How Immigration Affects Health
When you have been doing something your entire life, it is hard to imagine life as someone who may see things differently than the way you have always seen them. The United States is a land of many different opportunities that provides a way for many to grow and achieve their dreams, but it does not come without complications for those who immigrate.
Challenges are always expected when making a big move. You have to find the grocery store, the DMV, figure out where the closest Emergency Room is (just in case!) and work on making new friends. Most of these work themselves out within a few months and things start feeling more normal. But there are a lot of extra challenges that come in when making an international move, some that are often unexpected, making this learning curve last much much longer.
The amount of things that become overwhelming are probably comical, if it weren't so darn frustrating. When I moved to the US ten years ago, I was faced with all kinds of things that I didn't plan for. Things like figuring out where to buy paper, how to get a drivers license, of finding a hardware store. Mailing a letter was a huge problem. How the heck do I send one? I remember calling a new friend on the phone in panic after trying to figure this out for the longest time. She laughed out loud and said, "just put it in the mailbox and raise the flag and the mailman will pick it up." So I did it. And then I waited, looking outside my window at the time the mailman usually showed up to see if it would actually work. Like it was a tricky science experiment. Well, It worked! One less thing to learn about moving to America was now checked off my list.
Now, this example is silly and while useful, not a life or death situation. When it comes to healthcare, things are even more tricky, but with much more impactful outcomes. Unfortunately, for immigrants, it can feel completely overwhelming to try to get healthcare when they move to here.
In some countries, you can show up at a doctors office, pay a small, preset fee, wait your turn, and then get seen immediately by the doctor, and leave with your prescription you can fill within a few minutes next door. Things just aren't that simple here. Before you can even sit face to face with a doctor you first need to get insurance, navigate the insurance (is it in network? Is this procedure going to be covered?), figure out referrals, worry about how much this is all going to cost you, figure out how to set an appointment, deal with offices staff, sit in the waiting room, hang out with the nurse, sit half naked in the doctor's office and then finally sit face to face with the doctor for a rushed visit. Each one of these steps (if you can even figure out what they all are) feel like a huge deal to cross. Now imagine trying to navigate all those steps with a possible language and/or cultural barrier! It can feel like a lot! And it is!
This kind of problem is not unique to the United States. Immigrants to Canada are also more likely to develop long term health problems, and I am sure this can be an issue when navigating any new country. But these are issues that those who have lived somewhere long-term may not realize that their friends and neighbors are dealing with.
If navigating the healthcare system is so complicated, you can probably imagine that immigrants might become less healthy after they move here, and according to this professor at UCLA you might be right! This is one of the many factors that affect the health of immigrants to the United States and their approach to healthcare.
But the healthcare system is not the only factor that influences health outcomes. For example, in our study with Haitian immigrants we learned that nostalgia for home played a significant factor in the health of the participants. What this means is that the differences in lifestyle, diet, and overall culture create a feeling of overwhelm which can easily push management of a condition that requires a certain amount of brain power to second or third priority.
As we further study this phenomenon, we will be able to come up with better outcomes and patient education.