Doctoral Dissertation Research: Status and Healthcare Access in the U.S.-Mexico Borderlands

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Social scientists know that access to critical services, including healthcare, depends not only on cost and availability but also on a multitude of social, cultural, and political factors. These factors include the status of those seeking care, where they live, how they interact with healthcare providers, and if they fit cultural notions of being deserving. However, what is not well understood is how these factors interact and come together in any individual's actual experience of care and its outcome. This research project will address this gap by exploring in detail the multiple pathways through which legal status affects the experiences of Latin American immigrants who seek dialysis treatment for end-stage renal disease (ESRD) in the lower Rio Grande Valley of south Texas. The research will be conducted by University of Texas at San Antonio doctoral student Milena A. Melo, under the supervision of Dr. Kathryn J. Fleuriet.The South Texas borderlands are characterized by some of the highest rates of both poverty and undocumented residents in the country. Increasing militarization of the border has made crossing into Mexico for healthcare a virtual impossibility for undocumented immigrants. As a result, these borderlands are a particularly appropriate research site in which to pursue questions of the effects of external factors on healthcare. The particular lens through which these issues will be studied is the lived effects of immigration law and healthcare policy implementation for immigrants with different legal statuses. Methods will consist of twelve months of participant observation, surveys, and semi-structured interviews with healthcare professionals and low-income, Latin American dialysis patients. Findings from this research will contribute to understanding the relationship between normative understandings of rights, citizenship, and the social production of health disparities. While previous research has tended to generalize both the providers and the recipients of care, this project is structured to disaggregate these groups and to see how they navigate differently within the system, which will contribute to both better theory and better policy.