ABSTRACT
An estimated 10.5 million undocumented immigrants reside in the U.S.; 10% are 55 and older. Undocumented older adults do not qualify for Medicaid or Social Security benefits even though many pay taxes. The study examines undocumented older adults' perceptions on their health status and their experiences in accessing health care. In-depth semi-structured interviews were used to facilitate dialogue with undocumented older adults (N = 30) ages 55-63 (M = 61.67, SD = 5.50). Most of the participants were Mexican (n = 26, 87%) and had lived in the U.S. on average 21 years (SD = 8.78). A constant comparative approach was used while completing initial, focused, and axial coding. Participants were classified into a five-group typology that captures the intersection of perceived health status/need and access to health care; (1) High need, with access to care; (2) High need, with ambiguous access; (3) Undiagnosed need, with no access; (4) Perceived healthy status, with no access; (5) Healthy status, with access to care. Participants who reported high health needs experienced a range of chronic and degenerative health conditions. Participants accessed care by paying-out-of-pocket (between $100 and 300/visit for consultation, lab work, and medications). High need participants with ambiguous access have been able to access care through permanently residing under color of law status or Medically Indigent Services Programs; access is uncertain given their undocumented status and changes in policies. Participants faced multiple barriers to accessing health care-mainly high cost and documentation status. Limited access to care leads to several detrimental consequences such as debilitated health, emotional burden, and economic insecurity. Older undocumented adults are a vulnerable population that experience great health needs. The high cost for health care and limited access to care takes a toll on undocumented older adults. The findings highlight many opportunities for policy advocacy and practice with older undocumented adults.
