Welcome to AccessDenied: A Conversation on Unauthorized Im/migration and Health! The aim of this blog is to challenge readers and contributors to re-think the political common sense that denies migrants and immigrants access to health care and impedes their capacity to enjoy the social determinants of good health. We also consider how the increased movement of people across national borders affects the health of receiving communities.
We ask our readers and contributors to consider some morally and politically tough questions:
Arguing for Alliances: Why Business and Religious Leaders Should Promote Migrant Health Care – Ryan I. Logan
Ryan I. Logan
In June 2013, from a top-floor meeting room at the Indianapolis headquarters of pharmaceutical giant Eli Lilly and Company, I witnessed an unusual alliance of business leaders and religious leaders who joined to pledge their public support for the Border Security, Economic Opportunity, and Immigration Modernization Act (S.744). In front of reporters, these leaders expressed their support for comprehensive immigration reform to state politicians, the general public, and the grassroots political organization called the Indianapolis Congregation Action Network (IndyCAN). What would it take to develop a similarly powerful alliance between religious and business leaders advocating for the provision of adequate and affordable health care for undocumented migrants?
Members of the grassroots political organization IndyCAN, along with religious leaders of Catholic and Protestant denominations, meet with Congresswoman Susan Brooks (seated at table, left side) at a prayer vigil to request her public support for immigration reform. Photo by Ryan I. Logan.
At the June 2013 meeting promoting comprehensive immigration reform, several prominent businesses came out in support of immigration reform in addition to Eli Lilly and Company, including Indiana Farm Bureau Inc., the Indiana Chamber of Commerce, and Indiana Dairy Producers. Religious support came from across denominations and faiths including Catholic, Protestant, Jewish, and Muslim congregations. Prominent religious leaders included Joseph Tobin, Archbishop of the Catholic Archdiocese of Indianapolis, and Bishop William Gafkjen of the Indiana-Kentucky Synod of the Evangelical Lutheran Church of America.
The event at Eli Lilly demonstrated a cross-denominational and cross-sector alliance aimed at advocating for the political needs of undocumented migrants. This alliance, largely the work of IndyCAN, has been a central force in bringing together the community of Indianapolis with business, religious, and political leaders. IndyCAN uses messages such as “Hoosier families” and “together, we are stronger” as a means of being inclusive of undocumented migrants and their families. The impact of this activism has been apparent in several large demonstrations for comprehensive immigration reform – including at least one event that had over 800 people in attendance. IndyCAN attempts to appeal to the religious backgrounds and moral consciousness of politicians by emphasizing a shared religious faith as well as personal testimonials of migrants who have experienced the loss of family members through deportation.
As crucial allies for overarching systemic change in favor of comprehensive immigration reform, it is also prudent for business and religious leaders to advocate for the health of their migrant employees and parishioners. Through my year of volunteering with IndyCAN, I witnessed how one of their central facets, putting an emphasis on forging relationships between businesses, community members, religious leaders, and politicians, came to the forefront during the push for comprehensive immigration reform. This emphasis served as a means to connect these actors and press for the need to focus on the social justice needs of this marginalized community. As a volunteer, I typically formed part of the media team and I helped with distributing and translating press releases as well as contacting the local news to cover IndyCAN events. IndyCAN’s strategy of forging solidarity between these various groups was a prominent focus for the local news and serves to show the potential impact on creating policy change through face-to-face interactions. Thus, these leaders, along with the support of grassroots organizations, have the potential to influence policy and should advocate for the health of their migrant employees and parishioners.
Health care access is a pressing need for these migrants due to lack of insurance, low income, and other restrictions in obtaining clinical services (Heyman et al. 2009, Schor 2006, Wallace et al. 2012). Undocumented migrants in Indiana, as in most other states, are barred from accessing health care except on an emergency basis or for pregnancy-related care. Although there are occasional free clinics offering care to the uninsured, these are sporadic and only act as a band-aid to address larger health issues.
