The Health of DREAMers

In a recent defense of the now rescinded Deferred Action for Childhood Arrivals (DACA) program, Barack Obama remarked, “These Dreamers are Americans in their hearts, in their minds, in every single way but one: on paper.” In 2009 President Obama used executive power to establish the DACA program, in an effort to protect an especially vulnerable sub-group of the undocumented population. Hundreds of thousands of undocumented children were able to come out of the shadows and work, go to school, and live their lives with a semblance of normalcy and peace.

DACA recipients, often called DREAMers (Development, Relief, and Education for Alien Minors), present as high school valedictorians and service workers alike; they are unique human beings who are looking to succeed in a country they consider their home. And currently, their status is in jeopardy with the President’s rescindment of DACA.

They are also becoming sicker as a result. Physical and mental health outcomes have been clearly linked with immigration status. The health and wellbeing of DREAMers is influenced by politics, culture, racism, xenophobia, and discrimination. The health needs of these young people often go beyond lack of access to medical care.

Informing Immigration Policy with Research

“There is no [medical] help out there and if there is, it’s really hard to find,” remarked one DREAMer in an article by Raymond-Flesch, et al. published in the Journal of Adolescent Health.

In the authors’ study, 61 DACA-eligible Latinos aged 18-31 were recruited from the Los Angeles and Bay areas during the summer of 2013 to participate in qualitative interviews. The goal of the study was to assess the general health of DREAMers and their access to health care. Study participants were self-identified Latinos age 18-31 eligible for DACA.  Not much is known about this understudied population because they often live in the shadows.

Unmet Health Needs

Participants indicated that they had many unmet health needs, including stress and anxiety related to their immigration status and poor access to primary and specialty care. One participant speculated, “I think a lot of things get normalized, so stress, anxiety, working hours a week…I think a lot folks are in deep depression, but…don’t realize it.”

Several other important barriers to care were identified by the authors. DREAMers identified challenges in transition to adulthood and poor physical health due to their inability to access preventive care like vaccination, reproductive care, and annual physicals. Twenty-three percent reported being depressed in the last month, 62% reported binge drinking, and 25% reported a history of smoking.

DREAMers often sought alternative sources of care for all ailments except serious illness.  The most important barrier was cost. One DREAMer remarked, “Do I want to spend $40 or $35 on the checkup, or do I want to spend it on food?” Forty-three percent reported extreme poverty though most (80%) were employed. Health care literacy was the second major challenge. Fear and mistrust of medical professionals was also identified as a serious problem. A participant remarked, “[Doctors] don’t really know much about the status and what it means…so sometimes the alternatives that they offer…don’t work for you because you’re not eligible for them.”

Despite all of this, DREAMers reported their circumstances were “inadvertently protective” by forcing them to be resilient despite the many impediments created by their immigration status.  One participant remarked, “I needed to find a way to progress pretty much on my own…I feel more empowered, like I did it by myself.”

This study was published in 2014. Things have gotten much worse with the rescindment of DACA, but congressional intervention can play a major protective role in these hundreds of thousands of lives. As of this writing, Senate Majority Leader McConnell has promised debate on DACA and the President has said that DREAMers should be able to stay.

Feature image: Ignatian Solidarity Network, DSC00333, used under CC BY-NC 2.0