A recent survey of over 3,300 immigrants in the United States revealed significant challenges in accessing culturally competent healthcare, with 3 in 10 facing obstacles. Additionally, 25% experienced discrimination within the healthcare system. Despite these hurdles, most immigrants reported good health, but disparities existed based on race, income, and language proficiency. Community health centers played a crucial role in bridging access gaps. Concerns about accessing public services and the impact on immigration status persisted among immigrants. Addressing these issues is crucial to improving healthcare access for this diverse population.
A recent survey conducted by KFF and the LA Times sheds light on the difficulties faced by immigrant patients in the United States when seeking healthcare. The survey, which involved more than 3,300 immigrants, including naturalized citizens, lawfully present immigrants, and likely undocumented immigrants, reveals a complex landscape of healthcare access and discrimination experiences.
Even though a significant portion of immigrant respondents reported good overall health (with 79 percent rating their health as good or excellent), the survey highlights substantial shortcomings in the healthcare system’s ability to serve this traditionally underserved population.
One of the key findings is that three in 10 immigrant patients encountered multiple challenges in accessing culturally competent care. Additionally, 25 percent reported experiencing discrimination within the healthcare system, which may be linked to the scarcity of culturally competent and language-concordant care.
Specific challenges identified by the survey include:
1. Difficulty in Obtaining Respectful and Culturally Competent Care: Nearly 29 percent of immigrants found it challenging to access respectful and culturally competent healthcare. Among these patients, 17 percent felt that their healthcare providers did not take the time to listen to their concerns or ignored them, 15 percent noted that doctors failed to explain things understandably, and 12 percent reported experiencing disrespect from front office staff.
2. Lack of Interpreter Services: For individuals with limited English proficiency (LEP), 17 percent noted that interpreter services were either unavailable or not provided promptly.
These obstacles were more prevalent among Black, Hispanic, uninsured, and likely undocumented immigrants, highlighting disparities within the healthcare system.
The survey also revealed that 25 percent of immigrant patients experienced discrimination, irrespective of their immigration status. Discrimination was attributed to various factors, including insurance status or ability to pay (16 percent), accent or English-speaking ability (15 percent), and race, ethnicity, or skin color (13 percent).
Notably, Black patients experienced discrimination at a rate twice as high as White patients, and this trend was consistent among Hispanic immigrant adults. The same held true for uninsured people, with lower incomes or limited English proficiency.
Despite these challenges, immigrant respondents generally reported good health, with 15 percent describing their health as excellent, 32 percent as very good, and 32 percent as good. However, a significant proportion of low-income, Hispanic, and likely undocumented immigrants reported fair or poor health.
Access to healthcare services within the past year was relatively high, with 77 percent of respondents reporting at least one provider visit, and this number rose to 84 percent when including those who attempted to schedule an appointment.
However, the survey revealed disparities in healthcare access based on immigration status and insurance coverage. Likely undocumented immigrants faced lower rates of healthcare access, with only 63 percent accessing care, and uninsured individuals also encountered significant barriers, with only 48 percent accessing care.
Community health centers played a pivotal role in bridging the gap in healthcare access for immigrant patients. Nearly eight in 10 immigrant adults reported having a usual source of care that was not the emergency department, and 30 percent identified community health centers as their primary source of care. Community health center access was more common among uninsured individuals, low-income individuals, likely undocumented immigrants, and those with limited English proficiency.
Like their native-born counterparts, immigrants encountered cost-related barriers to accessing care. Approximately one in five immigrant adults struggled to afford healthcare in the past year, and 22 percent postponed or skipped necessary care due to cost concerns. Among the uninsured, a third had to forgo care due to financial constraints.
Other barriers to care access included inconvenient appointment times or locations, challenges in navigating the healthcare system, and a lack of access to interpreters or individuals who could communicate in their preferred language. Shockingly, 40 percent of immigrant adults who postponed or skipped care reported that their well-being suffered as a result.
To address these challenges, the healthcare industry should consider strategies to expand health insurance coverage for all adults while integrating culturally competent and language-concordant care. However, larger national politics and concerns about immigration status could hinder efforts to broaden insurance coverage.
Many immigrant adults are unaware of how to access social services like Medicare or Medicaid, and they worry that enrolling in these programs could impact their immigration status. This uncertainty extends to public charge rules, which stipulate that using public services like Medicare/Medicaid and food and housing assistance could affect immigration status. A significant 58 percent of respondents expressed uncertainty about these rules.
Although likely undocumented immigrants are generally ineligible for public services, their US-born children may qualify for these benefits. Despite this, both undocumented immigrants and those with limited English proficiency are more likely to fear the implications of public charge rules.
As a result of these concerns, 8 percent of immigrant adults have refrained from applying for healthcare, food, and housing assistance for which they are eligible. This reluctance is particularly pronounced among likely undocumented immigrants, with 27 percent avoiding enrollment in public assistance programs.
The researchers emphasize that addressing these challenges could significantly reduce financial stress and enhance access to care for immigrant families, especially those with lower incomes who struggle to meet basic needs like monthly bills, food, housing, and healthcare.
Overall, the survey underscores the importance of addressing the barriers to culturally competent healthcare and improving access for immigrant patients. By doing so, the healthcare system can better serve this diverse population and ensure that everyone receives the care they need, regardless of their immigration status or background.