Aside from inaccessible health care, state-level policies further marginalize undocumented migrants in Indiana. For example, HB1402, passed in 2011, bars undocumented migrants from receiving in-state tuition at public universities. Additionally, Indiana was one of several states that attempted to pass a copycat version of Arizona’s infamous SB1070.
As comprehensive immigration reform remains stalled, business and religious leaders should consider options for improving the health of undocumented migrants. Doing so would help to provide mutually beneficial results for all parties involved. The combined cost of fatal and nonfatal injuries in the United States is estimated at $250 billion, and Latino workers experience higher rates of occupational injury than non-Latino workers (Flynn and Eggerth 2014). For businesses, promoting the health of undocumented migrant employees can directly affect productivity and cost. Aside from the precarious position undocumented migrants experience when they face injury or illness, the loss of days due to illness or injury can cost employers in terms of lost productivity and profits. In Indiana, employers may be held responsible to pay health care costs associated with injuries sustained by employees, regardless of legal status. For all of these reasons, it would be prudent for employers to provide safer working conditions in order to promote their migrant employees’ health and decrease incidence of injury even as they advance their business interests.
Employers should also consider alternatives to providing health care such as providing health insurance to migrant workers. According to a report issued by the Indiana Office and Management and Budget in June 2012, the health care and public assistance costs for “illegal aliens” in the state of Indiana totaled almost $8 million in 2011 (IOMB 2012). Clearly, a cost-effective means of providing accessible health care for undocumented migrants is an urgent need.
At the same time, churches must continue to remain active in advocating for the needs of their parishioners from both a political and health standpoint. As religious leaders emphasize a moral discourse surrounding the need for comprehensive immigration reform, they must recognize that the health of their undocumented migrant parishioners is a central facet of their wellbeing and ability to provide for themselves and their families. Moreover, religion remains an important as aspect in the lives of many migrants. Many Catholic churches with declining populations have seen revitalizing numbers with an influx of Mexican and other Latino migrant parishioners. This is certainly the case in several Catholic churches in Indianapolis, which have seen the number of Latino migrant parishioners increase over the past decade and introduced Spanish and bilingual masses (Logan 2015). As religious leaders continue to care for the spiritual needs of their migrant parishioners, the necessity of accessible health care can and should be reframed as a moral necessity. As Archbishop Tobin of the Catholic Archdiocese of Indianapolis stated at a demonstration for immigration reform, “I’m the grandson of immigrants and I love my grandparents and I believe if we fail to respond the neediest today, then on the Day of Judgment, it won’t be them who condemn us. It will be our grandparents.”
Just as these religious leaders and business leaders offered a public display of their support during the immigration reform throughout the summer of 2013, they should also take an active role in advocating for the health of their migrant employees and parishioners. This kind of collaboration among grassroots activists, business leaders, and religious prelates – not just in Indiana, but throughout the United States – could pressure politicians to recognize how political designations directly affect wellbeing. The road to comprehensive immigration reform may not be won, but business and religious leaders who see its benefits ought to pay more careful attention to health, which is intimately tied to political status.
Since 2013, business and religious leaders in Indiana have continued advocating for immigrants and comprehensive reform. In July 2014, for instance, the Indiana Chamber of Commerce continued to push politicians on the issue of immigration reform while various business organizations put on events to highlight this need. Last November, Catholic, Protestant, Muslim, and Jewish religious leaders called on Governor Mike Pence to drop his lawsuit against President Obama’s executive order on immigration. New legislative developments include SB345, introduced in February, which seeks to grant in-state tuition to undocumented minors fitting certain requirements. As business and religious leaders advance these issues, they should reignite their alliance in support of immigration reform, but foreground the issue of health care for undocumented migrants. A powerful alliance like this one has the potential to bring more attention to undocumented migrants’ plight and strengthen the fight to meet their health needs, which is in everyone’s collective best interest.
