Every day, organizations worldwide are engaged in a collective two steps forward, one step back march toward improved immigration services and policies. What hard-earned lessons are these nonprofits, and the foundations that support them, learning from their persistent efforts? This collection of evaluations, case studies, and lessons learned exposes and explores the nuances of effective collaboration, the value of coordinated messaging, the bedrock of ongoing advocacy efforts, and the vital importance of long-term and flexible funding.

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Reducing Barriers, Improving Outcomes: Using Federal Opportunities to Expand Health Care Access for Individuals with Limited English Proficiency

July 1, 2023

The United States' health care system consistently fails people whose primary language is not English, frequently known as individuals with limited English proficiency (LEP). These breakdowns result in increases in both unnecessary care due to misdiagnoses and poor health outcomes. Luckily, there are clear and actionable policy interventions that Congress and federal agencies can take to address these health disparities. By increasing the quality of languages services, making them more available, and strengthening both provider and patient understanding of existing rights and tools, we can improve the health of millions of families in the U.S.

Employment Among Immigrants and Implications for Health and Health Care

June 12, 2023

Immigrants are an integral part of our nation, including our nation's workforce. Immigrants support the U.S. economy and its workforce by filling unmet labor market needs, especially in industries such as construction and agriculture that are at increased risk of adverse health outcomes and injuries, including climate-related health hazards. Through entrepreneurship and establishment of businesses, immigrants also create jobs that generate employment for other U.S. residents, including U.S.-born citizens. However, their employment patterns contribute to them having higher uninsured rates and facing increased health risks relative to their U.S.-born peers. While their employment patterns, in part, reflect lower educational attainment levels and skills among immigrant workers versus U.S.-born workers, research and data suggest that some immigrant workers may be overqualified for their jobs—that is having education or skills beyond what is necessary for their job. Addressing this occupational mismatch could help reduce disparities in health and health care faced by immigrant families and positively benefit the U.S. economy.This brief examines socioeconomic characteristics and employment patterns among immigrant workers and examines how they compare to U.S.-born workers, including differences among college-educated workers. It discusses the implications of these patterns for their health and well-being as well as the nation's economy.

Building Social Cohesion Among Diverse Youth During COVID-19: Insights from the Pilot Phase of the Youth Unity Project

June 8, 2023

The United States has a long, complex history of immigration that has shaped how we view the country—its strengths, its shortcomings, as well as its promise to be a sum greater than its parts. For us to reach our fullest potential as individuals and as a nation, it is incumbent on us to understand and explore our many immigration journeys. However, public debate around immigration is more divisive now than it has been in generations. Throughout the COVID-19 crisis, this widening divide has quickly created an environment in which youth, both new immigrants and those within the receiving community, feel less connected, engaged, and empowered to create their own, bold vision for a cohesive nation.The Youth Unity Project, a joint effort created by Y-USA and the Council, connects young, new immigrants with young people in their respective receiving communities and teaches them about immigration in the United States. Throughout the process, the young people engage on issues related to social justice, belonging, and social cohesion.

Children; Community-Based Outreach & Activity

More Humane Immigration Policies Will Reduce Migrant Trauma: A Conversation with Dr. Alfonso Mercado

May 25, 2023

Hostile immigration enforcement policies and anti-immigrant actions against refugees and asylum seekers are causing trauma to migrant families and exposing them to dangerous living conditions on both sides of the U.S.-Mexico border. In recent years, stress from the COVID-19 pandemic has compounded the negative effects of these policies on the health of migrants.This policy brief outlines a conversation held with Dr. Alfonso Mercado, a clinical psychologist and associate professor at the University of Texas Rio Grande Valley School of Medicine. He has conducted extensive clinical work in migrant tent encampments at the U.S.-Mexico border, and on Feb. 28, 2023, he met with migration policy experts and community leaders to discuss the detrimental mental health effects of the ongoing migrant crisis there. The conversation focused on the impact of key policies, such as the use of Title 42 on migrants' mental health and well-being.

Refugees & Asylum Seekers

Investing in Farmworker Health: How Research Can Help Protect the People Who Produce Our Food

April 21, 2023

Federal agencies are underfunding research on farmworker health, including areas that urgently need attention.The millions of US farmworkers who produce our food face a multitude of health hazards. Yet US law and employers afford them only limited protections.This analysis highlights the need for robust research from federal agencies. We recommend that the USDA increases funding for research on farmworker health in the next food and farm bill. Further, federal funding should encourage cross-agency collaboration, prioritize research on the combined impacts of climate change and multiple pesticide exposures, and create opportunities to serve populations underrepresented in current research.

