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      Policies of Exclusion: Implications for the Health of Immigrants and Their Children

      1 , 2
      Annual Review of Public Health
      Annual Reviews

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          Abstract

          Public policies play a crucial role in shaping how immigrants adapt to life in the United States. Federal, state, and local laws and administrative practices impact immigrants’ access to education, health insurance and medical care, cash assistance, food assistance, and other vital services. Additionally, immigration enforcement activities have substantial effects on immigrants’ health and participation in public programs, as well as effects on immigrants’ families. This review summarizes the growing literature on the consequences of public policies for immigrants’ health. Some policies are inclusive and promote immigrants’ adaptation to the United States, whereas other policies are exclusionary and restrict immigrants’ access to public programs as well as educational and economic opportunities. We explore the strategies that researchers have employed to tease out these effects, the methodological challenges of undertaking such studies, their varying impacts on immigrant health, and steps that can be undertaken to improve the health of immigrants and their families.

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          Liminal Legality: Salvadoran and Guatemalan Immigrants' Lives in the United States

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            The Rise of Anti-foreigner Sentiment in European Societies, 1988-2000

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              Is Open Access

              Barriers to health care for undocumented immigrants: a literature review

              With the unprecedented international migration seen in recent years, policies that limit health care access have become prevalent. Barriers to health care for undocumented immigrants go beyond policy and range from financial limitations, to discrimination and fear of deportation. This paper is aimed at reviewing the literature on barriers to health care for undocumented immigrants and identifying strategies that have or could be used to address these barriers. To address study questions, we conducted a literature review of published articles from the last 10 years in PubMed using three main concepts: immigrants, undocumented, and access to health care. The search yielded 341 articles of which 66 met study criteria. With regard to barriers, we identified barriers in the policy arena focused on issues related to law and policy including limitations to access and type of health care. These varied widely across countries but ultimately impacted the type and amount of health care any undocumented immigrant could receive. Within the health system, barriers included bureaucratic obstacles including paperwork and registration systems. The alternative care available (safety net) was generally limited and overwhelmed. Finally, there was evidence of widespread discriminatory practices within the health care system itself. The individual level focused on the immigrant’s fear of deportation, stigma, and lack of capital (both social and financial) to obtain services. Recommendations identified in the papers reviewed included advocating for policy change to increase access to health care for undocumented immigrants, providing novel insurance options, expanding safety net services, training providers to better care for immigrant populations, and educating undocumented immigrants on navigating the system. There are numerous barriers to health care for undocumented immigrants. These vary by country and frequently change. Despite concerns that access to health care attracts immigrants, data demonstrates that people generally do not migrate to obtain health care. Solutions are needed that provide for noncitizens’ health care.
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                Author and article information

                Journal
                Annual Review of Public Health
                Annu. Rev. Public Health
                Annual Reviews
                0163-7525
                1545-2093
                April 2019
                April 2019
                : 40
                : 1
                : 147-166
                Affiliations
                [1 ]Department of Social Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina 27599, USA;
                [2 ]Department of Sociology, University of California, Santa Cruz, California 95064, USA;
                Article
                10.1146/annurev-publhealth-040218-044115
                6494096
                30601722
                279223b5-bac8-47e7-92a5-2ad3d77b7e09
                © 2019
                History

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