Ryan I. Logan, MA is a dual degree student at the University of South Florida earning his PhD in applied anthropology on the medical anthropology track. He is also pursuing his master’s in public health in the Department of Health Policy and Management. His current research focuses on undocumented Latino migrants, policy, health disparities, migrant farmworker access to care, and the overall clinical experience.
Flynn, Michael A. and Donald E. Eggerth. 2014 Occupational Health Research with Immigrant Workers. In Migration and Health: A Research Methods Handbook. Schenker, Mark B.; Castañeda, Xóchitl; and Alfonso Rodriguez-Lainz, eds. Pp. 377-395. Oakland: University of California Press.
Heyman, Josiah McC.; Nuñéz-Mchiri, Guillermina Gina; and Victor Talavera. 2009 “Healthcare Access and Barriers for Unauthorized Immigrants in El Paso County, Texas,” Family and Community Health 32(1):4-21.
Indiana Office of Management and Budget (IOMB). 2012 Calculation of the Estimated Costs of Illegal Aliens in the State of Indiana. Report for the 2011 Indiana General Assembly.
Logan, Ryan I. 2015 “Transcending Differences and Persuading Through Faith: The Importance of Religion in Grassroots Organizing,” Practicing Anthropology 37(1):15-19.
Schor, Glenn. 2007 Low Wage Injured Workers and Access to Clinical Care: A Policy Analysis, 2004-2006. Policy Analysis. The California Wellness Foundation, for UCSF Community Occupational Health Project.
Wallace, Stephen P.; Torres, Jaqueline; Sadegh-Nobari, Tabashir; Pourat, Nadereh; and E. Richard Brown. 2012 Undocumented Immigrants and Health Care Reform. Final Report to the Commonwealth Fund. UCLA Center for Health Policy Research.
On Thursday, April 30, from 12:30-2:00pm EST, the Overseas Development Institute in London will hold a public event on “Europe’s migrant crisis: What can be done?” The event will also be livestreamed and tweeted using the hashtag #MigrantCrisis. To register, and for further details, see below or visit ODI’s website.
This year has already seen more than 1,750 migrants die in the Mediterranean as thousands attempt to flee Africa and the Middle East for Europe – largely from Syria, Eritrea and Somalia where conflict is rife.
With sophisticated criminal networks helping more and more people into boats, a lack of funding or support for search and rescue operations and a rising hostility towards migrants across Europe, what can be done to stop the soaring death rate in its tracks? For those tens of thousands who do make it ashore every week, what should happen next?
Can and should development policies play a greater role in supporting migration? Join ODI for this timely debate with migration experts and representatives with first-hand experience of making the journey.
Kevin Watkins, Executive Director, ODI
Chair: Paul Kenyon, BAFTA-winning Panorama journalist
Gonzalo Fanjul, Head of Research, porCausa Foundation (Madrid)
Marta Foresti, Director of Governance, security and livelihoods, Politics and Governance, ODI
Laurence Hart, Head of Migrant Assistance Division, International Organization for Migration (IOM)
Alexander Betts, Associate Professor of Refugee and Forced Migration Studies, University of Oxford
Gonzalo Vargas Llosa, Representative to the UK, UN Refugee Agency (UNHCR)
- Connecting civil rights, policy, and health, scholarly work on how immigrants’ health declines the longer they live in the United States suggests a policy need to address immigrant discrimination.
- Countering challenges to the President’s recent immigration action announcement, legal scholars have asserted the President’s legal authority to extend deportation deferrals to parents of young immigrants.
- In California, State Senator Ricardo Lara proposed a bill that would extend health insurance benefits to unauthorized immigrants who are not authorized to receive benefits through the Affordable Care Act.
- As a result of the President’s recently-announced immigration action, some pundits suggest more immigrants living in mixed immigration status families may be motivated to sign up for health care through the Affordable Care Act.
- LGBT organizations continue to criticize Immigration and Customs Enforcement officials for treatment of transgender detainees, failing to protect them from sexual assault or providing them with medical assistance.
- Despite allegations of Mexican immigrants playing a role in the resurgence of measles, whooping cough, and other vaccine-preventable disease, there is no evidence to support such claims, especially since vaccination rates Mexico are high.
