Summary
Summary: While immigrants in the U.S. suffer poor access to health care in general, access within immigrant populations varies notably by legal status and employment. Intersections between immigration, employment, and health care policy have shaped immigrants' access or exclusion from health care; however, little research has examined how immigrants experience and navigate these intersections.
Drawing on social exclusion theory and the theory of bounded agency, researchers aimed to investigate Mexican and Chinese immigrants' experiences of exclusion from health care as one key dimension of social exclusion and how this was shaped by interactions with the institutions of immigration and employment.
The examination of two ethnic immigrant groups who live under the same set of policies allows for a focus on the common impacts of policy. Authors selected Mexican and Chinese immigrants as the two largest subgroups in California's Latinx and Asian immigrant population. Authors use a policy lens to analyze qualitative data from the mixed-methods Research on Immigrant Health and State Policy (RIGHTS) Study, involving 60 in-depth interviews with Mexican and Chinese immigrants in California between August 2018–August 2019. Researchers identified two primary themes: pathways of social exclusion and access, and strategies used to address social exclusion.
This article references various studies that use California Health Interview Survey (CHIS) data and is based on interviews conducted as part of the RIGHTS study.
Findings: Findings show that immigrants' exclusion from health care is fundamentally linked to legal status and employment, and that immigrants navigate difficult choices between opportunities for improved employment and changes in legal status. Authors argue that multiple categories of legal status affect immigrants' employment opportunities and social position, which, in turn, translates to stratified health care access. Their findings support the literature establishing legal status as a mechanism of social stratification but challenge legal-illegal binary paradigms.
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