Barriers to Care for Individuals without Authorized Immigration Status with Cancer

• In Event: Medical Sociology Section Roundtables
  In Refereed Roundtable (90 minute): Table 12. Migration and Health

Abstract

There are over 11 million people, with 500,000 people in New York City, without authorized immigration status. However, little is known about the facilitators of and barriers to care, overall healthcare utilization, and experiences of individuals without authorized immigration status with cancer. In this study, we conducted 40 semi-structured interviews. First, we interviewed 20 respondents who work in clinical contexts (e.g., physicians, nurses, licensed clinical social workers) from varied institutions (e.g., size and type of the hospital, geographic region, demographic profile of patients served) that provide care to IWAIS patients to assess facilitators of and barriers to cancer care. Second, we conducted interviews with 20 respondents working in community-based and community health organizations (e.g., patient navigators, immigration health advocates, outreach and health education staff members) that support undocumented patients seeking cancer care. We then coded and analyzed transcripts from the interviews on Atlas.ti and discussed themes that emerged amongst the team members. On barriers to care for undocumented cancer patients, we identified several factors: (1) financial barriers and lack of insurance; (2) language and cultural barriers; (3) navigational challenges and coordination of care that leads to a lack of continuity of care; (4) unmet basic needs and the lack of social, community, and familial support; and (5) mistrust of state-run programs and healthcare institutions. Our findings point to the importance of cultural health capital—navigational capital, linguistic capital, social capital—(Shim 2010; Dubbin et al. 2013; Madden 2015; Næss 2019) in facilitating healthcare access for undocumented cancer patients, as well as the vital role that health intermediaries such as patient navigators at community-based organizations in brokering these various forms of capital (Kellogg 2014; López-Sanders 2017a; 2017b).

Authors

• Larry Au, City College of New York

• Joshua A. Budhu, Memorial Sloan Kettering Cancer Center