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Illegality as risk factor: A survey of unauthorized migrant patients in a Berlin clinic

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  • Castañeda, Heide

Abstract

Unauthorized migrants face health disadvantages in many receiving nations. However, few studies have explored precisely how the condition of "illegality" influences illness experiences, medical treatment, and convalescence. This article presents a case study from Germany (2004-2006 and 2008), where unauthorized migrants face limited access to health care and the threat of deportation results in avoidance of services and treatment delays. This is confounded by unique laws which essentially criminalize health care workers for aiding migrants. This article provides a snapshot of 183 patients who attended a Berlin clinic that functions as the single largest source of medical assistance for unauthorized persons in Germany. The demographic information sketches a picture of labor migrants with a mean age of approximately 29 years. More women than men presented at this clinic, a result of its ability to successfully arrange prenatal care and delivery as well as a reflection of local labor markets. The diversity of countries of origin (n = 55) is surprising, underscoring the utility of using illegal status as a unifying variable to highlight migrants' shared position in the global economy and the resulting barriers to basic medical services. Patients presented with a range of illnesses typical for their age group. However, the effects of illegal status resulted in four areas of disparities: 1) limits to the overall quality and quantity of care for mothers and infants; 2) delayed presentation and difficulties accessing a regular supply of medication for patients with chronic illnesses; 3) difficulties in accessing immediate medical attention for unpredictable injuries and other acute health concerns; and 4) a lack of mental health care options for generalized stress and anxiety affecting health. In Germany, an incoherent policy environment contributes to inadequate services and treatment delays. Solutions must address these legal ambiguities, which represent a primary barrier to equity in a nation with otherwise universal health coverage.

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  • Castañeda, Heide, 2009. "Illegality as risk factor: A survey of unauthorized migrant patients in a Berlin clinic," Social Science & Medicine, Elsevier, vol. 68(8), pages 1552-1560, April.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:8:p:1552-1560
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    References listed on IDEAS

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    1. Wolff, Hans & Stalder, Hans & Epiney, Manuella & Walder, Angela & Irion, Olivier & Morabia, Alfredo, 2005. "Health care and illegality: a survey of undocumented pregnant immigrants in Geneva," Social Science & Medicine, Elsevier, vol. 60(9), pages 2149-2154, May.
    2. Stuber, Jennifer & Meyer, Ilan & Link, Bruce, 2008. "Stigma, prejudice, discrimination and health," Social Science & Medicine, Elsevier, vol. 67(3), pages 351-357, August.
    3. Wingate, Martha S & Alexander, Greg R, 2006. "The healthy migrant theory: Variations in pregnancy outcomes among US-born migrants," Social Science & Medicine, Elsevier, vol. 62(2), pages 491-498, January.
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    1. Castañeda, Heide, 2013. "Structural vulnerability and access to medical care among migrant street-based male sex workers in Germany," Social Science & Medicine, Elsevier, vol. 84(C), pages 94-101.
    2. Marrow, Helen B., 2012. "Deserving to a point: Unauthorized immigrants in San Francisco’s universal access healthcare model," Social Science & Medicine, Elsevier, vol. 74(6), pages 846-854.
    3. Chavez, Leo R., 2012. "Undocumented immigrants and their use of medical services in Orange County, California," Social Science & Medicine, Elsevier, vol. 74(6), pages 887-893.
    4. Huffman, Samantha A. & Veen, Jaap & Hennink, Monique M. & McFarland, Deborah A., 2012. "Exploitation, vulnerability to tuberculosis and access to treatment among Uzbek labor migrants in Kazakhstan," Social Science & Medicine, Elsevier, vol. 74(6), pages 864-872.
    5. Viladrich, Anahí, 2012. "Beyond welfare reform: Reframing undocumented immigrants’ entitlement to health care in the United States, a critical review," Social Science & Medicine, Elsevier, vol. 74(6), pages 822-829.
    6. Vanthuyne, Karine & Meloni, Francesca & Ruiz-Casares, Monica & Rousseau, Cécile & Ricard-Guay, Alexandra, 2013. "Health workers' perceptions of access to care for children and pregnant women with precarious immigration status: Health as a right or a privilege?," Social Science & Medicine, Elsevier, vol. 93(C), pages 78-85.

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