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APHA Scientific Session and Event Listing

Andreea Seicean, Public Health & Pre-Profession Medical Program, Case Western Reserve University, 368 Columbia Rd., Bay Village, OH 44140, (440) 503-7288, andreea.seicean@case.edu, Sinziana Seicean, MD MPH, Department of Epidemiology and Biostatistics, Public Health Division, Case Western Reserve University, 368 Columbia Rd., Bay Village, OH 44140, and Nicholas King, PhD, Departments of Bioethics and History, Case Western Reserve School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106.

Most cultures recognize the importance of the extended family as a key agent in society. The separation of elderly parents from their adult children due to immigration to the United States leads to fragmentation and social isolation for hundreds of thousands of families. Since naturalized citizens have the legal right to bring their parents to the US, some elderly parents choose to rejoin their children, in order to reestablish family cohesion. These elderly immigrants often acquire (or already have) medical needs. However, while they may have had access to free health services in their native countries, obtaining healthcare in the US is very difficult for them. Due to their age, the cost of private health insurance policies is very high and may not be affordable to many of them. Preexisting health conditions, such as hypertension or diabetes, also exclude health insurance coverage from the private sector. Despite being here as legal immigrants and qualifying for all income and status criteria, they have been unable to use Medicare and other social welfare programs, since the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). With tremendous impact on the physical and psychological wellbeing of elderly immigrants, 64% of whom prior to 1996 depended on Medicaid, many play a lottery with their health in order to remain with their families, with poorly understood effects on the general immigrant population.

Learning Objectives:

• •Identify the emotional burdens placed upon separated families
• •Recognize the reasons that elderly (aged 65 and over) individuals immigrate to the United States
• •Evaluate the impact of government welfare programs such as Supplemental Security Income (SSI), food stamps, and most importantly Medicaid
• •Analyze the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA)
• •Assess the impact of the PRWORA in its 1st year after implementation
• •Identify the long term effects after Congress reformed to the PRWORA in 1997
• •Describe the current health status of elderly immigrants
• •Identify the ethical issues raised by health inequalities among elderly immigrants

Keywords: Access, Elderly

Presenting author's disclosure statement:

Not Answered