Disparity can take many shapes, health disparities can be recognized as…

Disparity can take many shapes, health disparities can be recognized as one of the utmost tangible indicators of disparity, often regulating who will live and who will die—with the poor and immigrants suffering unreasonably. We can appreciate that individual health behavior is limited by structured and institutionalized inequality that confines the power of individuals to make choices.

Limited choices then directly affect health outcomes. Individual support is limited by and confined within the choices that are accurately available. In many situations, health-promoting choices are not an option, or they may not embody the most respected strategy for a person in the context of other restricting features—irrespective of whether other choices are healthy or not. The fear for individuals who lack documents or have family members without papers, the fear is more concretely about being discovered. Deportation is an ever-present reality for people living in the shadows because they lack legal immigration status. This threat, especially when combined with the other dimensions of fear, becomes virtually paralyzing for many people in terms of seeking assistance with health problems. Many of those who lack documents do not feel comfortable or safe going to a clinic or to the emergency room. For example, when a physician or nurse has aggressive questioning for patients in regards to their immigration status, they fear INS [Immigration and Naturalization Service] may be looking over their answers (Page-Reeves, J., Niforatos, J., Mishra, S., Regino, L., Gingrich, A., & Bulten, J., 2013).

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