Discrimination based on cultural differences within the medical field is unfortunately common in the United States, particularly when it comes to vulnerable populations. Despite how far we have come as a nation and as a profession, research has shown that ethnic minorities and those living in poverty receive a lower quality of care and have a higher mortality rate. The quality of care is due to several reasons including: access, fear, and financial difficulties. Undocumented immigrants are especially affected by this trend, and because of their legal status, quality medical care can be hard to obtain.
In the case of Leticia Renteria, she is an undocumented immigrant who although is married to a United States citizen still lived in fear of being deported. She has had three children since coming to the United States, all of whom suffer from asthma and lack of necessities such as food and clean living conditions. Her living conditions do not help with managing their illness. The rural trailer park she lives in falls bellow livable standards. “Water coming from the well has recently been tested and reveals impermissibly high levels of arsenic contamination...homes are relying on septic systems, which unfortunately frequently fill or clog up, resulting in overflow, stench, …. down the street sits an illegal dump, …which now causes an unbearable stench and sometimes smoke in Leticia’s settlement” (Hutchison, 2018).. Leticia like many others in her region is living in poverty, and with poverty comes many environmental factors that serve only to exacerbate her and her family’s illnesses. Her living situation also increases their chances of contracting a more dangerous disease such as “toxocariasis, strongyloidiasis, dengue fever; toxoplasmosis, syphilis, and even leptospirosis”(Hortez,2018). This combined with the lack of constant nutritious meals, due to an insignificant knowledge of food stamps and another government aid has left her children in danger of future developmental problems.
One of the major barriers to quality medical care is access to reliable and consistent transportation. Like many living in poverty, Leticia and her family have only one means of transportation, which her husband takes while she is not working” (Hutchison, 2018). Marcos has the family’s only car at his work,..the nearest public transportation stop is more than 5 miles”. This severely limits her options and impacts both her and her family’s health. Each year over “3.6 million people in the United States” try and fail to obtain quality medical care due to their lack of transportation. Many of them like Leticia face the difficult choice between going to work and going to the doctors. Unfortunately, both Leticia and her husband work in professions where missing a single day of work can be the difference between eating or not eating. Because of this, they often put their health aside and postpone any necessary doctor’s visits. This affects their health greatly, one small medical issues can be compounded into something dire. What once could be treated with a simple medicine regiment now requires hospitalization. The lack of transportation also means that Leticia and her children are often trapped in their homes. The environment of their home is debilitating for their overall health; being trapped there most likely causes them to be sick more often. With the nearest public transportation miles away, even going grocery shopping is impossible “the nearest grocery stores, services, and recreation are more than 10 miles away.” (Hutchison, 2018). This not only limits where they can go, it also limits what they can eat. Without being able to go to the grocery store often, Leticia is most likely reduced to instant and frozen meals. These kinds of meals offer minimal nutrition, increasing the chances of malnutrition to set in along with all the health issues that accompany it. Even when Leticia manages to go to the doctors for her children’s asthma, she only goes to a small local clinic. This clinic, while it provides her medication does not have the resources to fully help with her families health issues.” the community clinic ...does not keep any data related to these kinds of causes and does not connect patients’ health indicators to any environmental factors'(Hutchison, 2018). Because of this, not only are her children in danger of even worse health issues, the clinic may not have access to information that could provide Leticia better options for treating her children’s asthma, or how to manage her environment to hopefully limit the impact it has on their health.
Leticia's lack of financial resources also has affected the quality of health care she and her family receives. Leticia and her family live in poverty, not making enough for necessities such as food shelter and medical care “ only bringing home a little more than $20,000 per year. This is far from enough to support their family of five” (Hutchison, 2018). One of the reasons Leticia only goes to the community clinic is because they cannot afford to go to a different better doctor. The annual cost for treatment of asthma is $3,266 per person all three of Leticia children have been diagnosed with some degree of asthma, which equals $ 9,798 total. That expense is almost half of their annual income. Because of this Leticia like many others, most likely either limit the use of medication to emergencies or share prescriptions. Those living in poverty face a difficult decision, between food and shelter or medications. The degree of discrimination increases, when dealing with undocumented immigrants. Many of them like Leticia are unable to find consistent and safe work due to their status. Many higher-paying jobs require potential employees to submit to either a background check or to provide a social security number. Because of this many are often forced to take seasonal low paying jobs. Leticia is forced to take jobs where she feels unsafe just get by, she is unable to complain because of her status as undocumented.
The last factor in the discrimination of medical care is fear. Leticia like many other undocumented immigrants fear being deported to their native country. This fear leads many to avoid seeking medical care even when they are gravely ill, choosing instead to self-medicate with over the counter medications in hopes they will get better. It is unfortunate that discriminatory practices exist within the health care system, while undocumented immigrants are protected under HIPPA there is still underlying fact that it just takes one anonymous call to ICE by a medical professional to have them deported. Many immigrants fear speaking their own native language. In the current political climate, speaking Spanish could have law enforcement called on you. In response to this, many immigrants who do seek medical attention go to lower quality establishments that do not ask many questions. They might also choose not to fill out prescription, to avoid being noticed by officials. As a consequence Leticia and her family’s health is poor, her children are in also in high risk for irreparable damage or death due to their asthma. Asthma is a chronic condition and requires not only medication but consistent doctors appointments to manage their symptoms. After her traumatic experience of being stopped and deported , when going to work she will most likely fear keeping up with doctors appointments anymore if was before in fear of being incarcerated again.
Leticia Like many other undocumented immigrates face challenges in obtaining medical care that many cannot fathom, due to circumstances outside of her control. Leticia came to the United States in search of the American dream, but because of her legal status she faces discrimination in medical care , making it almost impossible for her and her family to receive quality care that all Americans live healthily lives. More safeguards need to be put into place to not only protect undocumented immigrants like Leticia, but also their legal children .The of fear retribution or deportation has stoped many parents from looking for aid to help their children.
References
Hacker, K., Anies, M., Folb, B. L., & Zallman, L. (2015). Barriers to health care for undocumented immigrants: a literature review. Risk management and healthcare policy, 8, 175–183. doi:10.2147/RMHP.S70173
Hotez, P. J. (2008). Neglected infections of poverty in the United States of America. PLoS neglected tropical diseases, 2(6), e256.
Hutchison, E. D. (2018). Dimensions of human behavior (sixth edition.). Thousand Oaks, CA: SAGE Publications Incorporated.
Social Determinants of Health Series: Transportation and the Role of Hospitals: AHA. (2017). Retrieved from https://www.aha.org/ahahret-guides/2017-11-15-social-determinants-health-series-transportation-and-role-hospitals.