New immigrants may have trouble finding medical care
All the chairs in the waiting room were filled by dozens of newly arrived migrants waiting to be seen by a Cook County health worker at a clinic in Chicago. Julio Figuera, 43, was among them.
He didn't want to talk much about traveling to Chicago from Venezuela, where a social, political and economic crisis has pushed millions into poverty and led 7 million to flee, Figuera and three of his kids included.
But somewhere along the way, he'd gotten pneumonia.
Figuera, who was living with hundreds of other asylum-seekers at O'Hare International Airport while waiting for more permanent shelter, returned for follow-up care at the county clinic. The stubborn cough came back, so he did, too. The staff checked his vitals, listened to his chest and gave him a hepatitis vaccine.
“I rarely get sick,” he said. “It was the journey that got me sick.”
Tens of thousands of migrants who've come to the United States are navigating a patchwork system to find treatment for new or chronic health concerns.
Doctors across the country say it's rare that migrants receive medical screenings or anything beyond care for medical emergencies when they arrive at the U.S.-Mexico border, and there's no overarching national system to track the care, either. Migrants' options dwindle or expand after that — depending on where they end up — with some cities guiding new arrivals into robust public health systems and others relying on emergency departments or volunteer doctors to treat otherwise preventable health issues.
“You have these little islands of care. You have these little islands of shelter,” said Deliana Garcia, of the nonprofit Migrant Clinicians Network, which supported more than 1,000 migrants in need of medical care in the first 10 months of this year. “But how does anyone know what's going on east to west or north to south?”
More than 2 million people crossed the border illegally between October 2022 and September 2023, according to Border Patrol data. For the most part, doctors said, the migrants are healthy; they have to be to make the arduous journey. It's the travel that can turn manageable health issues into emergencies.
Because of that, public health leaders across the country — from New York to Los Angeles, Boston to Denver — say there's high demand for care.
“It's so core to what we do that I don't feel like anyone's really hesitated around this is the right thing for the organization to do,” said Craig Williams, chief administrative officer of Cook County's health system. “I don't feel like over the last year that we've backed off from really anything else because of doing this initiative.”
The work is not without a price: Roughly 14,500 migrants have visited the Cook County clinic this year, as many as 100 are picked up in vans from the shelters each day for immediate care, vaccinations and a foothold into the public health care system. The county spends about $2.2 million a month — or nearly $30 million since it opened the clinic about a year ago.
New York City Health and Hospitals logged 29,000 migrant patient visits in the last fiscal year, which ended in mid-June. There, health workers have administered more than 40,000 vaccines and provide medical screenings for all new arrivals
Other cities are trying to manage as best they can, like Denver, where nearly 26,000 migrants have arrived within the last year. Dr. Steve Federico, a director at Denver Health, said the city's process is inadequate. Migrants are asked by shelter staff if they need immediate medical attention. If they say yes, they're either sent to an emergency room or connected by phone with a nurse through Denver Health, a public hospital and health organization.
There are no basic health screenings, Federico said, which can increase the risk of infectious disease outbreaks among those living in shelters. In Chicago, one shelter saw a small outbreak of chickenpox.
Without catching and treating illnesses early, Federico said, “Now everybody has it. And then if somebody is at increased risk, they're going to get sicker.”
Federico and city spokesperson Jon Ewing both said Denver is already strained for resources — given the need to shelter and feed migrants. Ewing said Denver is looking to enhance its medical screening process, but added that it's not clear how much that will cost or whether there are enough resources to achieve it.