Investigating Health Access, Experience, and Outcome of Latin American Immigrants in Trenton, New Jersey through an Intersectional Lens

Abstract

The Latin American immigrant community of Trenton, New Jersey has been largely understudied. In particular, the health of this community, and how they navigate the Trenton healthcare system, has not yet been understood. Given the wide-reaching inequities that exist within the city, and the large proportion of Latin American immigrants in Trenton, establishing a baseline for the current state of healthcare for this community is a crucial first step to future research and policy formation. The present study establishes the following research question: In terms of access, experience, and outcome, to what extent does the healthcare system of Trenton, New Jersey succeed in supporting the Latin American immigrant community, and how do specific axes of discrimination (identities, social markers, socioeconomic considerations) influence these healthcare measures as understood through an intersectional framework? Given the significant diversity that exists within the broader Latin American immigrant community, the present study draws on a framework of which many scholars have named “intersectionality,” the manner in which certain axes of discrimination interact to further marginalize individuals and communities. Therefore, this thesis seeks to understand the role that particular axes play in navigating the healthcare system. Employing an intersectional framework ensures that the nuances within largely diverse and multiply marginalized communities, like the Latin American immigrant community of Trenton, are taken into account and understood at all stages of research, from questioning and forming methods to analyzing results and drafting implications. The investigation was undertaken through the implementation of a mixed-data, interview-based approach with 30 Latin American immigrants in Trenton. Interviews took place at the Latin American Legal Defense and Education Fund (LALDEF), an immigrant-supporting non-profit organization in the city. These interviews included three parts, the first two of which were brief forms and the third which presented verbal questions. Specifically, the first part of the interview collected particular demographic information including but not limited to gender, sexuality, age, and income-level. The second part established quantitative measures for each key metric—access, experience, and outcome. The third part collected key contextual information that expands on the findings of parts one and two and was analyzed qualitatively through thematic analysis. Based on the extensive literature review employed, it was hypothesized that all three metrics would show major room for improvement and that access would be the worst scoring metric. Further, it was hypothesized that gender, English-level, income-level, sexuality, and disability status would be associated with worsened results across these three metrics. The hypothesis was partly supported in that access was the worst scoring metric; however, experience and outcome both scored relatively close to ideal and showed only minimal room for improvement. In terms of axes-specific criteria, the hypothesis was partially supported in that English level, gender, and income-level were associated with lower scores on these metrics; however, unsupported in the consideration of sexuality and disability status as these could not be measured due to lack of representation in the sample. In addition, family configuration and time in the United States proved to be relevant in shaping these metrics, but had not been included in the hypothesis. The qualitative findings corroborated the quantitative findings, with most participants discussing barriers to access as their most significant concern. Through thematic analysis, five key types of barriers were identified: documentation status, financial issues, awareness of the healthcare system, logistical issues, and discrimination. Based on these findings, nine key policy recommendations were proposed spanning the organization of a health-related informational campaign to the implementation of a community emergency room program. In addition, numerous opportunities for future research were identified to further build upon the present findings. These include, but are not limited to, interviewing specifically LGBTQ+ and Latin American immigrants with disabilities as well as understanding the role of theories such as the “colonial mentality” and “linguicism” in shaping healthcare access, experience, and outcome.