Health migrations: How pre-migration healthcare experiences and US healthcare challenges shape immigrants’ transnational healthcare practices

Research examining immigrants' healthcare experiences in host countries have found that various structural and socio-cultural challenges impede their healthcare access. In response, migrants address unmet medical needs by engaging in what we call “transnational healthcare practices” (THCPs). But less research has explored how migrants' pre-migration healthcare experiences influence their negotiation of care across transnational contexts. This paper aims to fill that gap by addressing four questions: 1) How do pre-migration healthcare experiences at home shape immigrants' orientation to transnational healthcare practices (THCPs)?; 2) What structural and socio-cultural healthcare challenges facilitate migrants' THCPs?; 3) What THCPs do immigrants engage in?; and 4) How do providers' views of THCPs differ from migrants' perceptions? Data comes from 132 interviews conducted with Latin American immigrants and healthcare providers in Boston from 2012 to 2019. Findings indicate that: 1) pre-migration healthcare experiences generate “here” and “there” comparisons that facilitate migrants' THCPs in the US; 2) the complex and costly US healthcare system poses challenges that push migrants' THCP engagement; 3) migrants engage in THCPs like receiving medication from home, having transnational telehealth consultations, and traveling home for care; and 4) providers caution against THCPs because of health consequences, although migrants view them positively. Ultimately, THCPs represent migrants' agency to meet healthcare needs amid structural and socio-cultural challenges in the US healthcare system. Through highlighting the role of pre-migration healthcare practices at home as central to migrants’ THCPs, this article contributes to scholarship on transnationalism, immigration, and health care.