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Covid-19 Update: Essential Resources on Immigrant Health

The novel coronavirus pandemic has highlighted the vulnerabilities of low-wage immigrants to viral infection and severe Covid-19 illness. This public health emergency compounds the social (non-medical) determinants of health associated with immigrant status and with immigration policy priorities.

For undocumented immigrants, exclusion from federally funded insurance programs and fear of encounters that could lead to detention, deportation, or family separation immigration enforcement create barriers to health care access. For legally present immigrants, the chilling effects of the public charge rule, which jeopardizes eligibility for legal permanent residency (green card) if applicants are deemed “public charges” based on even short-term use of federally funded programs, create barriers to health care access and to use of health-related services such as health insurance, housing subsidies, or food stamps. These barriers have consequences for citizen children in mixed-status families.

The Hastings Center’s Undocumented Patients project, founded in 2011, maintains a public database of key literature and other resources on health care access for undocumented immigrants and other immigrant populations in the U.S. What follows is a selected bibliography designed to support learning and progress on immigrant health in a complex policy environment, with a new section reflecting Covid-19 data, reporting, and policy analysis.

COVID-19: impact on immigrant workers and communities

Artiga, Samantha, Rachel Garfield, and Kendal Orgera. “Communities of Color at Higher Risk for Health and Economic Challenges Due to COVID-19.” Kaiser Family Foundation, April 7, 2020. https://www.kff.org/disparities-policy/issue-brief/communities-of-color-at-higher-risk-for-health-and-economic-challenges-due-to-covid-19/.

Chishti, Muzaffar, and Sarah Pierce. “Crisis within a Crisis: Immigration in the United States in a Time of COVID-19.” Migration Policy Institute, March 26, 2020. https://www.migrationpolicy.org/article/crisis-within-crisis-immigration-time-covid-19.

Duncan, Whitney L., and Sarah B. Horton. 2020. “Serious Challenges and Potential Solutions for Immigrant Health During COVID-19.” Health Affairs Blog. April 18, 2020.    https://www.healthaffairs.org/do/10.1377/hblog20200416.887086/full/

Gelatt, Julia. “Immigrant Workers: Vital to the U.S. COVID-19 Response, Disproportionately Vulnerable.” Migration Policy Institute, March 2020. https://www.migrationpolicy.org/research/immigrant-workers-us-covid-19-response.

Kreiger, Nancy, Gregg Gonsalves, Mary T. Bassett, William Hanage, and Harlan M. Krumholz. “The Fierce Urgency Of Now: Closing Glaring Gaps In US Surveillance Data On COVID-19.” Health Affairs Blog, April 14, 2020. https://www.healthaffairs.org/do/10.1377/hblog20200414.238084/full/.

Krogstad, Jens Manuel, Ana Gonzalez-Barrera, and Luis Noe-Bustamante. “U.S. Latinos among Hardest Hit by Pay Cuts, Job Losses Due to Coronavirus.” Pew Research Center, April 3, 2020. https://www.pewresearch.org/fact-tank/2020/04/03/u-s-latinos-among-hardest-hit-by-pay-cuts-job-losses-due-to-coronavirus/.

McFarling, Usha Lee. “‘We’ll Be Deported’: Immigrants Fear Seeking Covid-19 Tests or Care.” STAT, April 15, 2020. https://www.statnews.com/2020/04/15/fearing-deportation-many-immigrants-at-higher-risk-of-covid-19-are-afraid-to-seek-testing-or-care/.

Narea, Nicole. “The Coronavirus Stimulus Bill’s Missing Piece: Relief for Immigrants.” Vox, April 1, 2020. https://www.vox.com/2020/4/1/21197017/immigrants-coronavirus-stimulus-relief-bill.

National Immigration Law Center.  “Equal Opportunities to Thrive: Rebates, Taxes/SSN/ITIN, Food Security, and Access to Food Programs.” April 16, 2020. https://www.nilc.org/get-involved/trainings/nilcwebinars/covid19-equal-opportunities-to-thrive/.

National Immigration Law Center. “Workers’ Rights: Critical Labor Protections for Immigrant Workers During the COVID-19 Pandemic.” April 15, 2020. https://www.nilc.org/get-involved/trainings/nilcwebinars/labor-protections-for-immigrant-workers-during-covid19/.

National Immigration Law Center. “Safe and Accessible: Immigrants’ Access to Health Care, Public Charge, and Safe Spaces in Health Care Centers.” April 14, 2020. https://www.nilc.org/get-involved/trainings/nilcwebinars/covid19-access-to-health-care-safe-spaces-public-charge/.

