certain rights in issues such as adequate housing and safe work conditions.
Q: What are the health experiences of immigrants, both undocumented and
those that are well-qualified and educated?
Dr. Macia: In some respects they are extremely different, while in
others quite similar. It is also important to note that there is no dichotomy
between undocumented and well-educated immigrants – many undocumented
immigrants are extremely well-educated and vice-versa. The distinction is often
in how they migrate to the U.S., whether undocumented or through legal visas. Undocumented
immigrants face more discrimination, and among them anxiety and depression are
common. Due to their low income, many find it very hard to access adequate
housing conditions. Undocumented immigrants, as well as many well-qualified and
educated immigrants, can find enrolling in health insurance extremely
difficult, if not impossible. For well-qualified immigrants, who are often
spouses of students or professionals, the inability to legally work is commonly
a trigger for depression. Many of them, facing economic pressures and feelings
of inadequacy by not being able to work, decide to accept jobs “under the
table,” such as housekeeping, that do not fit their educational background.
Q: How does immigration status impact a person’s mental, social and
physical health?
Dr. Documet: I cannot stress enough how much social isolation affects a
person’s social health. This, in turn, may bring about depression and anxiety.
Regarding physical health, it makes it more difficult to find resources in the
community to address any issues that emerge. Additionally, immigrants may take
up unhealthy behaviors, such as smoking, and stop healthy behaviors, such as
breastfeeding. Finally, they are more likely to develop health problems, such
as asthma, diabetes and obesity.
Q: Based on your research experience, what do you think is the best
immigration policy, both for our nation and citizens, as well as potential
immigrants?
Dr. Documet: It is difficult to answer this question and I certainly
have no research data on policies. From the health data I have collected, a
policy that allows for people who are contributing to our economy as workers to
receive health care in a non-threatening environment would be beneficial. As a
private citizen, a more general answer would be that a policy that provides a
path to citizenship for those who are currently in the U.S. illegally would be
beneficial. I believe it is fair that individuals have to undergo a background
check, pay a fine and be current in their taxes. Enforcement should concentrate
on detecting and deporting criminals and discouraging employers from hiring
undocumented workers.
Dr. Macia: I’m no expert on immigration legislation, and rather than
directly answering this, I can offer my thoughts on what needs to be considered
in crafting a good policy. Any policy that forces people to exist under the
radar will have a negative impact on those people, and will create the wrong
incentives for those who take advantage of them. Most immigrants come to the
U.S. for work. However, many immigrants face very grim work environments, with
little-to-no protections readily available to them. The mixed nature of these
messages is undeniable, and a good policy needs to correct this. If immigrants
are being pulled due to certain needs, such as economic force, they need to be
recognized as such and not be left in the shadows.