Dissertations, Theses, and Capstone Projects

Date of Degree

6-2023

Document Type

Dissertation

Degree Name

Ph.D.

Program

Sociology

Advisor

Barbara Katz Rothman

Committee Members

Philip Kasinitz

Mary Clare Lennon

Abigail Ross

Subject Categories

Medicine and Health | Migration Studies | Sociology

Keywords

New York City, Immigration, Legal Status, Social Determinants of Health, Physicians, Providers, Social Workers, SDOH

Abstract

This project examines how immigration is understood as a social determinant of health through the perspective of medical providers and social workers. Through the bridging of immigration studies in sociology and social epidemiology and public health, I demonstrate the need to bring these disciplines together to understand how immigration and legal status are encountered in clinical settings. I conducted a qualitative research study, specifically open-ended interviews with medical providers and social workers, to understand how providers currently screen for complex social determinants of health, and more specifically, how they engage with immigration as a factor influencing health during their patient encounters. My research shows that legal status and immigration are widely considered important social factors that influence health but are not screened for effectively due to several individual and systemic barriers that providers experience. Some of these barriers include issues with documenting in the electronic medical record, the lack of a systematic screening process, limited awareness, and lack of coordination of available resources, time constraints for providers, and limited understanding of the nuance of immigration and legal status. I conclude that there is a need to move upstream to address systemic barriers and create better integration and alignment across social work, medical care and legal services using a community-centered approach to improve the everyday lives of immigrant patients.

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