I spent my early years growing up on the brown side of the tracks. The Southern Pacific Railroad bifurcated my town, and the transition was dramatic. On my side, there were small houses with colorful flower bursts dotting the well-kept gardens. The paved roads dropped off after about two blocks from the main road through town, melting into hard, brown dirt roads scattered with gravel. We walked the few blocks to the bakery where you selected the slightly-sweet, colored breads off trays with tongs, or brought your saucepans on Saturday morning for “menudo,” a weekend favorite meal, or for steamy tortillas thrown in a stack and wrapped in pink paper to be carried home.
On the other side of the tracks, the streets were wide and meticulously paved, houses larger, grander and tending to be more sedate. The parking lots were built in front of the stores, making shopping a little easier.
As I have traveled America visiting APHA’s affiliated state and regional public health associations, I have met many immigrants. Every one of us who has ever worked in public health has known or taken care of many of these people. We know them as co-workers, translators, nurses, doctors, sanitarians and academics as well as clients. Many of them come from communities where they have to buy water not because they favor the taste, but to avoid disease; where girls do not hold the same values as boys; or where poverty or conditions of war simply made living unbearable. The people I met work as hard or harder than any of us.
However, undocumented and documented immigrants are less likely to have health coverage. Low-income workers are less likely to have employer-based health coverage. Welfare reform over the past few decades has limited immigrant access to public programs. Almost twice as many immigrants are not likely to have a source of care compared to low-income native citizens. Immigrants are less likely to utilize health services compared to native-born people. The long-awaited health reform law passed this year will provide health benefits for nearly all in this country, except immigrants.
Unfortunately, discrimination against immigrants continues to occur in some parts of this country. In July, news reports detailed an effort by some in Utah to publicize the names, addresses and personal information of possible undocumented immigrants in hopes that those on the list would be deported. Given the political vitriol that has been hurled at this issue over the last few years — the lack of health coverage, lack of health care access and lower utilization — this is a time bomb ready to explode. The next disaster or epidemic that hits a population group worried that public officials will have them deported breeds a dangerous brew.
We all live here together, and it is the responsibility of all public health workers to make certain that we are working to assure the conditions in which people can be healthy — which includes all of the people.
- Copyright The Nation’s Health, American Public Health Association
