The group I have chosen is immigrant women because they make the greater percentage of immigrants in the U.S. Statistics show that for every 96 immigrant men in the U.S, there are 100 women. Furthermore, as of 2011, 51.1% of immigrant living in the U.S, 55% of those obtaining green cards, and 54% of those who received American citizenship were women (Garcia & Franchim, 2013).Immigration is currently a pressing issue and the crackdown on illegal immigrants has affected the psychosocial status of immigrants everywhere. Women bear most of this load because and are therefore a vulnerable group because of the hardships they face due to the pressure to conform to a new way of life while also maintaining their native culture.
There are many reasons why women migrate to the United States. Some are political refugees escaping from oppressive regimes; others want to find a better future for themselves and often their children; there are those that are following their husbands; and yet others are brought forcibly as a part of illegal human and sex trafficking trades (Garcia & Franchim, 2013). Despite forming a large percentage of immigrants, the interests and issues of immigrant women are often overlooked in public policy. These women face health challenges, have lesser income thus are more prone to poverty, experience poor working conditions especially if they are undocumented, have a higher prevalence of domestic violence, and are more likely to face gender and racial discrimination at work and in the community among others (Kitchen, 1999).
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One of the most difficult situations that immigrant women face is acculturation. This is the process by which a person learns the values of another culture and it is often associated with stress and emotional distress for immigrants (Toselli, Gualdi-Russo, Marzouk, Sundquist, & Sundquist, 2014). They also face social economic problems such as poor housing, low wages, and living in disadvantaged areas. Most immigrants move into poor neighborhoods and women either take on household duties or take low paying jobs even if they used to work in their native countries (Garcia & Franchim, 2013). Most immigrant women who face these socioeconomic adversities come from cultures that offer social support to members and they have to contend with the individualistic culture in America. Coping therefore becomes difficult and if they are single, it becomes a leading risk factor for increased morbidity and mortality among immigrant women (Toselli, Gualdi-Russo, Marzouk, Sundquist, & Sundquist, 2014). Acculturation also causes the erosion of native cultures that protect from psychosocial pressure so that health outcomes decline as one stays longer in the United States.
There also exists a group of illegal immigrant women in the United States whose status causes even more distress as they live in constant fear of being discovered and punished. They are usually at high risk of working in poor conditions for poor pay because they cannot report this lest they risk deportation (Garcia and Franchim, 2013). They are more likely to be physically and sexually abused in the workplace for the same reason and have no prospects for upward economic mobility. Illegal immigrants cannot get support from the community because they fear being discovered ((Toselli, Gualdi-Russo, Marzouk, Sundquist, & Sundquist, 2014). With the tightening of immigration laws in the U.S, undocumented immigrant women are facing more stress because their discovery can cause separation from their American born children.
The above factors cause poor health outcome for both legal and illegal immigrant women and becomes a problem when they cannot access community health resources. Both legal and illegal immigrants are at higher risk of mental health issues Illegal women cannot access health care because it is ridden with rules that ensure that only those who are insured get full access to health care (Toselli, Gualdi-Russo, Marzouk, Sundquist, & Sundquist, 2014). Besides, immigrants only get access to Medicaid if they have resided in the U.S for five years. Therefore, in states that do not remove such barriers, these women cannot even get access to affordable services when they need prenatal care or other preventative services unless they have enough income to cover it themselves, which they often don’t (Garcia & Franchim, 2013). Even when documented, immigrant may opt for alternative remedies that are acceptable in their own cultures and which at times are ineffective. They might also avoid American health facilities due to issues like language barriers and discrimination.
Adopting culturally competent health care can help to improve the health outcomes of immigrant women. Cultural competence is having an awareness of the existence of other cultures besides one’s own, which enables professionals to respect and adapt to cultural differences (Kitchen, 1999). It enables NPs to communicate and interact with diverse groups of people without holding preconceived biases that are informed by their enculturation. Due to culture shock and the difficulties of acculturation, many immigrants are bewildered by the American health care system and other factors such as language barriers can make hinder access to quality care (Garcia & Franchim, 2013). Health care professionals can also be uninformed or uncertain on how to effectively inform women from diverse backgrounds about available health care options.
The first step to culturally competent care is to acquire awareness of one’s own culture and basic knowledge about the existent diverse cultures that one may deal with (Kitchen, 1999). This is important because different people hold varying opinions about good health practices and especially when it comes to pregnancy, reproductive health and child care which affect women. It can also help NPs recognize linguistic differences that can help them understand accents better and thus communicate effectively to patients without discriminating or disrespecting them.
Partnership with patients by advocating for remedies that mirror some of their beliefs can also help them to cooperate and adopt culturally sensitive preventative health practices. Especially for women, NPs should recognize that women are experts of their own health and accept their help in establishing medical histories and diagnosis (Kitchen, 1999). Interpreters can be used to bridge severe language barriers and explaining the cultural context of communication between the NP and the patient (Kitchen, 1999).
References
Garcia, A., & Franchim, S. (2013, March 8). 10 Facts You Need to Know About Immigrant Women (2013 Update). Retrieved from https://www.americanprogress.org/issues/immigration/news/2013/03/08/55794/10-facts-you-need-to-know-about-immigrant-women-2013-update/
Kitchen, A. (1999). Treating immigrant population- Cultural competence in health care. Bioethics Forum , 15 (2), 11-18. Retrieved from https://www.practicalbioethics.org/
Toselli, S., Gualdi-Russo, E., Marzouk, D., Sundquist, J., & Sundquist, K. (2014). Psychosocial health among immigrants in central and southern Europe. The European Journal of Public Health , 24 (suppl 1), 26-30. doi:10.1093/eurpub/cku100