Migrant Workers

Accessing Coverage in Covered California

April 14, 2023

Undocumented Californians are explicitly and unjustly excluded from accessing and purchasing health care coverage plans through Covered California, the state's marketplace established under the federal Affordable Care Act (ACA). Assembly Bill 4 (Arambula) would address this exclusion by taking the first step toward allowing undocumented Californians to buy health plans through Covered California. AB 4 would direct Covered California to apply for a federal waiver under section 1332 of the ACA to waive the specific section that explicitly prevents undocumented individuals from purchasing coverage in Covered California.

Coping During Displacement: Integrating Mental Health and Psychosocial Support in Refugee Assistance Programs

March 28, 2023

At JRS/USA, we recognize the immense challenges faced by refugees and displaced individuals. We understand that displacement can cause profound trauma, which can have long-lasting effects on mental and emotional health. That's why we believe it's crucial to integrate Mental Health and Psychosocial Support (MHPSS) into our refugee assistance programs.The 2023 report "Coping During Displacement: Integrating MHPSS in Refugee Assistance Programs" highlights the importance of MHPSS in supporting refugees and displaced persons. The report emphasizes the need for a holistic approach to MHPSS that considers the unique experiences of each individual. We believe that by integrating MHPSS into our programs, we can help refugees build resilience and cope with the challenges of displacement.

Refugees & Asylum Seekers

Migrant Women in Morocco: Improving Sexual Health and Tackling Gender-based Violence

March 20, 2023

In this policy brief, we summarize our research on the sexual and reproductive health of women migrants in Morocco, as well as their history of violence and utilization of support services. Our findings show a high prevalence of SGBV among women migrants in Morocco, poor utilization of support services, as well as significant SRH issues. We recommend improving access to adequate information about existing protection and support services, establishing and strengthening support networks, improving research and data collection on SGBV and the barriers to access services, improving coordination mechanisms between actors in migrant health and protection, and promoting transparency and accountability.

Health, Place, and Space: Adolescent Female Refugees in Palestinian Camps

March 19, 2023

Female Palestinian refugee adolescents living in camps face enormous challenges that influence their health. Studies have shown the spatial and physical contexts of people's lives — where and how they live — determine their health, meaning that refugee health cannot be fully understood in isolation from the spatial and physical contexts that shape and sustain health conditions and community environment. Chronic disease, mental health issues, health conditions, and behavior are all affected by spatial and physical factors such as neighborhood socioeconomics, social environment, and the physical (built) environment, all of which are amplified inside refugee camps, including Palestinian camps. Place and space take into account the social relations and social construction of a community as well as the personal experience of spatiality, temporality, and materiality that influence the process of shaping the health status of individuals, especially refugees. This study investigates the construct of space in Palestinian camps in Jordan and the West Bank, and its effect on the health of female adolescents living in these camps. We examine how place and space influence and shape the health status of refugees. To do this, we consider the social relations and social construction of these refugee communities as well as individual refugees' personal experiences of spatiality, temporality, and materiality.

Refugees & Asylum Seekers; Women

Gender and Security in Lebanon During and Post-COVID-19: The Case of Migrant and Refugee Women

March 18, 2023

Lebanon continues to navigate the country's most devastating political, economic, and financial crisis in its post-independence history. The layered and intersectional implications of this crisis have been felt hardest by the country's most vulnerable and marginalized communities — predominantly the country's millions of refugees and migrants. Whether in the areas of social inequality, unemployment, statelessness, homelessness, or food insecurity, Lebanon's refugee and migrant communities have been struggling to attain basic human rights.This brief examines how these intersectional factors exacerbate the insecurity and inequalities experienced by migrant and refugee women in Lebanon. It also looks at how the country's economic crisis and the COVID-19 pandemic are compounding matters for this vulnerable population. Finally, it offers recommendations for a comprehensive approach to combat gender inequalities that equips women in conflict settings with the health care and economic support they need.

Migrant Workers; Refugees & Asylum Seekers; Women

“Maybe It Is Because I Was Not Born in the United States”: Immigrant Stories of Challenges to Medicaid Enrollment

March 13, 2023

Enrolling for Medicaid can be an arduous and daunting process for anyone. The technical language, document requirements and substantial amounts of paperwork can create difficulties during enrollment that can deter individuals from applying. The enrollment process is even more challenging for foreign-born individuals who are often less familiar with Medicaid than people who grow up in the United States, may not speak English confidently, often lack access to a computer, and may experience xenophobia or other forms of discrimination when seeking out help with the process.

“I Have Never Heard the Word Medicaid”: Recommendations for Improving Enrollment for Immigrants

March 7, 2023

Experiences of administrative and cultural barriers when enrolling for Medicaid can lead to the unsuccessful completion of applications, which in turn reduces individuals' access to healthcare services that they are eligible for. Survey respondents reported several barriers that can deter individuals, and in particular immigrants, from applying for Medicaid.  To reduce and eradicate these barriers the federal government and states need to implement policies that will help increase access to Medicaid for vulnerable populations, such as immigrants.