In honor of Women’s History Month, we will highlight the impact of state and national policies on immigrant women’s health. Immigrant women are often left out of conversations on a path to citizenship, deportation, and labor. When immigrant women are considered, it is often through negative stereotypes – from the portrayal of immigrant women a threat to national security because of “anchor babies” to raising the fear of immigrant women as taking advantage of social safety net programs. These harmful portrayals justify harmful laws, with real impacts on women’s health and safety.
Policies and laws shape the safety, rights and resources of all people. Immigrant women are no exception: fear of deportation and family separation causes stress and anxiety; unauthorized status diminishes women’s rights and may lead to a range of forms of exploitation, from labor to sexual exploitation; or poor wages and lack of access to care can create barriers to health-promoting resources. The safety of immigrant women is threatened when immigration enforcement policies such as Secure Communities prevent women from accessing services or calling police.
Other social policies also shape health. Health reform initiatives actively bar immigrant women from receiving safety net benefits. While the Affordable Care Act (ACA) opened many doors for women to receive reproductive health care, expanding coverage for preventive health care including family planning, STI screening, and screening for domestic violence, undocumented immigrants are excluded from the ACA. In addition, in the US we are currently experiencing broad attacks on women’s reproductive health; 43 new policies were passed in 2012 restricting access to abortion services (Guttmacher Institute). Low-income and undocumented women are disproportionately impacted by these laws as they rely more heavily on community clinics to receive reproductive health services. These policies, whether part of our immigration, social welfare, or health care systems, determine what services and supports immigrant women have a “right” to and shape access to health-promoting resources – from U-Visas for domestic abuse survivors to health insurance.
One of the main narratives in research on immigrant health is the “Healthy Immigrant Paradox” (or the “Latino Paradox”) – in which immigrants have equal or better health outcomes despite lower wealth and education than US-born populations. This “paradox” hides many important issues and, despite some findings to support the theory, does not justify complacency about the health of immigrant women. Both gender and immigration status are important predictors of health. These multiple forms of discrimination overlap, or ”intersect,” to put immigrant women and particularly undocumented immigrants, at risk of a number of health challenges. Here is a brief overview of some of the many issues public health and immigrant rights activists might consider in their work. For more information, check out the research bibliography at the end of the post or feel free to contact The Curious Ostrich with any questions.
• Due to public health insurance program policies and limited access to employer-based health insurance, immigrant women are less likely to have health insurance, and less likely to have a regular source of health care, than non-immigrants (CDC 2005).
• After the 1996 Welfare Reform that barred many immigrants from receiving public benefits, immigrant women were less likely to access pre-natal care and other services (Fuentes-Afflick et al 2006)
• When Massachusetts implemented their health care reform policy, immigrants were left out. And the increased fear of deportation created new barriers to care among women who had previously accessed services at community clinics (Dennis et al 2009).
• Immigrant women often work in informal jobs such as domestic work and in jobs with high risks for injury (e.g. garment work). Undocumented workers face discrimination in the workplace, lack adequate protections due to insufficient regulation of informal labor markets, work in high-risk industries, and have higher rates of occupational injuries.
• Immigrant women are additionally affected by gender inequities, such as wage disparities (Browne and Misra 2003), and gender and sexual discrimination in the workplace.
Reproductive and Maternal Health
• Immigrant women have higher rates of mortality from cervical cancer
• Undocumented women have lower use of prenatal care services and higher rates of low birth weight, than documented immigrants (Korinek and Smith 2011).
• In border states with few abortion providers, such as Texas, Internal Border Patrol Checkpoints limit mobility, making it difficult for immigrant women to travel to abortion clinics.
Violence Against Women
• Intimate partner violence (IPV) is a risk factor for poor mental and physical health (Yick 2003, Barkho 2007). Although women of all national and ethnic backgrounds are victims of violence (Han 2010, Grzywacz 2009, Brabeck 2009, Bhuyan 2008, Barkho 2007), the immigration experience can exacerbate violence in relationships, putting immigrant women at particular risk (Han 2010, Grywacz 2009).
• Some women report that their partners use their vulnerable legal status as a way to control and threaten them – in a study of South Asian immigrant women in Boston, there was a strong association between having a partner who refused to help change their immigrant status and experiencing IPV (Raj et al 2005).
• A study of mother’s in New York City cited the fear of being “bad” mothers if they reported abusive family members (who would then face deportation) (Earner et al 2010).
• Immigrant women are at increased risk for poor mental health. Fear of deportation and family separation, as well as the challenges such as language and cultural barriers, are significant stressors for immigrant women (Arbona 2010, Norris 2011).
Yet, there are also policies and social movements that are promising to create better protections and facilitating increased social and economic opportunities for immigrant women.
Protecting Women’s Rights: The Violence Against Women Act, renewed this year, continues to provide protections for immigrant women in abusive situations. The act includes the U-Visa, which allows women who have been abused who are here with temporary or unauthorized status to gain legal residence (Moynihan 2008, Conyers 2007).
Supporting Integration: Policies that offer pathways to citizenship, or increase access to the rights that of citizenship, improve the health of immigrant women. In Western Europe, researchers found that in countries with more progressive immigration – or “integration” – policies including pathways to citizenship, anti-discrimination and affirmative action legislation, and policies protecting against economic and social exclusion, the health inequalities between immigrant and non-immigrant women were reduced and in some cases eliminated (Bollini et al 2009). In the US, state laws supporting immigrants rights also reduce health inequity. In 1999, Utah passed a law allowing undocumented immigrants to get driver licenses. While in general, undocumented women had poorer health outcomes than documented immigrants, those women who participated in the driver license program had higher rates of pre-natal care, demonstrating that policies supporting access to rights and resources among undocumented immigrants can significantly improve the health outcomes of women and children (Korinek and Smith 2011).
Organizing: Immigrant women around the nation are actively involved in promoting policies and opportunities for themselves and their communities. There are many immigrant women’s groups working to empower immigrant women. Mujeres Unidas y Activas in Oakland, California provides immigrant women with support, from crisis intervention services to job training, as well as leads statewide advocacy campaigns. The National Domestic Workers Bill of Rights is a nationwide campaign to protect domestic workers, who are predominantly immigrants, in their workplaces. This movement is quickly spreading throughout the nation. There are also many immigrant women entrepreneurs – 13% of all woman-owned businesses – working to create job opportunities for themselves and others.
There is a growing movement to protect the health of immigrants by expanding access to care and by pushing for a more humane immigration system. Women have distinct health needs (e.g. reproductive health services), and face distinct health challenges (e.g. the overlapping discrimination of gender and immigration status); and policies can unwittingly create new health risks for women when these specific issues aren’t taken into consideration. As these policy efforts move forward, we hope to see the rights of women explicitly considered and included in policy conversations.