
Photo by Alander RochaModerator Sebastián Martínez Valdivia and panelists Desmar Walkes, M.D., Sanjna Malpani, M.D., M.P.H., and Nambi Ndugga.
When writing about immigrant communities, it’s important for reporters to spend time building trust and to avoid portraying immigrants as victims, said panelists during an April 29 session at Health Journalism 2022 in Austin.
It’s not just language barriers that make reporting on these communities difficult, panelists said. Getting people to open up and share their stories takes time and patience, and understanding cultural sensibilities about divulging personal information and talking to the press.
“You can’t just meet someone one time and expect them to share all of their vulnerabilities,” said moderator Sebastián Martínez Valdivia, a reporter for KBIA in Columbia, Mo. “Make a recurring effort if this is something you’re interested in covering long term,” he said.
The panel focused on how the pandemic added new obstacles to health care access for immigrants, who were often on the front lines in essential industries. Speakers included Sanjna Malpani, M.D., M.P.H., executive and medical director at Northwest Austin Universal Health Clinic, Nambi Ndugga, policy analyst for racial equity and health policy at Kaiser Family Foundation and Desmar Walkes, M.D., medical director and health authority for Austin and Travis County in Texas.
Even before the pandemic, immigrant families faced barriers to assessing care. These problems escalated during the pandemic, and immigrant families faced disproportionate health and financial risks because many don’t have health insurance and work low-wage jobs. For example, Ndugga said immigrants are disproportionately employed by the service industry. During the pandemic they were more likely to lose their jobs. Even more, 40% of immigrants were uninsured and 25% did not participate because of fear, Ndugga said.
The panelists shared research and examples of how their organizations make inroads to deliver care with immigrant communities. Here are some key takeaways for journalists.
Sharing a vulnerability is an honor, and it’s important to remember that when people share stories, said Malpani. Conversations take time, patience and the desire to be there and listen. However, it’s not just about listening, she said.
“It’s about how you reply.” For example, Malpani said that sometimes she chooses not to force scientific evidence on patients, if that’s not where the person wants to be.
Meet people where they are, added Ndugga, who encouraged journalists and public health experts to involve community leaders to help reach the audience.
For example, at the beginning of the pandemic, she said, Latino and immigrant populations were less likely to get the vaccine. But with the support of community leaders, some clinics introduced pop-up locations, which led to an uptick in vaccinations.
Walkes said that the city of Austin provided training to build cultural competency. These efforts helped establish trust — not just when talking about vaccines, but also about procedures like colonoscopies and the importance of checking blood pressure.
Don’t portray immigrants as victims: Be clear about why people are resistant to go to the doctor in the first place. This can be due to experiences with the health care system in the U.S. and in their home countries or cultural norms, such as a stigma about mental health concerns.
Their hesitation can also be caused by obstacles, said Martínez Valdivia, a Spanish speaker who covers access to health care in immigrant and rural communities in Missouri. If you work in a processing plant where you can get fired for missing days of work, then you’re going to wait until the last possible minute to seek care, he said.
Understand the laws that affect access to health care for that population. Federal legislation like the Health Equity and Access Under the Law (HEAL) Act and the Lifting Immigrant Families Through Benefits Access Restoration Act (LIFT the BAR) Act could expand immigrant eligibility for health coverage if it passes through Congress.
Some states are taking steps to expand access to coverage locally, said Ndugga. For example, some states are hoping to change a requirement that requires many qualified non-citizens to wait five years before they qualify for Medicaid and the Children’s Health Insurance Program. Other efforts include providing 12-month postpartum coverage, regardless of immigration status, to low-income women.