Health Care Access for Latino Mixed-Status Families: Barriers, Strategies, and Implications for Reform
Health Care Access for Latino Mixed-Status Families: Barriers, Strategies, and Implications for Reform
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DOI：
10.1177/0002764214550290
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发表时间：
2014-12-01
影响因子：
3.2
通讯作者：
Melo, Milena Andrea
中科院分区：
文献类型：
--
作者：
Castaneda, Heide;Melo, Milena Andrea
美国大约有230万个混合身份的家庭，包括公民、永久法律的居民、无证移民和处于法律的边缘的个人的各种组合。这些家庭提供了一个机会，以审查当代国家的运作及其在家庭层面的渗透。对许多拉丁美洲青年来说，经历不仅是由他们自己的，而且是由其他家庭成员的法律的地位决定的。本文报道了在南德克萨斯州下格兰德河山谷的混合身份家庭的医疗保健寻求经验和最近的医疗保健改革（平价医疗法案）的影响。我们采用定性人种学方法，包括55个半结构化的采访与混合状态的家庭和43个采访与卫生保健提供者，个案工作者和公共卫生官员。结果表明，伴随着改革的变化直接和间接地影响到混合身份家庭获得保健的能力。我们描述了在疾病时期的战略，包括那些独特的边境社区。我们的结论是，成功实施与医疗保健改革相关的政策，必须解决更广泛的问题，移民身份，特别是对未来的机会正规化的焦虑。这些独特的影响混合状态的家庭，创造一个涟漪反应，对所有家庭成员，并导致意外的后果，美国公民的孩子。所涉问题指出，需要为父母提供一条获得公民身份的途径，作为改善儿童福祉的一个基本步骤。
There are approximately 2.3 million mixed-status families in the United States, containing varied combinations of citizens, permanent legal residents, undocumented immigrants, and individuals in legal limbo. These families offer an opportunity to examine the functioning of the contemporary state and its penetration at the household level. For many Latino youth, experiences are framed not only by their own but other family members' legal status. This article reports on health care seeking experiences of mixed-status families in the Lower Rio Grande Valley of South Texas and the impact of the recent health care reform (Affordable Care Act). We utilized qualitative ethnographic methods including 55 semistructured interviews with mixed-status families and 43 interviews with health care providers, caseworkers, and public health officials. Results indicate that changes accompanying the reform directly and indirectly affect mixed-status households' ability to access care. We describe strategies in times of illness, including those unique to border communities. We conclude that, for successful implementation of policies associated with health care reform, broader issues related to immigration status must be addressed, especially anxieties regarding future chances of regularization. These uniquely affect mixed-status families, create a ripple effect on all household members, and result in unintended consequences for U.S. citizen children. Implications point to the need for a pathway to citizenship for parents as a basic step in improving well-being of children.