- In a trial against her employer, a migrant worker in Hong Kong shared stories of physical abuse, bringing attention to migrant domestic worker mistreatment.
- Near Italy, more than 300 African migrants may have died in the Mediterranean Sea before Italian Coast Guard officials reached a group of survivors.
- The Australian Human Rights Commission has called for immigrant children to be released from detention facilities.
- After a cemetery shooting in Copenhagen, the Israeli government approved funds to encourage immigration from France, Belgium, and Ukraine.
Call for Papers for Executive Session Submission:
Policing, Estrangement, and Social Inequalities: Denaturalizing Law Enforcement and Police-based Governance
2015 American Anthropological Association Meeting
November 18-22, Denver, Colorado
From Michael Brown to Eric Garner and beyond, recent public attention to African American deaths occurring at the hands of law enforcement officers in the United States has reignited familiar conversations about police relationships with minority communities. Meanwhile, just as President Obama’s year-end immigration announcement pledges to shift the landscape of immigrant policing across the country, we reach a record-high 2.5 million deportations on his watch. While anthropology has long played a critical role in exposing how regimes of social control are perpetuated through taken-for-granted, normalized systems of authority, events such as these suggest there may be a renewed public space for anthropological intervention that helps draw attention to policing and make sense of its effects. Following this year’s AAA theme calling for questioning the familiar and making it strange, we seek papers that denaturalize policing and law enforcement and question how policing supports social inequalities. We specifically seek papers that explore how policing, broadly conceived as law enforcement actions or policy created with specific governing ideals, reinforces power hierarchies based on race, sex, citizenship, or other forms of social difference. In considering how policing may perpetuate inequality, we also welcome ethnographic inquiry into how policing is resisted, contested, and/or mediated as tensions emerge. By making strange regimes of social control operating through policing, we invite papers to respond to the following or related questions:
- How does police activity promote, reinforce, and conceal existing forms of social difference, and in what ways can anthropologists respond?
- How can policing estrange individuals, families, communities, and broad populations, and what are the related consequences?
- What strategies do some communities develop to resist, combat, and cope with intense forms of policing?
- What methodological and theoretical challenges are associated with studying policing, and who or what may be obstructive in ethnographies of police, policy, and power processes?
- How does dialogue across subfields and disciplines aid or hinder our abilities to scrutinize police activity, and what findings can be gleaned through interdisciplinary collaboration?
From Alienation to Protection: Central American Child Migration – Heide Castañeda, Lauren Heidbrink, and Kristin Yarris
Heide Castañeda, Lauren Heidbrink, and Kristin Yarris
During the summer of 2014, the eyes of the United States – indeed, the world – turned their gaze on the thousands of Central Americans crossing borders to seek refuge and opportunity. This resulted in a range of responses – from solidarity and support to racism and exclusion – and a stalled search for solutions. As three U.S.-based scholars conducting research along these migration routes over the past several years, this summer we were pulled somewhat unexpectedly into public debates about Central American migrant children and U.S. immigration policy. Coming one year after failed efforts towards comprehensive immigration reform in Congress, the issue of unaccompanied minors has complicated popular understandings of the reasons, processes, and meanings of migration. Here, we reflect on the broader context and policy implications of our research.
The push factors driving Central American migration to the United States have hardly fluctuated over the past decades. Foremost among them are economic and political insecurity, violence, and underdevelopment. The U.S.’ contribution to these “push factors” is well documented – whether through the expansion of “free trade” economic policies that undermine local agricultural production and heighten food insecurity, dismantle unions, and slash the public sector workforce, or through political support of anti-democratic and quasi-legitimate governments. Current U.S. “aid” to Central America is concentrated primarily on military and police training of the very groups that often contribute to violence against the poor – precisely the violence that drives contemporary outmigration. Domestic policy shifts have further compounded the issue. Mass deportations of immigrants accused of criminal offenses, originating during the Clinton era, have led to re-grouping and strengthening of criminal gangs in the “Northern Triangle” of Central America (that is, Honduras, El Salvador, and Guatemala). The absolute failure to achieve comprehensive immigration reform has only exacerbated the current crisis. Despite immigration law’s claim to privilege the family, family-based petitions for legal status remain out of reach for most Central Americans in the U.S., leaving parents and their children few choices other than risking the dangers of clandestine migration.