Taladrid, Stephania. “The Risks Undocumented Workers Are Facing During the Covid-19 Pandemic.” The New Yorker, April 13, 2020. https://www.newyorker.com/news/video-dept/the-risks-undocumented-workers-are-facing-during-the-covid-19-pandemic

Public charge: health consequences

Artiga, Samantha, Rachel Garfield, and Anthony Damico. 2019. “Estimated Impacts of Final Public Charge Inadmissibility Rule on Immigrants and Medicaid Coverage.” Kaiser Family Foundation. https://www.kff.org/disparities-policy/issue-brief/estimated-impacts-of-final-public-charge-inadmissibility-rule-on-immigrants-and-medicaid-coverage/

Bernstein, Hamutal, Dulce Gonzalez, Michael Karpman, and Stephen Zuckerman. 2019. “One in Seven Adults in Immigrant Families Reported Avoiding Public Benefit Programs in 2018.” Urban Institute. https://www.urban.org/research/publication/one-seven-adults-immigrant-families-reported-avoiding-public-benefit-programs-2018

Bernstein, Hamutal, Dulce Gonzalez, Michael Karpman, Sarah McTarnaghan, and Stephen Zuckerman. 2019. “Five Ways the “Public Charge” Rule Is Affecting Immigrants in America.” Urban Institute. https://www.urban.org/urban-wire/five-ways-public-charge-rule-affecting-immigrants-america

Gelatt, Julia, and Mark Greenburg. 2019. “Health Insurance Test for Green-Card Applicants Could Sharply Cut Future U.S. Legal Immigration.” Migration Policy Institute. https://www.migrationpolicy.org/news/health-insurance-test-green-card-applicants-could-sharply-cut-future-us-legal-immigration

Katz, Mitchell H., and Dave A. Chokshi. 2018. “The ‘Public Charge’ Proposal and Public Health.” JAMA 320 (20): 2075. https://doi.org/10.1001/jama.2018.16391.

Page, Kathleen R., and Sarah Polk. 2017. “Chilling Effect? Post-Election Health Care Use by Undocumented and Mixed-Status Families.” New England Journal of Medicine 376 (12): e20. https://doi.org/10.1056/nejmp1700829.

Parmet, Wendy E. 2020. “Supreme Court Allows Public Charge Rule To Take Effect While Appeals Continue.” Health Affairs. https://doi.org/10.1377/hblog20200131.845894.

Zallman, Leah, and Karen Finnegan. 2018. “Changing Public Charge Immigration Rules: The Potential Impact on Children Who Need Care.” California Health Care Foundation. https://www.chcf.org/publication/changing-public-charge-immigration-rules/

Zallman, Leah, Karen E. Finnegan, David U. Himmelstein, Sharon Touw, and Steffie Woolhandler. 2019. “Implications of Changing Public Charge Immigration Rules for Children Who Need Medical Care.” JAMA Pediatrics, July, e191744. https://doi.org/10.1001/jamapediatrics.2019.1744

Immigration enforcement: health consequences

Artiga, Samantha, and Barbara Lyons. 2018. “Family Consequences of Detention/Deportation: Effects on Finances, Health, and Well-Being.” Kaiser Family Foundation. https://www.kff.org/disparities-policy/issue-brief/family-consequences-of-detention-deportation-effects-on-finances-health-and-well-being/

McKenzie, Katherine C. 2019. “Loud, Gray, and Arbitrary — The Compounding Trauma of Detention for Asylum Seekers.” New England Journal of Medicine 380 (9): 807–9. https://doi.org/10.1056/NEJMp1816400.

Spiegel, Paul, Nancy Kass, and Leonard Rubenstein. 2019. “Can Physicians Work in US Immigration Detention Facilities While Upholding Their Hippocratic Oath?” JAMA, August. https://doi.org/10.1001/jama.2019.12567.

Stoughton, Sarah, and Kathryn Hampton. 2019. “Not in My Exam Room: How U.S. Immigration Enforcement Is Obstructing Medical Care.” Physicians for Human Rights. https://phr.org/our-work/resources/not-in-my-exam-room/.

Migration and metropolitan areas in the United States

Kalor, Yair, Mel Meder, Satya Rhodes-Conway, and Mariah Young-Jones. 2018. “Building Immigrant-friendly Cities.” Mayors Innovation Project. https://www.mayorsinnovation.org/images/uploads/pdf/Immigration_Brief.pdf

Passel, Jeffrey S., and D’Vera Cohn. 2019. “Twenty Metro Areas Are Home to Six-in-Ten Unauthorized Immigrants in U.S.” Pew Research Center. https://www.pewresearch.org/fact-tank/2019/03/11/us-metro-areas-unauthorized-immigrants/.

For more resources, visit The Hastings Center’s Undocumented Patients public database.

This resource was developed by Ben Curran Wills, a project manager/research assistant at The Hastings Center, and Nancy Berlinger, a research scholar at The Hastings Center and the cofounder of the Center’s Undocumented Patients project.

The Hastings Center has never shied away from the toughest ethical challenges faced by society.


The Hastings Center has never shied away from the toughest ethical challenges faced by society.