Mapping Key Detriments of Immigrants’ Health in Brooklyn and Queens

This report examined the determinants of immigrant health, focusing primarily on noncitizens and undocumented individuals living in Brooklyn and Queens, New York. The goal of the study was to enable healthcare providers, government agencies, and non-profit migrant-serving entities to identify gaps in their services to immigrant populations, and to help meet the needs of subgroups with heightened risk of adverse health outcomes. Using American Community Survey and other data for the years 2014-2018, the authors generated “detailed population profiles … for native-born citizens, naturalized citizens, legal noncitizens, and undocumented immigrants” in relationship to selected determinants of health in 32 community districts (CDs) in Brooklyn and Queens. The researchers found that poverty, overcrowding, undocumented residency status, limited English proficiency, lack of a high school education, and percent uninsured were associated with poorer health outcomes. However, significant variations existed among immigrant sub-groups. Naturalized citizens, for example, had health profiles more like the native-born population than noncitizens. Noncitizens also had relatively larger percentages of essential workers than the native-born or naturalized populations and thus were more likely to have been adversely affected by the COVID-19 crisis. Lack of health insurance – an important health determinant – affected the undocumented population more than it did residents with legal status. The authors concluded with a series of recommendations relating to improving health care access and insurance coverage, eliminating the public charge rule, addressing job and housing insecurity, increasing outreach and disseminating information, facilitating citizenship and naturalization services, and attaining legal status. Understanding that “immigrants are a heterogeneous group with many different legal statuses” is an important contribution of this study. A holistic and tailored approach to service delivery in specific neighborhoods will be needed to address the determinants of immigrant health and improve health outcomes. (Robert Like, MD, MS

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