Social Science and Medicine
Volume 74, Issue 6, 2012, Pages 822-829

Beyond welfare reform: Reframing undocumented immigrants' entitlement to health care in the United States, a critical review (Article)

Viladrich A.*
  • a Queens College and The Graduate Center, The City University of New York, Flushing, New York City, NY 11367, United States

Abstract

This article addresses the main scholarly frames that supported the deservingness of unauthorized immigrants to health benefits in the United States (U.S.) following the passage of the Personal Responsibility Work Opportunity Reconciliation Act (PRWORA), known as the Welfare Reform bill, in 1996. Based on a critical literature review, conducted between January 1997 and March 2011, this article begins with an analysis of the public health rhetorics that endorsed immigrants' inclusion into the U.S. health safety net. In this vein, the " cost-saving" and " the effortful immigrant" frames underscore immigrants' contributions to society vis-à-vis their low utilization of health services. These are complemented by a " surveillance" account that claims to protect the American public from communicable diseases. A " maternalistic" frame is also discussed as a tool to safeguard families, and particularly immigrant mothers, in their roles as bearers and caretakers of their American-born children.The analyses of the " chilling" and the " injustice" frames are then introduced to underscore major anthropological contributions to the formulation of counter-mainstream discourses on immigrants' selective inclusion into the U.S. health care system. First, the " chilling effect," defined as the voluntary withdrawal from health benefits, is examined in light of unauthorized immigrants' internalized feelings of undeservingness. Second, an " injustice" narrative highlights both the contributions and the limitations of a social justice paradigm, which advocated for the restoration of government benefits to elderly immigrants and refugees after the passage of PRWORA. By analyzing the contradictions among all these diverse frames, this paper finally reflects on the conceptual challenges faced by medical anthropology, and the social sciences at large, in advancing health equity and human rights paradigms. © 2011 Elsevier Ltd.

Author Keywords

immigrants Welfare reform Deservingness Review framing U.S.A. Health services health care Undocumented

Index Keywords

Vulnerable Populations vulnerable population social justice maternal care immigrant elderly care refugee human medically underserved Health Care Rationing welfare reform qualitative research human rights United States act health care cost Humans Personal Responsibility Work Opportunity Reconciliation Act social welfare health services Article health care health care utilization communicable disease cost control health care access medicaid Sociology, Medical health care system Transients and Migrants Health Care Reform public policy illegal immigrant Health Services Accessibility Medical Assistance public health

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84857451094&doi=10.1016%2fj.socscimed.2011.05.050&partnerID=40&md5=a33d49902e9427fbceaedb4963741408

DOI: 10.1016/j.socscimed.2011.05.050
ISSN: 02779536
Cited by: 49
Original Language: English