Publication year: 2011
Source: Social Science & Medicine, In Press, Accepted Manuscript, Available online 23 August 2011
Helen B., Marrow
In the “decidedly hostile” federal context toward unauthorized immigrants in American health care (Newton & Adams, 2009, p. 422), a few subnational governments have implemented strategies seeking to expand their access to and utilization of care. In this article, I draw on interviews conducted with 36 primary care providers working in San Francisco’s public safety net between May and September 2009 to examine how such inclusive local policies work. On one hand, San Francisco’s inclusive local policy climate both encourages and reinforces public safety-net providers’ views of unauthorized immigrants as patients morally deserving of equal care, and helps them to…
Highlights: ► San Francisco’s inclusive local policy environment lowers the barriers to access to health. ► care for unauthorized immigrants. ► Symbolically, it encourages providers to view unauthorized immigrants as morally deserving clients. ► Instrumentally, it provides material resources that allow providers to extend care in a more systematic way. ► Yet formal barriers to specialty medical and ancillary care, and bureaucratic barriers to primary medical care, remain. ► This case study highlights institutional contradictions underlying inclusive subnational strategies to reduce unauthorized immigrants’ health vulnerability.