Adapting to a new country is hard enough and navigating the health care system can be stressful – even for those who grew up here. We would to like share Singh's story, a family medicine resident who is planning to specialize in adolescent medicine. She emigrated to the U.S. from India as a teenager and is an American doctor now. Here's her experience:
When I was 11-years-old, my parents told me we were moving to the United States. I needed to pick out my favorite things to put into the few suitcases we were bringing over. I was overwhelmed from the first day we arrived in our new home. Our immunization records did not make it into the suitcases, which is true for a lot of immigrant families. Walking out of a clinic after getting seven vaccines in one day and a follow-up card for one month later for more vaccines was not what I expected before starting middle school.
The feeling of being overwhelmed continued through the first day of school. Though I had already learned English, it was not enough. When I talked to the other kids, all they would say "Why is your accent so weird?" and "I can't understand anything you're saying." I just did not fit in – whether it was my name, which the teachers had a difficult time pronouncing correctly, or my lunch, which didn't have chips and a juice box. I really wanted to lose my accent and sound like everyone else. When I came home that first day, I didn't even know how to share with my parents how awful my day went.
I thought I never would fit in, but I was able to make friends over time. I even started sharing my Indian food with them at lunch. Middle school is hard enough for teenagers, but it's even harder when you have to face language and cultural differences. I was lucky that my parents were educated and able to navigate the educational and medical system to get us what we needed. But not every immigrant child is as fortunate…
In 2016, 2.1 million children living in the U.S. were born in another country. Individuals applying for immigrant visas or green cards must undergo a medical exam by a government-approved civil surgeon, according to Emily M. Cohen, an attorney practicing immigration law in Philadelphia. This is to ensure that the applicant is not inadmissible to the U.S. on public health grounds. A single medical exam, however, is not the same as regular visits to a primary care provider.
Access to health care is key to preventing and treating health problems. The American Academy of Pediatrics says that children living in the U.S. who are immigrants may suffer from health problems that could be prevented or treated. For example, immigrant children in elementary school have been found to have twice as many dental cavities as their U.S.-born peers. Why does this disparity exist? Immigrant children not only face language barriers, but also may not be able to access comprehensive, affordable and culturally-sensitive health care. In other words, they are medically underserved.
Finding health coverage. Many immigrants are eligible for health insurance coverage through the Health Insurance Marketplace or through Medicaid or the Children's Health Insurance Program, Cohen says. An immigrant does not have to be a U.S. citizen or U.S. national to qualify for Medicaid or CHIP or to enroll in a health plan if he or she is lawfully present in the U.S. However, in many cases, there is a five-year waiting period to qualify for Medicaid or CHIP.
How to get health care if you are in the five-year "waiting room"?
Look locally. For example, I practice adolescent medicine at Crozer-Keystone Health System in Upland, Pa., where we provide comprehensive medical and family planning to both insured and uninsured teenagers and young adults up to age 26.
Home sweet home. The AAP supports a community-based approach to health-care delivery to ensure that underserved children have a "medical home" with a primary care provider to coordinate their care. Ashu and I wholeheartedly agree: all children deserve to have a "medical home" where everyone knows their names.
If you know an immigrant family, we ask you to share this article with them.