Rutgers professor publishes study on federal health centers for immigrant communities

On Sept. 3, a study was published outlining the potential of federal programs aimed at uplifting immigrant communities, through the lens of Federally Qualified Health Centers (FQHCs).

Emily Parker, assistant professor at the Edward J. Bloustein School of Planning and Public Policy and co-author of the study, said that FQHCs is a federal program that ensures there are clinics in places where proper health care services are not available, especially in areas which are low income, providing care despite an inability to pay or lack of citizenship.

"They serve over 30 million patients annually and the majority of these patients are living under the poverty line and (are) racial and ethnic minorities," she said. "The population that they serve tends to be marginalized within the broader health care system."

She said she decided to study FQHCs after working with multiple clinics when she was at the New York Health Foundation, helping them build the structure to handle the inflow of new, insured patients, as well as to administer others for health insurance that became recently available under the Affordable Care Act.

Parker said that this is a long-term project that utilized archives, data from the federal government and interviews of patients at FQHCs to look at how the program evolved and the wider impacts these centers have had on the health of their communities.

She said that for the study, her team used data from the National Agricultural Workers Survey (NAWS) and linked it to the data from the geographic spread of the FQHCs. This allowed them to look at the proportion of people of different legal statuses living close to an FQHC and the amount of funding they received.

Parker said that, specifically, undocumented farm workers used health care at a greater amount when they were in counties that had an FQHC.

"We do find really strong evidence that both documented and undocumented immigrant farm workers … reported lower barriers to care based on their linguistic needs," she said. "We find very promising evidence in that regard that suggests that (FQHCs) are providing that culturally competent care that matches the language of their country of birth, primarily Spanish speaking."

Parker said that there were no similar reports when it came to cost-related barriers, a large part of which is due to FQHCs only offering primary care, with higher levels of care requiring visits to the hospital.

She said that FQHCs also require payment on a sliding scale, costing anywhere from $5 to $25, which disincentives low-income farm workers from attempting to get care.

"We find some really promising results suggesting that FQHCs could be a really important part of increasing access to care for this population, but we also find some limits and suggest that we need policymakers to address these cost barriers in the future," Parker said.

She said that although there are more FQHCs now than there were 10 years ago, the clinics need to ensure that they can serve every patient regardless of whether they can pay, which is dependent on the amount of funding they get from the federal government.

Parker said that if the government would increase funding for all the clinics in the country or the most impactful ones in the community, this could lead to reductions in the cost-related barriers related to care.

"The federal government needs to step in and say, 'We will support you, please continue providing services to anyone who walks in,'" she said. "'Don't start turning people away because they're uninsured' … that's what these cost-related barriers results make us worried about, that they're not actually serving everyone who comes in the door."

Parker said that more people should learn about the locations of their local health centers, many of which are in the New Brunswick area, in order to offer their support in spreading their awareness and making sure people have access to affordable health care.

She said a lot of immigrants are not aware of FQHCs and do not know that there are places to receive care where there is no proof of legal status or citizenship and where they can not legally be turned away.

"The type of work that agricultural workers do for our society is really undervalued … This is the workforce that is providing us with our food and they should be treated with dignity and they should have the best health care that we can offer."

Editor's note: This article has been updated to correct the reference to undocumented immigrants in the seventh paragraph and to specify that funding needs to be increased in the 13th paragraph.