Medical-legal partnerships are valued by immigrant, migrant populations: Study

Immigration status, immigration vulnerability and understanding of immigration-related legal options are critical components of safety, access to public benefits and wellness for many immigrants/migrants. While immigration status is increasingly recognized as an independent social determinant of health, understanding best practices for health care systems that might mitigate the health disparities that result from unequal health care access dictated by immigration status is just beginning to be studied.

In an effort to better understand best practices, researchers from Boston University Chobanian & Avedisian School of Medicine evaluated the impact of embedding immigration legal services into a primary care clinic to try and meet the needs of immigrant patients. This novel program, which was able to help patients better understand their immigration legal options, was ranked "very positive" by the participants.

"Participants appreciated that the information they received was coming from a trusted source and that the clinic provided trustworthy access to immigration advice. Many talked about the difficulty of navigating the immigration process independently," said corresponding author Sarah L. Kimball, MD, assistant professor of medicine at the School.

The researchers performed qualitative and quantitative follow-ups with patients before and after an immigration legal intervention in a primary care clinic and then conducted follow up phone calls at 60 and 90 days after. They found participants had very favorable impressions of the legal clinic held in a familiar and safe environment—an important feature of this intervention.

According to the researchers, these findings shows how collaborations can be impactful between the health care system and immigration experts. "Because immigration status has such a huge impact on health, this intervention has the possibility of helping to mitigate some of the barriers that immigrants face in getting their health care needs met," adds Kimball, who also is director of the Immigrant & Refugee Health Center at Boston Medical Center.

The researchers hope that programs such as these are just the beginning of physicians thinking creatively and outside of the box about what needs to done in healthcare to meet the needs of immigrant and refugee patients. "Nevertheless, public health and community interventions that attempt to put in place protections for immigrant/migrant communities are critical to begin to reverse the climate of fear and mistrust that has caused toxic stress levels and health disparities in these communities."

These findings appear online in the Journal of Health Care for the Poor and Underserved.