In this context, the construct of the “unaccompanied alien child” is problematic for a number of reasons. First, this language situates children as victims of parental neglect and/or criminal human traffickers (coyotes) rather than as involved contributors in their own migration decisions. Children, even very young children, are able to understand the causes of migration and respond in ways that help themselves and their families escape the problems in their home countries. By their early teens, youth also contribute to their own migration decisions, weighing the risks, dangers, and opportunities of remaining or migrating. Media portrayals fail to acknowledge children’s social agency in migration processes. For children and families facing extreme hardship, poverty, and life-threatening violence who lack “legal” means of migration, paying someone who is perceived to heighten the promise of passage is a rational choice rather than evidence of criminal intention. Yet taking an anthropological view of children as actors in global migration does not exclude them from also being deserving of social and political support by migrant-receiving and transit countries. Further, representing children as either geopolitical pawns or as unduly susceptible to rumor fails to acknowledge the capacity of young people to act on their own circumstances.
Second, the juridical term “unaccompanied alien child” others migrant children in multiple ways. Not only do they come from other countries (and therefore are framed as undeserving of U.S. residency), but child migrants also represent an other view of childhood that challenges some assumptions of U.S. culture. Rather than a period of innocence sheltered from the violence and insecurities of adulthood, migrant children are exposed and responding to the very precarity created by contemporary geopolitical systems. Additionally, these children may be “unaccompanied” by family members in their migration journeys, but family relationships very much structure child migration decisions. Viewing child migrants solely as “unaccompanied” or unattached further shifts attention away from the failure of U.S. immigration policy to assist families in reunifying and minimizes U.S. government accountability for the conditions pushing families and children to embark on life-threatening journeys.
Another manifestation of this othering in media reporting in summer 2014 were accusations that migrant children could be dangerous disease-carriers. This was the case even though by law, all children are screened (often multiple times) and vaccinated upon apprehension. Indeed, placing blame on immigrants for spreading disease is a longstanding xenophobic discourse that dates at least to the end of the 19th century, as ambivalent American approaches towards new immigrants arriving to ports such as Ellis Island sought to exclude them on the basis of illness or disability. Over the past several months, news stories have alleged that migrant children are bringing a plethora of diseases including lice, scabies, chicken pox, tuberculosis, H1N1 influenza – illnesses largely attributable to conditions of their migrant journey and subsequent detention. Other sources speculated that even Ebola could enter the US in this manner. Headlines have labelled the situation a “medical crisis” and even a “full-blown public health disaster.” Notably, there is a higher rate of childhood vaccination in Central America than in the U.S.; 93% of children in Guatemala, Honduras and El Salvador are vaccinated against disease like measles. Nonetheless, fear of disease continues to motivate some communities and elected officials against this immigration stream, as panic around alleged “contagion” further emphasizes the idea of children as alien others and directly underscores calls for additional securitization of the border.
From our on-the-ground engagement in research sites in the U.S., Mexico, and Central America, we offer several important policy recommendations:
- The United States must respect the human and legal rights of due process and protection of children. The international community overwhelmingly deems these children and families refugees based on the UNHCR definition, which holds that refugees are those “with a well-founded fear of persecution” and who are “unwilling or unable to return” to origin countries for fear of persecution. Given the endemic poverty and violence from which children are fleeing, their legal cases must be seen in light of international law and not just U.S. political expediency. The Obama Administration’s push for rapid repatriation of children and families not only circumvents the legal protections and due process for children afforded by bi-partisan legislation of the Trafficking Victims Protection Reauthorization Act (TVPRA), but also exacerbates the conditions of violence and poverty that spurred their migration in the first place, ensnaring young migrants in cycles of deportation and migration. Essential short-term policy responses include immediately desisting the rapid repatriation, providing sufficient funds and time for case processing, allocating funding for direct legal representation through the Department of Justice, and allocating resources for post-release services.
