Nov 5 2012
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Lesson from APHA: For Most Immigrants, Immigration Policy is Health Policy and Vice Versa

Tiffany D. Joseph, PhD, is a Robert Wood Johnson Foundation (RWJF) Scholar in Health Policy Research at Harvard University (2011-2013).  This post is part of a series in which RWJF scholars, fellows and alumni who are attending the American Public Health Association annual meeting reflect on the experience.

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It was incredibly exciting to attend the American Public Health Association (APHA) meeting for the first time! As a sociologist and current RWJF Health Policy Research Scholar, I am thrilled to be at a multidisciplinary conference with an explicit focus on all aspects of health: outcomes, disparities, coverage, service utilization. You name it, there is a session for it.

The opening was especially motivating and inspiring as Dr. Reed Tuckson and Gail Sheehy provided insightful talks on the relevance of preventive health throughout the life course and how public health professionals must continue to work to improve access to, and quality of, health care for a U.S. population that is increasingly racially, ethnically, and socioeconomically diverse.

U.S. Representative Nancy Pelosi also stopped by, unannounced, to welcome the APHA to San Francisco and thank its members for their steadfast commitment to, and support for, passage and implementation of the Patient Protection and Affordable Care Act (PPACA or ACA).  Needless to say, everyone in attendance was thrilled and excited by her surprise visit and warm words.

Because my current research explores health care access among immigrants in Boston, particularly in light of Massachusetts health reform, I enjoyed hearing how many states are preparing for full PPACA implementation among vulnerable populations. As I have heard about these different strategies and challenges that will remain after implementation, I am reminded of the progress that has already been made, but the work that remains to be done in Massachusetts six years after the passage of health reform.

My recent interviews with immigrants, providers, and organizations have revealed that gaps still remain in care, even for individuals with coverage. This has been a recurring theme in sessions I attended on the ACA: that having insurance coverage does not guarantee access to and use of actual health care services. Additional barriers in documentation status, language proficiency, cultural competency, health literacy, and patient-provider interactions still influence health care. Though increasing insurance coverage is a huge step toward decreasing health disparities and improving the health outcomes of people in the U.S., coverage through the ACA will not be available to all undocumented and some legal immigrants.

My attendance at APHA thus far as an immigration and health researcher has also further convinced me of the interconnected relationship between immigration policy and health policy. For most immigrants, and especially the undocumented, immigration policy is health policy and vice versa. The increase in anti-immigrant state policies and lack of comprehensive reform at the federal level have far-reaching impacts on the health outcomes and health care of immigrants and their U.S. and/or foreign-born children. Some APHA sessions emphasized these impacts, which also overlapped with my own preliminary research in Boston. With (pending) full implementation of the ACA, I look forward to examining how other states with large immigrant populations incorporate ACA guidelines alongside figuring out how to provide care for immigrant and other vulnerable populations. Being at the APHA has allowed me to further contemplate these issues with public health professionals who may be potential colleagues in future research.

On a lighter note, I have noticed some differences between APHA and my primary professional organization, the American Sociological Association (ASA). The first is the sheer size of the conference and the organization. With more than 12,000 people in attendance and 1,000 sessions, there were a wealth of opportunities to learn about different disciplinary approaches to doing health research and connect with scholars, community workers, and clinicians doing similar research. Having scholarly conversations with and thinking about the possibility of developing future collaborations with clinicians I have met at APHA will refine my research questions and improve the research design of my health-related research.

Another difference I have noticed is how every attendee’s nametag includes every degree that the attendee has. I have met people who have five degrees listed on their nametags, which sometimes makes it difficult to read attendees’ names and affiliations. ASA attendees and sociologists generally do not list their degrees on nametags.

Finally, there is more diversity in the professions represented at the APHA than at ASA who are primarily academics. APHA attendees are academics, policy-makers, clinicians, and non-profit organization employees, to name a few. Thus, I imagine it is easier to translate their research to a broader and non-academic audience, which is not always easy for sociologists.

Last but not least, I have enjoyed running into former colleagues and attending receptions, which provided more opportunities to network. It was especially great to attend the two RWJF receptions, one for the New Connections Program and a general RWJF reception, which further reminded me of what a privilege it is to be a part of the RWJF family! I will certainly head back to Boston even more inspired and excited to continue my current RWJF research and keep in touch with relevant connections I have made at APHA.

Tags: APHA 2012, Access and barriers to care, Affordable Care Act (ACA), Diversity, Health reform, Human Capital, Public health, Scholars in Health Policy Research, Voices from the Field