Speakers at Tuesday’s Keynote Series session on immigrant health at the ATS 2024 International Conference discussed health-related issues for immigrants in the U.S. who are faced with an ever-changing and fragmented health care system, limited access to care, and occupational hazards.

“This is a vulnerable population that faces many challenges, but it’s also a population from which we learn a lot about resiliency,” said Fernando L. Holguin, MD, MPH, professor of medicine-pulmonary sciences & critical care at the University of Colorado, who moderated the session.

Immigrants Deserve Comprehensive Health Care

Denisse Rojas Marquez, MD, MPP, an emergency medical physician at Boston Medical Center Emergency Medicine and co-founder of Pre-Health Dreamers, stressed that efforts to improve access to health care for immigrants often leave out mental health and dental care.

“Immigrants face significant trauma, not only from their home country and journey to the U.S., but also from the stigma and discrimination of being a new or undocumented immigrant,” she said.

Julie Linton, MD, FAAP, immediate past chair of the American Academy of Pediatrics Council on Immigrant Child and Family Health, agreed, citing the importance of mental health care for children.

“Mental health is so important for both children and their parents,” she said. “The most important buffer for ongoing stress in a child’s life is having a stable, loving adult. That includes having a parent with access to services.”

Immigrants are at Increased Risk of Occupational Injury

Marc B. Schenker, MD, MPH, distinguished professor emeritus of public health sciences and medicine at the University of California Davis School of Medicine, discussed the burden of occupational health hazards among immigrants.

“I realized after several years [of studying occupational health among agricultural workers] that being an immigrant contributed to their health risk in ways that were equal to the risk of the job,” he said.

Immigrants are more likely to work in dangerous industries, such as agriculture, construction, and transportation. However, even within the same industry or occupation, immigrants have higher injury and fatality rates compared to native-born workers.

Part of this is due to a lack of protection for immigrants. In addition, immigrants may not be offered safety training and therefore, may be unaware of the potential occupational risks they face.

“Immigrant workers are often in a vulnerable and precarious position,” said Dr. Schenker. “They are told that if they don’t want to work, someone else will. They are unwilling to complain and more likely to take extra risks on the job.”

He urged physicians to ask immigrants about their jobs and any occupational exposure to dust, fumes, or gases.

Physicians Should be Aware of Local Health Care Policies

Speakers also advised physicians to be aware of ever-changing state policies. They shared stories of immigrants who were incorrectly told they were ineligible for care because new policies had not been implemented at an administrative level, even years after the law was enacted.

“So much is changing day by day,” said Dr. Rojas Marquez. “It’s a tall order for an immigrant to know.”

Even laws not directly related to health care can impact access to care. For example, several states do not allow immigrants to receive driver’s licenses.

“We can’t provide care if people can’t get here,” said Dr. Linton. “Every time a patient gets into a car to see me, they are taking a risk.”

Dr. Rojas Marquez urged attendees to not only remain aware of local policies but to use their expertise and authority as physicians to enact change.

“We are all members of institutions that lobby at the federal or state level,” she said. “If we don’t add our voice, our legislators will not prioritize the issues that are important to us.”