Immigrant policy: Issues for social work practice

Abstract

Immigrants make up a significant segment of U.S. society. Immigration to the United States has been characterized by steady growth, dramatic changes in ethnic composition, and declining socioeconomic levels. The challenge for social work is to respond to the social services needs of immigrants by designing appropriate programs that will contribute to the social and economic integration of immigrants. This article provides an overview of the major policy issues relevant to social work practice with immigrants and describes the recent U.S. immigrant population. It discusses current federal policy that affects service provision to immigrants, defines immigrant eligibility for social services, outlines the major areas of need among immigrants, and considers implications for social work practice.

Headnote

Immigrants make up a significant segment of U.S. society. Immigration to the United States has been characterized by steady

growth, dramatic changes in ethnic composition, and declining socioeconomic levels. The challenge for social work is to respond to the social services needs of immigrants by designing appropriate programs that will contribute to the social and economic integration

of immigrants. This article provides an overview of the major policy issues relevant to social work practice with immigrants and describes the recent U.S. immigrant population. It discusses current federal policy that affects service provision to immigrants, defines immigrant eligibility for social services, outlines the major areas of need among immigrants, and considers implications for social work practice.

Key words: immigrant policy; immigration; refugees; social welfare programs

Immigrant policy refers to policies aimed at facilitating the social and economic integration of immigrants (Fix & Passel, 1994). Immigrant policy is distinguished from immigration policy, which is concerned with regulating who enters the United States and in what numbers. Immigrant policies are related to social welfare, health, education, and housing and employment programs. Thus, the provision of social services plays a central part in immigrant policy. As the primary profession involved in social services delivery, social workers must consider the policy context of providing social services to immigrants. Attention to the changing demographic characteristics of immigrants, their primary areas of need, and the opportunities and limitations of current immigrant policies can provide the foundation for appropriate social work intervention.

Although social work literature has included discussions of practice with immigrants, the underlying concerns have been with their cultural adaptation, namely an understanding of how practice can be sensitive to differences in the worldviews of immigrants given their unique cultural backgrounds. Still, social work has made limited, but important, contributions to the study of immigrant integration at a broader level. Recent analyses by Drachman (1992), Jacob (1994), and Sherraden and Martin ( 1994) provide a conceptual framework for understanding the relevance of earlier immigrant group experiences to their adjustment to their country of destination.

Overall, the social work literature shows that to different degrees, immigrants face a series of stress-producing events that result in the need for assistance and support; such events include separation from family and community, journeys of different durations and levels of danger, and relocation problems associated with finding housing and employment.

Social work's primary concern in the field has been the conceptualization of the psychosocial aspects of immigration and their impact on the successful integration of immigrants. The focus has been on the needs, experiences, and circumstances of immigrants at different phases of the immigration process (premigration, transit, and resettlement) and the need to consider this knowledge in designing responsive service delivery (Drachman, 1992).

In studies of immigration, the emphasis on individual adaptation has given way to the realization that the success of immigrants also depends on the extent to which social and economic conditions and related policies facilitate their integration (Edmonston & Passel, 1994). Therefore, along with an understanding of immigrant experiences, the ability of social workers to provide services to immigrant families is defined by the policy context in which they operate. Although social work practice depends largely on changing policy directives, much less attention has been given to this dimension of social work with immigrants (Le-Doux & Stephens, 1992).

This article examines current issues related to immigration in the United States. The increasing numbers of and diversity among immigrants and the pressing needs of these new arrivals present a challenge for social work practitioners. At the same time, federal and state immigrant policies provide the context for the level of resources and services available to help immigrants assimilate economically and socially. It is important to understand immigrant access to government assistance, the extent to which immigrants use social services to meet their needs, and the other strategies they use to survive.

Changing Demographic Profile of Immigrants

To project the types of services that immigrants need to facilitate their social and economic incorporation, it is necessary first to have a clear knowledge of the changing demographic trends in immigration and some of the major factors shaping those trends. Immigrants make up a significant segment of U.S. society. Moreover, immigration to the United States is characterized by steady growth, dramatic changes in ethnic composition, and declining socioeconomic levels. In 1990 the proportion of immigrants in the total U.S. population was almost 9 percent (Edmonston & Passel, 1994). Over 7 million people immigrated during the past decade, reflecting consistent increases over previous decades (Borjas, 1994), and these increases are expected to continue. By 2040 one in four Americans will be an immigrant (first generation) or the child of immigrants (second generation), and by 2010 children of immigrants will account for 22 percent of the school-age population (Fix & Passel, 1994).

