Understanding the Impacts of Immigration Status on Access to Primary Healthcare Services: Evidence From the Lived Experiences of Ethiopian Immigrant Women in the United States.

Abstract

ObjectivesHealth inequity is a significant and pressing concern in the United States, and multiple studies showed that immigrants are one of the groups with the poorest access to healthcare compared to native-born populations. This study focuses on developing an in-depth understanding of how immigration status impacts primary healthcare (PHC) access among African immigrant women, particularly Ethiopian immigrant women (EIW).DesignA cross-sectional qualitative design was used to examine how immigration status shaped the healthcare experiences of EIW. In-depth interviews were conducted with 21 EIW in-person and virtually. The interviews were audio recorded and transcribed verbatim. Data analysis followed an inductive thematic analysis using NVivo 12 software.ResultsFour major themes emerged from the analysis, demonstrating how immigration and immigration status shape EIW's healthcare access and experiences. These were: (1) Employment-based insurance, (2) Eligibility for primary healthcare services, (3) Work conditions and time, and (4) Fear of losing status and the unknown. Across all themes, participants' experiences were deeply gendered and tied to broader labor and sociocultural conditions, highlighting the vitality of immigration status in determining healthcare access.ConclusionThe findings demonstrated the crucial need to expand work authorization to all immigrant groups, streamline the application process, and extend document validity to mitigate healthcare access barriers and prevent immigrants from taking low-wage, unprotected, and hazardous jobs that heighten health risks. Expanding eligibility to different groups of immigrants for programs such as Medicaid and Children's Health Insurance Program, and providing clear, comprehensive healthcare information tailored for immigrant populations are recommended.