NR 602 Marginalized Women Assignment

NR 602 Marginalized Women Assignment

NR 602 Marginalized Women Assignment

Immigrant Women in Texas

This paper will discuss the healthcare issues that face immigrant women in the United States, specifically in the state of Texas and specifically unauthorized or undocumented immigrants. This group is considered marginalized because they are not legally residents of the United States, so they are much less likely to seek or get the healthcare that they need. As a family nurse practitioner in south Texas, this will be an issue that will be dealt with very regularly. This paper will outline the unique needs that immigrant women have and the plan that will be put forth to address those needs.

Background and Significance

The United States has historically been a place of refuge to those seeking a better life from other countries. It is estimated that approximately 13% of the entire population was born outside of the United States. Half of this population is living in the states of New York, Florida, Texas, and California, and 53% of those are from Latin America. Because this 13% of the overall population is largely undocumented, their overall access to healthcare is extremely limited, much less adequate and proper healthcare, making them a high risk population (Committee on Health Care for Underserved Women, 2015). This also puts the rest of the population at risk because this group is more likely to have communicable diseases that are not cared for or controlled (Hacker, Anies, Folb, & Zallman, 2015).

 

Socio-Economic Issues

Since unauthorized immigrant women are not likely to have access to health insurance, they are less likely to visit primary care providers, much less anyone else in healthcare. This makes them much more likely to have adverse health events, undesirable health outcomes, and neonatal morbidity and mortality. These women are also more likely to be hospitalized for childbirth-related complications, most likely because they are much later, if at all, to seek or get prenatal care. There is also a rise in the incidence and mortality from cervical cancer among unauthorized immigrants (Committee on Health Care for Underserved Women, 2015). All of these issues are unique to the immigrant women, especially those that are here unauthorized.

NR 602 Marginalized Women Assignment

Social Justice

Whether or not unauthorized immigrants should receive healthcare in the United States is a “hot topic” these days. There are a wide variety of opinions on this subject and this paper is not intended to debate this at all; however, the basic fact is that many of these unique women do not get the healthcare they need because they do not have the funds to pay for it themselves and do not qualify for any kind of healthcare assistance. This causes some incredibly important situations that require, many times, critical thinking and creativity at its best in order to get this group of individuals the care that they need (Committee on Health Care for Underserved Women, 2015).

Ethical Issues

The major issues regarding barriers to healthcare for unauthorized immigrant women (and unauthorized immigrants in general) are legal barriers, financial constraints that limit their ability to even get to or pay for healthcare, and discrimination based on documentation status (Hacker, Anies, Folb, & Zallman, 2015). All three of these could be considered ethical issues, depending on how one was to look at it, but without a doubt, the issue of discrimination is an ethical one, especially when it involves healthcare providers. Additionally, the legal barriers such as denied access to healthcare assistance and insurance could be an ethical issue and has been a very hot topic in the United States with the question of whether or not unauthorized immigrants should have access to healthcare. This begs the question: since these individuals are here “illegally,” do they have the right to the healthcare benefits that hardworking, legal Americans are paying for? And if they do not, then how do they get care when they are here? As previously mentioned, the purpose of this paper is absolutely not to debate the legalities and opinions of whether or not “illegals” should be insured; it is simply to point out the issue and to come up with a plan to solve it.

Plan of Action

Although the plan should absolutely include changes at the state and maybe even federal level, this paper is going to discuss how these issues can be addressed in the local clinic on a day-to-day basis.

Culturally Appropriate Materials

Not only should culturally and linguistically appropriate materials be available in the clinic setting, but they should also be made available in the community, with details on how the immigrant woman, especially the undocumented immigrant woman, can receive adequate healthcare. These can be placed in the clinic in the waiting room and can be placed in various areas in the community, such as grocery stores, gas stations, and laudromats. These should also be in the most common languages seen in that specific area (Hacker, Anies, Folb, & Zallman, 2015). While this is not necessarily easily measurable, it could be set forth in a schedule so that a certain amount of materials are put out every so often so as to make sure that it was maintained adequately.

Staff Training

Staff (providers as well as support staff) should be trained on a regular basis on cultural significance and sensitivity (Hacker, Anies, Folb, & Zallman, 2015), even perhaps basic medical terminology classes in the most common foreign languages could be offered to be able to communicate better with patients that do not speak English. In order to measure this, incentives could be offered so that everyone feels more inclined to take the language classes, and every staff member could be required to take specific cultural sensitivity training. Further incentives could be offered if the staff gets above a 95% compliance for cultural training for the year. These numbers and percentages could easily be kept in a spreadsheet and someone could be tasked with keeping up with it.

NR 602 Marginalized Women Assignment

Cash Payment Options

This plan is a bit more complicated because, depending on the clinic’s financial situation, it could mean that a financial loss would be risked if too many discounted cash appointments and procedures are offered (Hacker, Anies, Folb, & Zallman, 2015).  There is a potential that this could be written off as charitable work, especially in a rural area. This would be a perfect opportunity to offer a set number of appointments at a discounted cash price for those that cannot afford or is not qualified for insurance coverage, which would include most immigrants. There could potentially even be a whole day set aside for this purpose alone, even setting aside a specific number of appointments for women’s health, since that is one of the most important factors (Hacker, Anies, Folb, & Zallman, 2015); of course, this would mean that some very detailed numbers would need to be “crunched” in order to make sure that the business could stay afloat and still be able to offer these services. Once a specific financial plan is put in place, it could be easily measured (and would absolutely have to be) in order to ensure that the clinic could keep offering this specific service for this very unique population.

Conclusion

The immigrant population is a very unique and specific group with very specific and unique needs that have to handled creatively and with some incredibly creative thinking. There is a large need in several very large and populous states for this need to be met, regardless of one’s political stance or personal thoughts on whether or not this population should qualify for state or federal healthcare assistance. The bottom line is that they are here, and are likely to continue to be here, and if they do not receive basic medical care, they will not only be at higher risk for serious health issues themselves, but could potentially be putting the remainder of the population at risk. We have a moral and human obligation to somehow figure out how to give care to this unique population of women, even if healthcare providers must get creative in order to get that care to them.

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References

Committee on Healthcare for Underserved Women. (2015). Committee opinion number 627: Health care for unauthorized immigrants. The American College of Obstetricians and Gynecologists, 125, 755-759. Retrieved from https://www.acog.org/-/media/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/co627.pdf?dmc=1&ts=20181005T2009318651

Hacker, K., Anies, M., Folb, B.L., & Zallman, L. (2015). Barriers to health care for undocumented immigrants: A literature review. Risk Management and Healthcare Policy, 8,175-183. Doi: 10.2147/RMHP.S70173