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September 14, 2018

Undocumented immigrants see doctors less often, but are they healthier than other U.S. populations?

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Stock_Carroll - Drexel University Thom Carroll/PhillyVoice

Drexel University.

Undocumented immigrants are among the least likely populations in the United States to seek out health care services, yet their health compared to other demographic groups appears to be better, according to researchers at Drexel University.

The findings come from a health survey conducted between 2011 and 2015 in California, where approximately 51,000 people answered questions about their health care use, access to health care and physical and mental conditions at the time. The survey covered a representative sample of all younger, Latino and US-born, non-Latino white adults, among whom about 3,000 people were undocumented immigrants.

“There are significant disparities in access to and utilization of health care by legal authorizations status,” said Alex Ortega, who led the study and serves as chair of Drexel's Department of Health Management and Policy. . “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 undocumented immigrants in the study have any form of health insurance, while about four in 10 reported not having a regular source of care or having seen a doctor at all.

While 61 percent of white people reported being in "excellent" or "very good" health, just 25 percent of undocumented immigrants said the same.

And yet undocumented immigrants were among the least likely to receive a diagnosis of high blood pressure, heart disease or asthma.

“The political talking point that undocumented immigrants come to the U.S. and overburden our health care system is not evidenced by our findings," said Ortega, who pointed out this Latino immigrants have a lower risk of chronic disease than other immigrants and U.S. citizens.

Still, Ortega cautioned that it's not entirely clear why those who see doctors more infrequently, if at all, would be be less prone to chronic disease.

“There are two ways to interpret this,” Ortega said. “One way is that immigrants are not accessing services because they do not have a medical need. 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.”

The study also found that 77 percent undocumented respondents were unlikely to seek mental health services, particularly because of the high associated costs.

Ortega said that the trends away from health care for undocumented immigrants have gotten worse since he conducted a similar study 15 years ago. Some municipalities in California, recognizing that the the current situation poses long-term risks, have introduced programs that allow health care access for Latinos regardless of their documentation status.

“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 said. “California and its localities have learned that providing care — particularly preventive care — can save costs and improve population health.”

The full study was published this week in the journal Medical Care.