Journal of Adolescent Health
Volume 55, Issue 3, 2014, Pages 323-328

There is no help out there and if there is, it's really hard to find": A qualitative study of the health concerns and health care access of latino "dREAMers (Article)

Raymond-Flesch M.* , Siemons R. , Pourat N. , Jacobs K. , Brindis C.D.
  • a Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Francisco, 3333 California Street, San Francisco, CA 94118, United States
  • b Joint Medical Program, University of California Berkeley, University of California San Francisco, Berkeley, CA, United States
  • c Department of Health Services, University of California Los Angeles, School of Public Health, Los Angeles, CA, United States
  • d Center for Labor Research and Education, University of California Berkeley, Berkeley, CA, United States
  • e Philip R. Lee Institute for Health Policy Studies, Department of Obstetrics, Gynecology, and Reproductive Health, University of California San Francisco, San Francisco, CA, United States

Abstract

Purpose Young immigrants without documentation who qualify for the Deferred Action for Childhood Arrivals (DACA) program are eligible for temporary legal status but excluded from the Affordable Care Act's Medicaid expansion and Health Care Exchanges. Little is known about this population's health or access to care. Methods Sixty-one DACA-eligible Latinos aged 18-31 years were recruited from community and Internet settings to participate in nine focus groups in California. An advisory board of immigration and health advocates assisted in the project's design and validation of results. Results Participants reported avoiding the health care system whenever possible, first turning to family members and unlicensed community healers, then seeking safety net providers if necessary. Barriers to care included cost, limited intergenerational knowledge about the health care system, lack of a driver's license, and mistrust of providers due to fear of discrimination and deportation. Mental health care was the greatest unmet health need. They wanted more information about their health care options and access to primary care, dental, and vision benefits. Participants reported refraining from high-risk behaviors to avoid associated financial and legal burdens that might threaten their immigration status. Conclusions As the first study to describe DACA-eligible young adults' health needs, these data demonstrate their profound mental health challenges and numerous barriers to health care access. Many barriers were attributed to their undocumented status and persisted even when they gained temporary legal status. This work provides a foundation for evidence-based policy changes to address the health needs of this and other undocumented populations. © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Author Keywords

Health services accessibility Latino immigrants Health literacy Immigration Undocumented

Index Keywords

information processing physical activity anxiety mental health care Communication Barriers depression mistrust dental health primary medical care traditional healer health care personnel health insurance human community immigration Health Behavior communication disorder injury health service coping behavior health status diet priority journal substance abuse Internet Hispanic Americans qualitative research Health Services Needs and Demand knowledge academic achievement psychology United States Young Adult health care cost Humans vision migrant Hispanic Adolescent California male avoidance behavior family female health services research stress Emigrants and Immigrants medical information health services safety net hospital Article high risk behavior online system help seeking behavior adult health care access utilization child advocacy adulthood normal human Health Services Accessibility health care system driver licence Trust Focus Groups social discrimination health literacy Fear citizenship employment health care need health care delivery

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84906555387&doi=10.1016%2fj.jadohealth.2014.05.012&partnerID=40&md5=8260899252fe5db9d557eb485920b61b

DOI: 10.1016/j.jadohealth.2014.05.012
ISSN: 1054139X
Cited by: 46
Original Language: English