Health care access and advocacy with immigrants; Legal and ethical issues for public health social workers

An increasing number of Americans seeking health care are immigrants. By mid century newcomers will make up almost half of the population in the United States. Thus information on immigrant status becomes crucial in understanding health care access and resultant disparities. Social workers in public health have continually sought to help immigrants access, utilize, and follow up on health care. The legal status of immigrants, however, often detrimentally affects immigrants' access to health care. The first part of this presentation will focus on the legal definitions of newcomers, including legal immigrants, refugees, and undocumented immigrants, grounds for deportation (which includes health issues), and entitlement to public benefits. Since access to health care is often based upon legal status, those that have entered the United States illegally often face the greatest barriers in seeking health care. Lack of preventive or adequate health care contributes to health disparities in immigrant populations as evidenced by acute and chronic illness. Based upon the NASW Code of Ethics, as well as the Public Health Standards and Competencies, public health social workers have an ethical commitment to help their clients regardless of ethnicity, nationality, or cultural difference to access health care, yet their efforts have often been thwarted by policy limitations to health care for non-citizens. The presentation will close with a discussion of advocacy strategies with individual clients as well as agencies and communities that public health social workers can use to help their immigrant clients receive needed health care.