Arizona's immigration law and health care

By Paul T. Cheung
Denver Post, 06/16/2010

Even though the impact of Governor Brewer of Arizona signing S.B. 1070 into law may appear distant, the law has far reaching implications for the general public including here in Colorado.

Amid all the discussions of the legislation - including the marginalization of the Latino culture and society - few have noted its impact on health. Arizona S.B. 1070 will decrease health care usage, leading to increase public medical care spending, worse health outcomes, and lower immunization rates.

Take for example Juan, the owner of a local taqueria restaurant in Aurora, whom I met last month. He is a legal citizen facing a number of challenges in obtaining health care. For many years, he did not have regular access to a primary care physician and has relied on cultural remedies as his main source of care. Juan told me a common story. Care is difficult to come by for a multitude of reasons: time, money, lack of transportation, language barriers, and the complexity of navigating the maze that is the U.S. health system.

When Juan learned I was a medical student, he told me about his health. Several weeks ago, he was stricken with severe heart palpitations, night sweats, and chest pain. He waited three weeks before he decided to go see a doctor. Ultimately, the doctor that saw Juan diagnosed his high blood pressure and gave him a prescription to control it. Untreated, he was at significant risk for strokes and heart attacks. Juan waited to seek help because he does not have insurance and had no idea how to get an appointment with a Spanish-speaking physician.

To the long list of barriers Latinos face in getting care in this country, the Arizona immigration law adds another. Our health care system works best when chronic conditions such as high blood pressure, diabetes, and asthma are controlled. Had Juan suffered a stroke or heart attack from uncontrolled blood pressure, his medical costs would rise dramatically and ultimately be passed on to the community through taxes and higher insurance premiums. More importantly, Juan likely would have suffered long term health effects impacting the quality of his daily life.

On a broader level, the law will strain the relationship between the Latino community and health care providers. Important public health goals such as immunizations will be compromised. High immunization rates are important for children who are in close contact in school to prevent spread of disease. This law will prevent Latino families from bringing their children in to see the doctor and these unimmunized children will increase the presence of diseases like flu, measles, and mumps in the community. Fear and uncertainty about the health care providers' role in enforcing the documentation requirement will foster distrust of physicians by Latino patients.

The Latino community already is facing numerous challenges in obtaining optimal care. Routine medical attention consistently leads to better control and treatment of chronic conditions like high blood pressure. Barriers to health care need to be removed.

As a medical student, I am concerned about how this new law will affect health in the community. As I progress into my clinical training, I am worried about meeting more patients like Juan - who nearly missed more serious health consequences from his untreated high blood pressure - because of barriers to care. Ultimately, such delays will lead to even more expensive health care for all.

Paul Cheung is a first year medical student at the University of Colorado School of Medicine and a resident of Aurora. EDITOR'S NOTE: This is an online-only column and has not been edited.