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, explained that FQHCs are a federal program ensuring clinics are available in underserved areas, particularly low-income regions, providing care regardless of an individual's ability to pay or citizenship status.
“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.”
Parker decided to study FQHCs after working with multiple clinics during her tenure at the New York Health Foundation. There, she helped them manage new insured patients and assist others in obtaining health insurance under the Affordable Care Act.
This long-term project utilized archives, federal data, and patient interviews at FQHCs to examine how the program has evolved and its impact on community health. Parker's team linked data from the National Agricultural Workers Survey (NAWS) with geographic information on FQHCs to analyze the proportion of people with different legal statuses living near an FQHC and their funding levels.
Specifically, Parker noted that documented farm workers used healthcare services more frequently when residing in counties with 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 culturally competent care that matches the language of their country of birth, primarily Spanish speaking.”
However, there were no similar findings regarding cost-related barriers due to FQHCs only offering primary care; higher levels of care require hospital visits. Payment is required on a sliding scale ranging from $5 to $25, which can disincentivize low-income farm workers from seeking 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.
Although there are more FQHCs now than a decade ago, these clinics must ensure they can serve every patient regardless of payment ability, contingent upon federal funding levels.
Parker emphasized government support as crucial for reducing cost-related barriers: “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.”
She encouraged public awareness about local health centers' locations—many in New Brunswick—to support affordable healthcare access.
Many immigrants remain unaware of FQHCs' existence or their policy not requiring proof of legal status or citizenship for receiving care.
“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.”
