Beyond Borders: Advancing Equitable Care in the Emergency Department for Migration-Affected Patients

The emergency department is uniquely positioned within the U.S. healthcare system to provide emergency evaluation and stabilizing treatment regardless of insurance status, ability to pay, or immigration status. Immigration status does not alter the professional obligations of emergency physicians under Emergency Medical Treatment and Labor Act (EMTALA) and established ethical standards to provide equitable, evidence-based care, nor does it alter the fundamental human right to quality health care. Emergency physicians must therefore understand the health implications of migration and the distinct needs of these diverse patient populations, including recognizing the unique risks, exposures, and barriers that can shape health outcomes and healthcare interactions among immigrant, refugee, asylum-seeking, and other migration-affected populations.

This article outlines best practices, culminating in the development of 4 key principles for providing care to these groups, while underscoring the role of emergency medicine in providing equitable care to all migration-affected populations: (1) Evidence-based clinical care to reduce bias, (2) Awareness of local and federal policies and migration factors that may influence patient care trends, (3) Targeted screening for population-specific risks and tailored patient care services, and (4) Community partnership and interdisciplinary care teams.

Emergency physicians and their departments must recognize the complex health needs of immigrant, refugee, asylum-seeking, and other migration-affected populations, while upholding professional and ethical responsibilities to provide equitable, evidence-based care consistent with EMTALA and established standards of emergency medicine practice.