Denial of Care to Illegal Immigrants — Proposition 187 in California

Ziv, Tal Ann; Lo, Bernard

doi:10.1056/nejm199504203321612

Cited by 67 publications

(24 citation statements)

References 4 publications

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“…Proposition 187 intended to discontinue undocumented immigrants' eligibility for most health services while mandating that health care professionals report suspected undocumented patients to authorities. [47][48][49][50][51][52][53][54][55] The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, the Welfare reform, greatly restricted the provision of public services to undocumented immigrants and based eligibility on citizenship status. [56][57][58] This adverse social climate for immigrants has been progressively exacerbating.…”

Section: Discussionmentioning

confidence: 99%

Impact of U.S. Citizenship status on cancer screening among immigrant women

et al. 2005

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Objectives: We evaluated the relationship between U.S. citizenship status and the receipt of Pap smears and mammograms among immigrant women in California. Design: Cross‐sectional study using data from the 2001 California Health Interview Survey. Patients/Participants: Noninstitutionalized, civilian women, aged 18 years and older living in California. Measurements And Main Results: We analyzed data from the 2001 California Health Interview Survey and used logistic regression models to adjust for sociodemographic factors and for access and utilization of health services. After adjusting we found that U.S. citizen immigrants were significantly more likely to report receiving a Pap smear ever (adjusted prevalence ratio [aPR], 1.05; 95% confidence interval [CI], 1.01 to 1.08), a recent Pap smear (aPR, 1.07; 95% CI, 1.03 to 1.11), a mammogram ever (aPR, 1.17; 95% CI, 1.12 to 1.21), and a recent mammogram (aPR, 1.38; 95% CI, 1.26 to 1.49) as compared to immigrants who are not U.S. citizens. Also associated with receiving cancer screening were income, having a usual source of care, and having health insurance. Hispanic women were more likely to receive Pap smears as compared to whites and Asians. Conclusions: Not being a U.S. citizen is a barrier to receiving cervical and breast cancer screening. Additional research is needed to explore causal factors for differences in cancer screening rates between citizens and noncitizens.

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Section: Discussionmentioning

confidence: 99%

Impact of U.S. Citizenship status on cancer screening among immigrant women

et al. 2005

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“…[3][4][5][6][7][8][9][10] After Proposition 187 passed, community health care providers in California reported declines in visits from UDLI, despite the proposition never having taken effect. [6][7][8][11][12][13][14] Several studies have demonstrated that UDLI use EDs and other ambulatory health care services at significantly lower rates than non-Latinos and U.S.-born Latinos. 1,4,[15][16][17][18][19] This lower rate of utilization may arise from fear of accessing these services.…”

mentioning

confidence: 99%

Fear of Discovery Among Latino Immigrants Presenting to the Emergency Department

Maldonado

Rodriguez

Torres

et al. 2013

Academic Emergency Medicine

105

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Objectives: Recent legislation mandating reporting of undocumented immigrants may instill fear of discovery when they access emergency department (ED) services. The objectives of this study were to: 1) characterize the knowledge and beliefs of undocumented Latino immigrants (UDLI) about health care workers' reporting (or nonreporting) of illegal immigrants in the ED, 2) determine whether UDLI fear discovery when presenting to the ED, and 3) determine the nature and sources of this fear.Methods: This was a cross-sectional study of UDLI and two comparison groups conducted in two California county EDs, from November 2009 to August 2010. The authors interviewed a convenience sample of adult UDLI, Latino legal residents (LLR), and non-Latino legal residents (NLLR) using a structured instrument in their native language. The main outcome was fear of discovery among UDLI and the sources of that fear.Results: Of 1,224 patients approached, 1,007 (82.3%) were interviewed: 314 UDLI, 373 LLR, and 320 NLLR. The median age was 43 years (interquartile range [IQR] = 31 to 55 years), and 51% were male. UDLIs were less likely to speak English (14%, 95% confidence interval [CI] = 10% to 18%), have health insurance (39%, 95% CI 32% to 44%), or have a regular primary care provider (PCP; 39%, 95% CI = 34% to 45%), compared to LLR (English 56%, 95% CI = 51% to 61%; health insurance 50%, 95% CI = 45% to 55%; regular PCP 51%, 95% = CI 46% to 57%) and NLLR (English 95%, 95% CI = 92% to 97%; health insurance 49%, 95% CI = 43% to 54%; regular PCP 51%, 95% CI = 45% to 56%). Of the 16% of UDLI who stated that nurses and doctors treat undocumented immigrant patients differently than citizens, 41% (95% CI = 29% to 54%) reported less respect given to UDLI by staff. Thirty-two percent of UDLI had heard of Proposition 187, 13% believed hospital staff reported UDLI to immigration authorities, and 9% said they were asked about their citizenship status. Fear of coming to the hospital because of discovery was expressed by 12% (95% CI = 9% to 16%) of UDLI, with 42% (95% CI = 28% to 58%) citing discussions with friends/family, 32% (95% CI = 19% to 47%) citing media and 16% (95% CI = 7% to 30%) citing both as sources of this fear. Conclusions:One in eight of UDLI presenting to the ED express fear of discovery and consequent deportation. Belief that medical staff report UDLI and recent immigration are risk factors for this fear. Family, friends, and media are the primary sources of these concerns.ACADEMIC EMERGENCY MEDICINE 2013; 20:155-161

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“…The potential for significant health problems, including epidemic disease, that can potentially result from such an underserved segment of our population is alarming, to say the least. [66][67][68][69] As pediatricians and children's health professionals, we have a major stake in the success of meeting these challenges with creative and culturally sensitive solutions. These include the refinement and development of community and schoolbased clinics in immigrant neighborhoods; linkage of such efforts with educational training programs for today's health professionals in training; and active research that investigates the social, cultural, and health needs of these diverse communities.…”

Section: Discussionmentioning

confidence: 99%

Caring for the Foreign Born

Markel

1998

Arch Pediatr Adolesc Med

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Denial of Care to Illegal Immigrants — Proposition 187 in California

Cited by 67 publications

References 4 publications

Impact of U.S. Citizenship status on cancer screening among immigrant women

Impact of U.S. Citizenship status on cancer screening among immigrant women

Fear of Discovery Among Latino Immigrants Presenting to the Emergency Department

Caring for the Foreign Born

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