Undocumented Patients in the Emergency Department: Challenges and Opportunities

Samra, Shamsher; Taira, Breena R.; Pinheiro, Erika; Trotzky-Sirr, Rebecca; Schneberk, Todd

doi:10.5811/westjem.2019.7.41489

Cited by 24 publications

(15 citation statements)

References 34 publications

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“…We identified 24 relevant publications: 376 – 399 20 observational studies 376 – 395 ; one interventional study 399 ; and three commentary publications. 396 – 398 All observational publications investigated ED utilization in immigrant vs non-immigrant groups, with some specifically assessing Latino populations. Two publications (10%) studied the fear of ED utilization among Latino populations.…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

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Introduction: Social emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed. Methods: We conducted a comprehensive PubMed search using Medical Subject Heading terms and phrases pertaining to social EM topic areas (e.g., “homelessness,” “housing instability”) based on previously published expert consensus. For searches that yielded fewer than 100 total publications, we used the PubMed “similar publications” tool to expand the search and ensure no relevant publications were missed. Studies were independently abstracted by two investigators and classified as relevant if they were conducted in US or Canadian emergency departments (ED). We classified relevant publications by study design type (observational or interventional research, systematic review, or commentary), publication site, and year. Discrepancies in relevant publications or classification were reviewed by a third investigator. Results: Our search strategy yielded 1,571 publications, of which 590 (38%) were relevant to social EM; among relevant publications, 58 (10%) were interventional studies, 410 (69%) were observational studies, 26 (4%) were systematic reviews, and 96 (16%) were commentaries. The majority (68%) of studies were published between 2010–2020. Firearm research and lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research in particular grew rapidly over the last five years. The human trafficking topic area had the highest percentage (21%) of interventional studies. A significant portion of publications -- as high as 42% in the firearm violence topic area – included observational data or interventions related to children or the pediatric ED. Areas with more search results often included many publications describing disparities known to predispose ED patients to adverse outcomes (e.g., socioeconomic or racial disparities), or the influence of social determinants on ED utilization. Conclusion: Social emergency medicine research has been growing over the past 10 years, although areas such as firearm violence and LGBTQ health have had more research activity than other topics. The field would benefit from a consensus-driven research agenda.

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Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

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“…We found that patients utilizing Emergency Medicaid were nearly three times as likely to die as patients utilizing commercial insurance ( These observations are aligned with research showing poorer health outcomes among patients who delay receiving care, particularly immigrants. 41,42,43 These patients also may have presented with more severe COVID-19 illness owing to a lack of engagement with health care and concerns over presenting for care in light of federal rulings on public charge and immigration enforcement. We found that Chinese patients were most frequently new to NYC H+H (50.6%), which may reflect their known reluctance to and delay in seeking care, as described above.…”

Section: Covid-19 Outcomes Of Asian American Patientsmentioning

confidence: 99%

Disaggregating Asian Race Reveals COVID-19 Disparities among Asian Americans at New York City’s Public Hospital System

Marcello

Dolle

Tariq

et al. 2020

Preprint

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There is growing recognition of the burden of COVID-19 among Asian Americans, but data on outcomes among Asian ethnic subgroups remain extremely limited. We conducted a retrospective analysis of 85,328 patients tested for COVID-19 at New York City’s public hospital system between March 1 and May 31, 2020, to describe characteristics and COVID-19 outcomes of Asian ethnic subgroups compared to Asians overall and other racial/ethnic groups. South Asians had the highest rates of positivity and hospitalization among Asians, second only to Hispanics for positivity and Blacks for hospitalization. Chinese patients had the highest mortality rate of all groups and were nearly 1.5 times more likely to die than Whites. The high burden of COVID-19 among South Asian and Chinese Americans underscores the urgent needs for improved data collection and reporting as well as public health program and policy efforts to mitigate the disparate impact of COVID-19 among these communities.

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“…With estimates suggesting that as many as 68% of undocumented immigrants lack health insurance coverage and that only about 1 in 5 ULIs having access to health insurance via their employer, it is perhaps not surprising that the health services that are deemed as preventative and/or require established care are also those that ULIs reported having the most difficulties with [12,13,18]. On the other hand, it is equally not surpring that ULIs reported that they encountered the least number of difficulties with emergency medical services as these services are typically available to most to some degree regardless of insurance status or immigration legal status [12,38]. Furthermore, referencing the robust literature suggesting that Latino/a do not seek mental health services at the same rate as their Non-Hispanic White counterparts and that they are more likely to receive mental health support from informal routes, it is also somewhat expected that participants would report the least number of difficulties in accessing this type of care [39,40].…”

Section: Assessment Of Resultsmentioning

confidence: 99%

Another Brick in the Wall: Healthcare Access Difficulties and Their Implications for Undocumented Latino/a Immigrants

Galvan

Lill

Garcini

2021

J Immigrant Minority Health

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The mounting evidence highlighting the disproportionate impact of the COVID-19 pandemic in ethnic minority communities underscores the need to understand how distress and healthcare access impacts the well-being of undocumented Latino/a immigrants (ULIs), one of the most marginalized and vulnerable ethnic minority communities in the U.S. We used existing data from a cross sectional study (Proyecto Voces) of 252 ULIs to conduct path analyses that explored the relations among distress due to immigration legal status, healthcare access difficulties, and the health of ULIs. Results demonstrated that distress due to immigration legal status is related to the physical and mental health of ULIs, and that difficulties in accessing healthcare explained these relations. These data support the importance of immediate, targeted efforts for increasing access to healthcare among undocumented immigrants and highlight the long-term importance of a much-needed healthcare reform for improving access to marginalized populations.

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Undocumented Patients in the Emergency Department: Challenges and Opportunities

Cited by 24 publications

References 34 publications

A Scoping Review of Current Social Emergency Medicine Research

A Scoping Review of Current Social Emergency Medicine Research

Disaggregating Asian Race Reveals COVID-19 Disparities among Asian Americans at New York City’s Public Hospital System

Another Brick in the Wall: Healthcare Access Difficulties and Their Implications for Undocumented Latino/a Immigrants

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