This doctoral dissertation project will examine the types of geopolitical barriers new migrants face while accessing and obtaining healthcare in the U.S. South. This study goes beyond the usual studies of healthcare access as it analyzes actual healthcare experiences, thereby contributing to new health geography by focusing on how migrants experience healthcare access. This study also contributes to migration research that examines the region of the U.S. South as it is currently being shaped by new migration. Combining archival research, participant observation, interviews, and focus groups, this project answers a set of questions that address the barriers that exist for migrant access to healthcare, how these barriers have been created, and the role that struggling with these barriers plays in the shaping of citizenship in the U.S.
Findings from this project will be made available via a research report as the results will be of interest to healthcare providers, advocates, as well as policymakers. Results from this research will be included in undergraduate teaching. As a Doctoral Dissertation Research Improvement Award, this project will provide support to enable a promising student to establish an independent research career.
This Doctoral Dissertation Research Improvement grant from the National Science Foundation provided the co-PI with the resources needed to complete timely and significant research on immigrants’ access to healthcare in the U.S. Specifically, this project examined the challenges recent Latina immigrants faced when accessing and receiving reproductive healthcare in Atlanta, GA. Atlanta is an important city to study in the context of immigration: along with many other metropolitan areas in the U.S. South, the Atlanta metro area has experienced a drastic increase in Hispanic migration within the past several decades. It is important to study these "emerging immigrant gateway cities" because, unlike longstanding immigrant destinations, the networks and services that help immigrants acclimate to their new surroundings are currently in a highly nebulous state. Further, this study contributes to work that explores the changing racial makeup of the U.S. South, which has long been characterized by a distinctly black-and-white divide. The NSF DDRI grant allowed the co-PI to gather the data needed to further explore these issues by living and conducting fieldwork in the Atlanta metro area during the spring and summer of 2013. Throughout this time, the co-PI interviewed 15 immigrant healthcare advocates and 56 recent Latina immigrants. As she is not fluent in Spanish, the-co-PI was able to hire a Latina immigrant as interpreter to help facilitate interviews with Latina immigrants. The co-PI also volunteered at several organizations that specialize in immigrant healthcare advocacy. Finally, she performed participant observation at Grady Memorial Hospital’s International Clinic, which has a substantial Latina immigrant clientele. These research methods allowed the co-PI to gather enough data to fully address the project’s intellectual merit and broader impact objectives. The co-PI discovered that, although networks and service that help immigrants to better adjust to their new communities are limited relative to longstanding immigrant gateway cities, programs and clinics that cater to immigrants are becoming more prevalent and are reaching a wider number of immigrants. Moreover, this research revealed that informal social networks exist among Latina immigrants in order to disseminate reproductive healthcare information, as well as advice about which clinics and hospitals were best. With that being said, however, Latina immigrants face many obstacles to accessing reproductive healthcare, and many difficulties in their experiences of receiving it. For instance, many of the women the co-PI spoke with had to rely on public transportation or walking in order to get to their doctor’s appointments, which often took hours out of their days. Once at the doctor’s office, many women had to wait upwards of an hour in the waiting room, as low-cost, culturally competent facilities are limited, and thus often overcrowded. Another problem many Latina immigrants encountered was that they did not feel they were treated with respect during appointments, and thus did not feel as though they received an adequate quality of healthcare. Much of this had to do with the rushed nature of appointments, with most lasting around five to ten minutes. There were other compounding factors, such as lack of interpreters and difficulty communicating even when interpreters were present. In terms of what this study contributes to research on the changing racial landscape of the U.S. South, the co-PI found that because of the unfamiliarity with Hispanic culture and hostility towards Hispanic immigrants, whom are very often perceived as "illegal," the U.S. South has a ways to go to be fully accepting of this new population, who are increasingly become an important part of their community and economy. A general conclusion from this study is that caring for the health of Hispanic immigrants is caring for the social and economic vitality of the place they now call home. This grant has provided the co-PI with data to complete her doctoral dissertation, which will consist of three articles to be disseminated via highly ranked academic journals in geography. The first article, in preparation now, is about to be submitted to Political Geography, a top journal in the field. The results from this research have also been presented at several national conferences, with several other presentations planned for the future. Finally, data from this project has greatly informed the co-PI’s undergraduate teaching, for example the co-PI’s fall 2014 semester’s general education course on U.S. Cities at the University of Kentucky.
