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Healthcare Access and Barriers for Unauthorized Immigrants in El Paso County, Texas

Heyman, Josiah McC. PhD; Núñez, Guillermina Gina PhD; Talavera, Victor MA

Section Editor(s): Rao, Satya P. PhD, CHES

doi: 10.1097/01.FCH.0000342813.42025.a3

This article presents a large body of qualitative material on healthcare access and barriers for unauthorized immigrants living in the US-Mexico borderlands. The focus is on active sequences of health-seeking behavior and barriers encountered in them. Barriers include direct legal mandates, fear of authorities, obstacles to movement by immigration law enforcement, interaction of unauthorized legal status with workplace and household relations, and hierarchical social interactions in healthcare and wider social settings. At the same time, important resilience factors include community-oriented healthcare services and the learning/confidence-building process that enable the unauthorized to connect to such services. An important finding is that barriers are not discrete factors but rather occur as webs that make solution of challenges more difficult than individual barriers alone. Outcomes include incomplete sequences of care, especially breakdowns in complex diagnoses, long-term treatment, and monitoring of chronic conditions.

From the Department of Sociology and Anthropology (Drs Heyman and Núñez) and College of Health Sciences (Mr Talavera), University of Texas at El Paso.

Corresponding author: Josiah McC. Heyman, PhD, Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, TX 79968 (e-mail:

This research was supported by a grant from the Center for Border Health Research, Paso del Norte Health Foundation (N. Homedes, PI). The authors thank their collaborators in the research project, Nuria Homedes, and Carla Alvarado, as well as the people who generously gave their time to them to be visited and interviewed. All responsibility for errors of fact and interpretation are their own.

© 2009 Lippincott Williams & Wilkins, Inc.