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In the Shadows: Health Utilization Outcomes Among Black Undocumented Immigrants.

Joseph Nwadiuko^1,2, Arrianna Marie Planey³, Naomi Zewde⁴

¹Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

|June 15, 2026

Summary

This summary is machine-generated.

Black undocumented immigrants face significant barriers to health care access, including higher rates of uninsurance and fewer physician visits. Legal status is a key determinant of insurance and outpatient care utilization for Black immigrants.

Keywords:

healthcare utilization immigration race and structural racism

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A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents

A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents

Published on: July 10, 2017

Area of Science:

Health Services Research
Health Disparities
Immigration and Health

Background:

Black undocumented immigrants experience compounded barriers to healthcare access due to legal status and systemic racism.
Previous research indicates lower insurance rates among Black immigrants, but limited data exists on other access dimensions for undocumented individuals.

Purpose of the Study:

To examine health care access and outcomes for Black individuals aged 40 and above, stratified by legal status.
To compare access dimensions including insurance, physician visits, and hospitalizations across different legal statuses.

Main Methods:

Analysis of nationally representative data from the National Health Interview Survey (NHIS) spanning 1999-2018.
Examination of clinician visits, emergency room visits, overnight hospitalizations, and preventive screenings based on legal status.
Utilized Non-Hispanic White US-born citizens (NHWC) as the reference group.

Main Results:

Black undocumented immigrants exhibited significantly higher odds of uninsurance and fewer recent physician encounters.
Lower utilization of emergency room visits, overnight hospitalizations, blood pressure measurements, and cervical cancer screenings were observed among Black undocumented immigrants.
Healthcare utilization decreased progressively with less secure legal status among Black individuals.

Conclusions:

Legal status is a significant factor influencing insurance coverage and outpatient care access for Black immigrants.
The interplay between race and legal status profoundly impacts healthcare access and outcomes within the Black immigrant population.