Differences in Barriers to Healthcare and Discrimination in Healthcare Settings Among Undocumented Immigrants by Deferred Action for Childhood Arrivals (DACA) Status

Abstract

Undocumented immigrants face barriers to and discrimination in healthcare, but those with Deferred Action for Childhood Arrivals (DACA) status may fare better. This analysis uses the cross-sectional BRAVE Study of young undocumented Latinx and Asian immigrants to examine differences in barriers to and discrimination in healthcare by DACA status. A majority of respondents experienced financial, language, and cultural barriers, and up to half experienced documentation status barriers, discrimination when seeking healthcare or by a health provider, and negative experiences related to documentation status. In multivariable analyses, DACA recipients have over 90% lower odds of language and cultural barriers, approximately 80% lower odds of discrimination when seeking healthcare and by a health provider, and approximately 70% lower odds of documentation status barriers and negative experience related to documentation status compared to nonrecipients. These findings indicate that DACA recipients experience fewer barriers to healthcare and discrimination in healthcare compared to nonrecipients.

Barriers and facilitators to healthcare for people without documentation status: A systematic integrative literature review

“…Policy-level barriers at the state and federal levels restricted access to healthcare for PWDS and perpetuated systems of discrimination. These findings are consistent with international research outside the US, demonstrating the multidimensional and transnational barriers to healthcare faced by PWDS around the globe resulting in lower utilization of healthcare services by this population (Abubakar et al, 2018;Hacker et al, 2015;Lebano et al, 2020;Winters et al, 2018).…”

“…Even in settings with interpreters or translators, PWDS described interpreters who were not fluent in their native language, resulting in poor communication with providers (Armenta & Sarabia, 2020; Dang et al, 2012). Asian PWDS had over six times higher odds of experiencing language barriers compared with Latinx PWDS (95% CI; 2.16, 20.17; Woofter & Sudhinaraset, 2022). Cultural differences also posed a barrier, with one PWDS describing how she did not like to visibly express her emotions even when she was in pain because she believed severe emotions could lead to serious physical consequences (Chandler et al, 2012).…”

“…Discrimination was a common experience for PWDS. Among 203 young adults WDS, 30% reported experiencing discrimination by a healthcare provider and 41.9% when seeking health services (Woofter & Sudhinaraset, 2022). PWDS perceived discrimination not only due to their immigration status but also due to race, ethnicity, skin colour and gender identity (Armenta & Sarabia, 2020).…”

“…In addition, DACA status provided the ability to obtain a driver's licence, which facilitated travel to healthcare services. DACA recipients reported fewer barriers to heath care and discrimination (Woofter & Sudhinaraset, 2022), and were less likely to report gaps in care compared to non‐recipients (65.9% vs. 84.6%; Sudhinaraset, Ling, et al, 2022; Sudhinaraset, Choi, et al, 2022).…”

“…Consequently, addressing the healthcare needs for migrants, including PWDS, is a major public health challenge around the world. A review of literature on the use of healthcare by PWDS in Europe (Winters et al, 2018) found that PWDS underutilized healthcare services compared to legally residing migrants, even in countries that provided high levels of access to primary and secondary care (e.g., Italy, Portugal). In Latin America, Mexico has become a significant migration route to the US, with increased numbers of migrants fleeing persecution, violence and natural disasters.…”