- The United States must cease the militarization of the U.S.-Mexico border. Border enforcement has not halted migration; rather, people seek alternative routes that end up being more dangerous that only grow illicit networks of smugglers and organized crime in Mexico. Migrants are increasingly forced along riskier passages, such as the treacherous Sonoran desert, where there have been 5,595 recorded deaths of migrants since 1998. Current deployment of National and State Guard troops to help Border Patrol agents respond to the spike in unaccompanied migrants is a misguided continuation of failed securitization policies and not an effective use of human or financial resources. The presence of the National Guard along the border has raised concerns among experts about adequate training, especially due to unfamiliarity with immigration law, racial profiling, and the logic of using military troops to respond to people who are surrendering. A shift towards protection and away from surveillance and securitization can save human lives in the short run and humanize transnational migrants in the long run.
- The United States must transform its policy in the hemisphere away from investing in “security” via policing and militarization and towards social security through economic and social development. For many children, migration is the choice of last resort. Creating opportunities for education, employment and safety would allow young people to thrive in their homelands. Here, the example of Nicaragua might be insightful; this is the Central American country receiving the lowest levels of U.S. foreign aid but achieving some of the highest indicators of economic development and social security. This relative security has resulted in fewer Nicaraguan children – as compared to children from Honduras, El Salvador, and Guatemala – joining the current flow of migration northward.
As scholars and U.S. citizens, we call upon the Obama administration and Congress to undertake the critical work they were elected to do – conduct a meaningful debate on immigration reform and propose viable, long-term solutions to a crisis of the U.S.’ own making.
Nine-year old Carla from San Pedro Sula, Honduras used strips from Mylar foil blankets provided at the Border Patrol detention facilities to tie back her tangled hair after 6 days with no shower. (McAllen, Texas; photo by Heide Castañeda)
About the Authors
Heide Castañeda is Associate Professor in the Department of Anthropology at the University of South Florida. A medical anthropologist who has worked in Germany, Mexico, and in the United States, her primary research areas include migrant health, health policy, undocumented/unauthorized migration, and constructs of citizenship. She is a founding member of the AccessDenied editorial collective.
Lauren Heidbrink is an Assistant Professor in Social and Behavioral Sciences and Co-Director of the Public Policy program at National Louis University in Chicago. Her research and teaching interests include the anthropology of childhood and youth, transnational migration, performance and identity, law at the margins of the state and Latin America. She recent published an ethnography on unaccompanied child migration and detention entitled Migrant Youth, Transnational Families, and the State: Care and Contested Interests (University of Pennsylvania Press, 2014).
Kristin Elizabeth Yarris, PhD MPH MA, is an Assistant Professor of International Studies at the University of Oregon. Her research and teaching interests are in the fields of global health, global mental health, social and cultural determinants of health, transnational migration and family life, and migrant and refugee health. Kristin is a faculty mentor for the Latino Mental Health Research and Training program. She is currently working on a book manuscript titled, “Grandmothers and Global Migration: Intergenerational Caregiving in Nicaraguan Transnational Families.”
- Responding to rampant gang violence in Honduras, the Obama administration is considering a proposal to screen minors there to see if they can enter the U.S. on refugee or emergency humanitarian grounds and thus bypass the dangerous migration through Mexico.
- Child migrants from Central America have shared harrowing stories of their journeys through Mexico and across the border, many involving abuse. Sonia Nazario describes the hometown contexts of this group she terms “children of the drug wars.” Commentators attribute the rise in child migration primarily to misinformation about the Obama administration’s Deferred Action program, although some politicians and concerned citizens are training the conversation on political-economic causes including the international weapons trade, crime, and poverty.