Migration project helps refugees claim their rights to health care

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A Cornell collaboration crossing medicine, law, technology and communication aims to encourage the use of health care benefits by refugees in the United States – who often suffer from poor health but use these rights less than by the past.

“Many of them believe – wrongly – that if they take public benefits, they will become deportable or will not be able to get a green card,” said Stephen Yale-Loehr ’77, JD ’81, professor of practice of the immigration law at Cornell Law. School. “They lack clear and precise information on the public benefits to which they are entitled in the United States.”

Led by Yale-Loehr and Dr. Gunisha Kaur ’06, MD ’10assistant professor of anesthesiology, Weill Cornell Medicine, the team tackling this information gap includes Natalie Bazarova, associate professor of communication in the College of Agriculture and Life Sciences, and researchers from the Bronfenbrenner Center for translational research.

Researchers have joined forces through the Mario Einaudi Center for International Studies and Global Cornell’s multidisciplinary Migrations initiative, with multi-year funding to find out what immigrants know about public benefits and identify the best ways to educate them about their legal rights.

Forced to leave their homes, refugees and asylum seekers often have health problems such as post-traumatic stress disorder and anxiety, as well as undiagnosed infections or illnesses. In the first phase of the project, researchers assessed immigrants’ barriers to health care services; the next phase will focus on changing their behavior to help them use the services they need.

“Immigrants, and especially refugees and asylum seekers, face tremendous barriers to accessing health care,” said Kaur, who is also medical director of the Weill Cornell Center for Human Rights. man. The COVID-19 pandemic, she said, shows that everyone, including immigrants, needs access to testing and vaccination.

“It’s what makes us safe as individuals and as a community,” she said. “Understanding barriers to access and building trust with immigrants is a major part of public health.”

Researchers interviewed Weill Cornell Medicine patients — current and former refugees and asylum seekers — as well as legal and medical professionals who work with immigrants. They discovered considerable confusion and fear about how US government-administered fee programs can affect users’ immigration status and long-term prospects in the country.

Part of the misunderstanding stems from the Trump administration’s 2019 changes to the public charge rule that deterred immigrants from accessing public benefits such as food stamps, housing assistance, or Medicaid by tying the public assistance to negative consequences that would be used against them if they sought to change their immigration status. The rule was scrapped in 2021, but immigrants remain reluctant to use the benefits — even those to which they are entitled, the researchers said.

The team also wanted to know where refugees and asylum seekers currently get their information on immigration matters and how they rate its reliability. One important finding: Immigrants are more likely to trust websites that have .gov or .edu addresses, Yale-Loehr said.

“We found that immigrants don’t know what to trust on the internet,” he said. “But they are more likely to trust information from universities, government or hospitals than something on a website or something they hear on the street.”

The next phase of the project aims to create a change in the behavior of migrants so that more of them take advantage of their health care benefits. To educate immigrants about the health benefits they can access, researchers are designing a website called Rights for Health. The site bears the domain name cornell.edu and highlights current information about public health benefits in New York State for immigrants and their health care providers.

Bazarova, who runs a social media lab focused on designing digital engagement tools, is helping develop the website. The team plans to refine the site through a participatory design process, working with social workers, immigrant rights advocates and medical professionals.

“One idea is to allow these professional responders to create customizable tip sheets that they can give to immigrants to help them find up-to-date legal information relevant to their specific healthcare needs,” Bazarova said. .

The personalized, one-on-one approach is a strategy for conveying accurate information that immigrants will find both personally relevant and credible, the researchers said. After the launch of the website, the team plans to branch out into different technologies to spread the information more widely. Communication strategies could include cellphone apps, print comics, and even radio plays.

The project’s findings on barriers to claiming legal rights apply to many types of public benefits, Yale-Loehr said — and to a range of immigrants, who make up about 14% of the U.S. population.

“We started with a small sample in a small sector,” he said, “but the implications are huge.”

Jackie Swift is a freelance writer for Global Cornell.

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