Throughout the entire life course, a visible social gradient in health exists, such that socially disadvantaged individuals have a higher risk of adverse health outcomes than those with social privilege. Studies indicate that the social condition of an individual impact their health in different ways. For instance, socially disadvantaged Persons usually experience more stress, have fewer resources, or live in socially disadvantaged neighborhoods. This interplay between social determinants increases the susceptibility to poor health (van der Meer et al., 2022). This paper will analyze the undocumented immigrants who are vulnerable groups in the United States, the social determinant of health (SDOH) model, and the Life Course Perspective linking specific social determinants such as poverty and inadequate access to healthcare to health inequity, and interventions that can mitigate poor health attributed to social determinants.
The Social Determinant of Health (SODH) model: This theory proposes that socioeconomic factors profoundly influence health outcomes. Social determinants are the conditions in which an individual is born, lives, grows, works, and ages. Social determinants of Health (SODH) can be grouped as macro and micro-level social determinants influencing an individual’s health. Macro-level social determinant includes health policies, education, and the labor market. Macro-level determinant influences society’s social stratification. On the other hand, micro-level determinants of individuals’ socioeconomic position, such as income and wealth, influence their daily exposure and environment (van der Meer et al., 2022). On the other hand, the Life Course Perspective proposes that socioeconomic conditions an individual experiences can impact their health outcomes throughout their lifetime. For example, children from low-income families may experience various challenges, leading to physical and mental health problems. Health equity can be defined as a state in which individuals, irrespective of their race, color, gender, or ethnicity, among other discriminatory grounds, have just and fair opportunities to attain their highest level of health (CDC, 2022). SODH factors such as education, income, health policy, wealth, and the labor market influence health equity.
The United States healthcare system is among the best in the world; however, it has many flaws attributed to health disparities, particularly among the vulnerable population or individuals (Mason et al. 200). Vulnerabilities populations or groups are defined as those that require special healthcare attention, protection, or care. The interests of these individuals or groups are often more likely to be considered unjustly (Sossauer et al., 2019). Vulnerable groups include immigrants (Undocumented) (Mason et al., 2020). Poverty and lack of access to healthcare are the main SDOHs affecting these populations.
Demographics of Immigrants
According to Chang (2019), the United States has more than 44.5 million foreign-born population. This population constitutes 13.7% of the total United States population. In New Jersey, Texas, Illinois, New York, and California, more than 12.1 million undocumented immigrants reside these states. Most Immigrants in the US are mixed families. Mixed families include at least one legal immigrant child or one citizen and at least one undocumented parent. Studies indicate that immigrant communities have a higher mental health prevalence than native-born homeless individuals in the United States due to social factors such as poverty and access to health care that influence their health outcomes.
According to Chang (2019), undocumented immigrants face a high rate of poverty that is disproportionate. Studies indicate that more than half of the undocumented immigrants live below the federal line of poverty compared to the United States-born and natural citizens at 11%. Poverty among immigrants is attributed to low wages compared with native citizens. In addition, immigrants are less likely to receive health insurance among other employer-provided benefits. Furthermore, immigrants cannot meet their basic needs, such as housing and food, which prevents them from addressing their health necessities and those of their children. Due to poverty, Immigrant children often experience poor well-being, including negative development and mental and physical-related health outcomes (Chang, 2019). Financial hardships among undocumented immigrants are worsened following the deportation of a parent. This causes a sudden loss of income, leaving most immigrant families experiencing homelessness and food insecurity. Consequently, this increases stress and mental conditions such as depression and anxiety among the remaining children and the parent. Also, this leads to school dropout among older children as they seek jobs to support their families financially instead of pursuing a college degree.
Health Care System
Access to health care among the immigrant population, particularly the undocumented, significantly contributes to health disparities in the United States of America. The federal government does not provide benefits such as the Children’s Health Insurance Program (CHIP) and Medicaid for undocumented immigrants. For instance, the federal government signed the Patient Protection and Affordable Care Act (ACA) which provides insurance to millions of individuals into law; however, the ACT excluded undocumented immigrants (Chang, 2019). Furthermore, undocumented immigrants are prevented from buying Marketplace health coverage, receiving premium tax credits, or obtaining other savings on the Marketplace plans. Due to the lack of these subsidies, undocumented immigrants facing poverty find it difficult to buy this insurance. As a result, they depend on employer-based insurance or services from free clinics, community health clinics, and emergency departments. Again, healthcare professionals offer suboptimal care to undocumented immigrants, increasing health disparities. They also experience mental illness stigma and denial, which prevents them from seeking treatment.
Interventions for mitigating poor heath attributed to poverty and poor healthcare access among undocumented immigrants include improving access to healthcare and increasing economic opportunities among this population or promoting a health culture (Mason et al., 2020). The US government can improve access to healthcare by providing undocumented immigrants free or low-cost healthcare. In addition, the government can increase undocumented immigrants’ transport to healthcare and improve the healthcare providers’ availability. The economic opportunities can be increased through job creation, providing undocumented immigrants with training and education, and increasing their access to financial resources. Other reforms include reforming immigration policies to allow undocumented immigrants to gain citizenship. This intervention differs from the usual primary prevention strategies because they target the root cause of health inequalities.
Chang, C. D. (2019). Social Determinants of Health and Health Disparities Among Immigrants and their Children. Current Problems in Pediatric and Adolescent Health Care, 49(1), 23–30. https://doi.org/10.1016/j.cppeds.2018.11.009
CDC. (2022, July 1). What is health equity? Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/whatis/index.html
Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2020). Policy & politics in nursing and health care. St. Louis, MO: Saunders/Elsevier.van der Meer, L., Barsties, L. S., Daalderop, L. A., Waelput, A. J. M., Steegers, E. A. P., & Bertens, L. C. M. (2022). Social determinants of vulnerability in the reproductive age population: a systematic review. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-13651-6
Sossauer, L., Schindler, M., & Hurst, S. (2019). Vulnerability identified in clinical practice: A qualitative analysis. BMC Medical Ethics, 20(1). https://doi.org/10.1186/s12910-019-0416-4