For refugees to the US, discrimination can make healthcare harder to get
Having health insurance or being eligible for care doesn’t guarantee that it is truly within reach.
Arriving as refugees in the United States, many individuals face challenges in securing the healthcare they require. As a researcher specializing in refugee resettlement, mental health, and access to care, I am aware that numerous refugees have experienced significant trauma prior to migration. Adapting to a new country can be overwhelmingly stressful, encompassing language barriers, financial difficulties, and intricate immigration procedures.
Additionally, the U.S. healthcare system is notoriously intricate to navigate, exacerbating these challenges.
Despite this, emerging research highlights a lesser-known difficulty: how refugees perceive they are treated in everyday American life. Even though refugees enter the country through a formal resettlement system, completing medical examinations before arrival and receiving comprehensive health screenings shortly after, they still encounter difficulties accessing medical care.
According to the Annual Survey of Refugees – a voluntary survey of refugees within their initial five years in the U.S. – approximately half of the respondents reported at least one obstacle to obtaining medical care. The survey probes whether factors such as cost, lack of transportation, language barriers, uncertainty regarding the appropriate location, or difficulty scheduling appointments hindered medical care access.
Furthermore, it inquires whether refugees have encountered unfair treatment due to their race, language or accent, culture, or religion – on the street, at work, in housing, interactions with law enforcement, and within healthcare.
My colleague Gashaye Melaku Tefera, a social work scholar at Florida State University, and I examined the responses of around 4,500 adults who completed the survey in 2020, 2021, and 2022. Our findings revealed a marked disparity between refugees who did not report experiencing discrimination and those who did. Among the former group, 39% identified at least one barrier to healthcare.
Conversely, among the latter group, this figure soared to 66%. This discrepancy persisted even after accounting for health status, English proficiency, financial hardship, education, employment, insurance coverage, and residency duration. In fact, reported discrimination proved more strongly associated with difficulties accessing healthcare than limited English proficiency or financial hardship.
The survey captures each person's circumstances at a single point in time, thus, it cannot definitively establish a cause-and-effect relationship. Nevertheless, this pattern aligns with a broader body of research. For instance, a 2023 survey of over 3,300 immigrant adults living in the U.S. found that one in four who had received healthcare reported receiving unfair treatment from providers.
Additionally, over one in five participants in that survey stated they had skipped or postponed care in the previous year. While the survey did not explicitly connect these delays to unfair treatment, it underscores that both are prevalent among immigrants seeking healthcare.
These experiences extend beyond healthcare settings. The same national survey indicated that 38% of immigrants had received inferior treatment compared to U.S.-born individuals in at least one everyday situation, including interactions at stores or restaurants, encounters with law enforcement, or while purchasing or renting a home.
Navigating the U.S. healthcare system poses a considerable challenge even for native Americans, let alone newcomers who are unfamiliar with the culture. Research indicates that unfair treatment in healthcare settings can lead to mistrust and a reluctance to seek necessary care. Furthermore, such treatment by an employer, landlord, or law enforcement officer may make it harder to trust that a clinic would provide a different experience.
In my research, I have discovered that this connection remains robust even among older refugees, as even those unsure about experiencing discrimination reported a similar increase in healthcare barriers compared to those who answered affirmatively.
Written by urgent.news from The Conversation's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
