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Health is the Human Denominator. Where is the Access?

by Dr. Sofía Gómez, Public Health Researcher and Practitioner

Health equity in the U.S. remains an economic, social, and political issue. If there is any small silver lining in COVID-19’s dark clouds, it is that the pandemic has beckoned us as citizens to reflect on our society’s common denominator: our health.

COVID-19 has also confirmed our reliance on essential workers, many whom are immigrants who continue to provide critical services while most of us safely shelter in place. Why then are accessibility and availability of healthcare still such a barrier for our immigrant communities?

The answer is the lack of immigration reform coupled with increasingly restrictive immigration policies have created huge gaps in care for immigrants. Notwithstanding the efforts of the Obama administration, the fact is that access and quality of healthcare persist. Nowhere are the inequities more visible than among immigrant families that are often made up of mixed status households.  Due to the lack of a comprehensive immigration reform, many immigrant households are fragmented not only by their immigration status but also by their accessibility to healthcare.

Bottom line: Immigrants continue to have limited access, if at all, and lower quality of care than majority of Americans. Recent Studies already predict that COVID-19 will most likely disproportionately impact immigrant communities.

Like many past epidemics and pandemics, social and economic factors sharply influence COVID-19’s infection rates and health outcomes.  Consequently, low-income and vulnerable populations will continue to be disproportionately affected.  At-risk populations, and particularly immigrants who often work in lower paying jobs with no employer sponsored health care, have higher rates of co-morbidities. Healthcare insurance and affordable access is critical for supporting the growing needs of our current public health crisis. How state and local governments respond to increased restrictive federal legislation can either widen the gap or improve health equity within immigrant communities.

Immigrants have limited access, if at all, and lower quality of care than majority of Americans.

Just as states like Arizona have exercised local powers to further restrict public health benefits to immigrant communities, state and local governments can use their discretionary powers to expand services to them, as we have seen in the case of California. DACA-mented Voices in Healthcare Project, a project I led in Arizona, explored the healthcare experiences of undocumented youth with Deferred Action for Childhood Arrivals (DACA) status (the recipients often refer to themselves as “DACA-mented” playing off terms of documented and undocumented). Participating DACA-mented youth illustrated their problems through photographs, stories, and poems (also known as the photovoice method). Powerful images illustrated their immigrant households’ healthcare experiences – from high medical cost, discrimination, fear of being identified as undocumented to the possibility of deportation and separation from family. What did DACA-mented youth ask for? Recognition of their humanity through inclusion, equity, unity, and justice.

DACAmented youth have set a unique example through their commitment to social justice. Members of DACA-mented Voices in Healthcare ask for equity in access to primary care and mental health services, tailored and inclusive services, and a healthcare workforce that reflects their community. Their collective message is to acknowledge that all persons within the United States are entitled to health care as a basic human right.


Dr. Sofia Gómez is currently working as a Senior Researcher with the County of Santa Clara’s Social Service Agency in San Jose, CA. She obtained her doctorate in public health at the University of Arizona’s Mel & Enid Zuckerman College of Public Health. Her doctoral research examined immigrant families’ healthcare experiences in Arizona’s restrictive political climate.

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