Diaz C, Ortiz V, Sanchez L, Fernandez J, Andrade EA, Akiyama MJ, Ross J. Harmful by Design-a Qualitative Study of the Health Impacts of Immigration Detention.
J Gen Intern Med 2022:10.1007/s11606-022-07914-6. [PMID:
36451013 PMCID:
PMC9713141 DOI:
10.1007/s11606-022-07914-6]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/28/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND
The USA has the largest immigration detention system in the world with over 20,000 individuals imprisoned by Immigration and Customs Enforcement (ICE) daily. Numerous reports have documented human rights abuses in immigration detention, yet little is known about its health impacts.
OBJECTIVE
To characterize how the US immigration detention system impacts health from the perspective of people who were recently detained by ICE.
DESIGN
Qualitative study using anonymous, semi-structured phone interviews in English or Spanish conducted between July 2020 and February 2021.
PARTICIPANTS
Adults who had been detained by ICE for at least 30 days in the New York City metropolitan area within the previous 2 years, and that were fluent in English and/or Spanish.
APPROACH
We explored participants' health histories and experiences trying to meet physical and mental health needs while in detention and after release. We conducted a reflective thematic analysis using an inductive approach.
KEY RESULTS
Of 16 participants, 13 identified as male; five as lesbian, gay, bisexual, or queer; and four as Black; they were from nine countries. Participants had spent a median of 20 years living in the USA and spent a median of 11 months in immigration detention. Four themes emerged from our analysis: (1) poor conditions and inhumane treatment, (2) a pervasive sense of injustice, (3) structural barriers limiting access to care, and (4) negative health impacts of immigration detention.
CONCLUSIONS
The narratives illustrate how structural features of immigration detention erode health while creating barriers to accessing needed medical care. Clinicians caring for immigrant communities must be cognizant of these health impacts. Community-based alternatives to immigration detention should be prioritized to mitigate health harms.
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