Undocumented immigrants least likely to visit doctor, yet healthier than many others

PHILADELPHIA — Undocumented immigrants sit among those at the bottom when it comes to health care use in America, but interestingly, they also might not need it as much as everyone else, a new study finds.

Researchers at Drexel University analyzed data collected during a California health survey conducted between 2011 and 2015 and found that while undocumented immigrants are the least likely population to seek medical treatment, the minority group as a whole is healthier on average than many other populations.

“There are significant disparities in access to and utilization of health care by legal authorizations status,” notes Dr. Alex Ortega, department chair of Health Management and Policy at Drexel and lead author of the study, in a university release. “And given the current political climate that is very hostile to immigration — especially from Latin America — we can only expect the disparities to get worse.”

Less than half of the 3,000 undocumented immigrants surveyed in the study had any type of health insurance, and about 40% had no access to regular medical care. About 61% of the white respondents said they had “excellent” or “very good” health overall, compared to only about 25% of immigrants not in the country legally.

But undocumented immigrants were among the least likely of the populations surveyed to be diagnosed with common health problems like high blood pressure, asthma, and heart disease.

“They have lower risk of chronic disease than other immigrants and U.S. citizens,” says Ortega. “The political talking point that undocumented immigrants come to the U.S. and overburden our health care system is not evidenced by our findings.”

As for how so many people could seemingly have such better health without having adequate health care, Ortega sees two ways to interpret it.

“One way is that immigrants are not accessing services because they do not have a medical need,” he says. “Another way is that they do not have physician-based diagnoses of chronic disease because they have not used primary care and preventive services that would provide the opportunity to be screened and diagnosed.”

Still, some of that may also be voluntary. More than three-quarters of undocumented immigrants (77%) say they wouldn’t seek help for mental health concerns because it was too expensive. Less than one in 20 said they’d met with a mental health professional in the past year, the lowest rate for populations measured by the survey.

“Delaying care can result in having diseases that become more difficult to treat and manage, making their medical costs more expensive in the long-run,” Ortega adds. “California and its localities have learned that providing care — particularly preventive care — can save costs and improve population health.”

The full study was published on September 12, 2018 in the journal Medical Care.

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