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First do No harm: Medical legal violence and immigrant health in Coral County, USA

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  • Van Natta, Meredith

Abstract

Contemporary U.S. health and immigration policies exclude millions of noncitizens from healthcare coverage. Growing scholarship emphasizes legal status as a technology of social exclusion and determinant of health, but few studies capture the effects of recent policy uncertainty on noncitizen health. By examining the case of Coral County (a pseudonym), I highlight the challenges facing safety-net clinics and their noncitizen patients making life and death decisions amidst uncertainty before and after the 2016 presidential election. Observational and interview data with patients, clinic workers, and community partners (n = 27) revealed that growing anxiety over federal immigration policies altered clinical risk calculations through a process I refer to as “medical legal violence” (MLV). Whereas previous risk negotiation strategies leveraged bureaucratic routines to elevate imminent threats of illness and/or injury in health decisions, heightened immigration enforcement under the Trump administration shifted the balance in clinical risk calculations toward social risks of detention, deportation, and family separation. This transformed clinical care in Coral County by turning trusted medical-legal bureaucracies into potential tools for federal biopolitical surveillance of immigrant patients, blocking healthcare pathways and increasing patients’ fear and anxiety.

Suggested Citation

  • Van Natta, Meredith, 2019. "First do No harm: Medical legal violence and immigrant health in Coral County, USA," Social Science & Medicine, Elsevier, vol. 235(C), pages 1-1.
    • Handle: RePEc:eee:socmed:v:235:y:2019:i:c:18
    DOI: 10.1016/j.socscimed.2019.112411
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    Cited by:

    1. Marquez, Beatriz Aldana & Marquez-Velarde, Guadalupe & Eason, John M. & Aldana, Linda, 2021. "Pushing them to the edge: Suicide in immigrant detention centers as a product of organizational failure," Social Science & Medicine, Elsevier, vol. 283(C).
    2. Jimenez, Anthony M., 2021. "The legal violence of care: Navigating the US health care system while undocumented and illegible," Social Science & Medicine, Elsevier, vol. 270(C).
    3. Akalın, Nilüfer, 2024. "Immigrant-blind care: How immigrants experience the “inclusive” health system as they access care," Social Science & Medicine, Elsevier, vol. 348(C).
    4. Parker, Emily, 2021. "Spatial variation in access to the health care safety net for Hispanic immigrants, 1970–2017," Social Science & Medicine, Elsevier, vol. 273(C).

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