Table of Contents
Introduction
Immigrant adults make up a diverse population in the United States, representing 16% of adults in the country. They play a significant role in the workforce and communities, with one in four children in the U.S. having at least one immigrant parent. However, the experiences of immigrants in terms of health and access to health care are not always well-reflected in policy debates or discussions. Limited data on health and health care for immigrants, particularly in relation to immigration status, have hindered a comprehensive understanding of the variation in experiences among immigrants. This report aims to provide new data on the health and health care experiences of immigrant adults in the U.S., including data on immigration status, income, race and ethnicity, and other factors.
Methodology
The data for this report is based on the Survey of Immigrants, the largest and most representative nongovernmental survey of immigrants living in the U.S. to date. The survey was conducted by KFF in partnership with the Los Angeles Times during Spring 2023. The survey provides a more nuanced understanding of the diversity of immigrant experiences and offers broader insights into experiences in health care settings. In addition to the survey data, focus groups with immigrants from various backgrounds were conducted to provide additional insights.
Key Findings
Health Status of Immigrant Adults
- The majority of immigrant adults (79%) report being in good to excellent health.
- Lower income immigrant adults are more likely to report worse health and have health conditions requiring ongoing treatment.
Health Coverage of Immigrant Adults
- Half of likely undocumented immigrant adults and nearly one in five lawfully present immigrant adults are uninsured compared to less than one in ten citizens.
- Coverage rates also vary by income, with a quarter of lower income immigrant adults reporting being uninsured compared to 5% of higher income immigrant adults.
- State coverage policies make a difference, as immigrant adults in states with more expansive coverage are less likely to be uninsured.
Use of Health Care in the U.S.
- Most immigrant adults have sought or obtained medical care in the U.S., with 84% reporting that they have received or tried to receive care.
- Uninsured immigrant adults are less likely than those with coverage to seek or use health care services.
- Private doctor’s offices and community health clinics are the most common sources of care for immigrant adults.
Experiences with Health Care
- One in four immigrant adults who have received care in the U.S. report being treated unfairly by a health care provider based on factors such as insurance status, accent or ability to speak English, and race, ethnicity, or skin color.
- Black and Hispanic immigrant adults are more likely to report unfair treatment compared to White immigrant adults.
- Immigrant adults, especially those who are uninsured, lower income, and have limited English proficiency, face difficulties obtaining respectful and culturally competent care.
Challenges Accessing Health Care
- About one in five immigrant adults report problems paying for health care, with higher rates among lower income and noncitizen immigrants.
- One in five immigrant adults say they skipped or postponed health care in the past year, with higher rates among uninsured immigrants.
- Some immigrant adults report that their health worsened as a result of skipping or postponing care.
Use of Public Assistance and Public Charge Fears
- Many immigrant adults are uncertain about how using assistance for food, housing, and health care may impact their immigration status.
- Some immigrant adults, especially those who are likely undocumented, avoid applying for government assistance due to immigration-related fears.
- Linguistic barriers and eligibility restrictions also contribute to challenges in accessing public assistance.
Conclusion
The experiences of immigrant adults in the United States regarding health and access to health care are diverse and influenced by factors such as immigration status, income, race and ethnicity, and language proficiency. Many immigrants face barriers to accessing health coverage and care, including higher uninsured rates, difficulties in finding a trusted doctor, and experiences of unfair treatment. Language barriers and immigration-related fears also contribute to challenges in obtaining respectful and culturally competent care. Public assistance programs could help reduce financial stress and improve access to care for immigrant families, but confusion and fear about the impact on immigration status hinder their utilization. Addressing these challenges and promoting equitable access to health care for immigrant adults is essential for their health and well-being.