Countries of Origin and Settlement Patterns

The ethnic composition of immigrants is extremely diverse because of shifts in immigration streams in recent history. Before the 1960s the vast majority of immigrants came from Europe or Canada (Bean, Cushing, & Haynes, 199495). However, by the 1980s only 12.5 percent of legal immigrants originated in these countries, whereas 84.4 percent were from Asia or Latin America (Bean et al., 1994-95). Asian immigrants came primarily from Korea, the Philippines, Vietnam, and China. Latin American immigrants came primarily from Mexico and El Salvador; other Spanish-speaking immigrants came from the Dominican Republic in the Caribbean (Rolph, 1992). By far the largest group of immigrants in the United States is from Mexico, representing over one-fifth (22 percent) of the foreign-born population (Borjas, 1994). Before the 1960s Mexicans were only 11.9 percent of all immigrants (Borjas, 1994).

The new ethnic communities are not dispersed evenly across the United States but rather tend to be concentrated in particular areas. Fully 74 percent of immigrants locate in only six states: California, Florida, Illinois, New Jersey, New York, and Texas (Rolph, 1992). In addition, immigrants tend overwhelmingly to settle in urban centers, with fewer than 7 percent locating in rural areas in 1987 (Portes & Rumbaut, 1990). Certain metropolitan areas experience disproportionately high rates of immigrant settlement. Immigrants are more than 15 percent of the populations of Chicago, Boston, and Houston; more than 38 percent in Los Angeles; and more than 60 percent in Miami (Fix & Zimmermann, 1994).

Immigration Policy

The changing profile of the immigrant population has been partly shaped by key U.S. immigration policies. The so-called new flow of immigrants from Asia and Latin America began in the late 1960s as a result of the Immigration and Nationality Act of 1965 (P.L. 89-236), which relaxed the restrictions on immigration from countries in those parts of the world (Edmonston & Passel, 1994). Immigration from Asia also greatly increased with the passage of the Refugee Act of 1980 (P.L. 96-212), which gave legal status to refugees and asylees (Rolph,1992).In addition,the Immigration Reform and Control Act of 1986 (IRCA) (P.L. 99-603) resulted in the legalization of over 2 million long-term undocumented workers. The vast majority of these workers were from Mexico, Central America, and the Caribbean. Immigration from these same parts of Latin America was also expanded with the Immigration Act of 1990 (P.L. 101-649), which granted temporary protective status on an individual basis to people from countries suffering from armed conflict or natural disasters (Rolph, 1992).

Socioeconomic Characteristics

With the vast majority of immigrants originating from Third World countries, the new entrants of the 1980s and 1990s have been considerably less skilled than native-born workers and less skilled than earlier immigrant populations (Bean, Chapa, Berg, & Sowards, 1994). They tend to have significantly lower educational and occupational levels relative to U.S.-born groups. Fully a quarter of immigrants over 25 years of age have fewer than nine years of education, compared with 9 percent of the U.S.-born population (Fix & Passel, 1994).

The lack of English language proficiency is a major problem. Twenty-five percent of immigrants do not speak English or do not speak it well (Fix & Passel, 1994). Two other factors help explain the lower socioeconomic status of current immigrants. The first factor is the large proportion of recent arrivals: In 1990, 44 percent had come within the preceding 10 years (Fix & Passel, 1994). The second factor is the substantial number of illegal immigrants and refugees, who tend to fare worse than legal immigrants. As of 1990, 87 percent of immigrants had entered the country legally. Of these, 33 percent had become naturalized citizens, 49 percent were legal permanent residents, and 6 percent were refugees and asyleespeople admitted into the country for humanitarian reasons. Estimates are that 13 percent of the total immigrant population are undocumented individuals. About 62 percent of illegal entrants are from Mexico, 13 percent from Europe and Canada. and the rest from a large variety of countries in other parts of the world (Fix & Passel, 1994).

In light of the large numbers of recent arrivals and their lower average educational and occupational status, poverty levels are higher among immigrant households than among native households (16.7 percent compared with 12.3 percent), because immigrants are concentrated in low-paying jobs. Regardless of country of origin, recent arrivals fare considerably worse, with an overall poverty rate of 24.8 percent (Fix & Passel, 1994). In 1990 the average poverty rates for foreign-born households from Europe and Canada, Mexico, other Latin American countries, Asia, and Africa were all higher than the poverty rates of U.S.-born citizens. However, this disparity is true only for recent arrivals. Long-term immigrants from each of these regions have lower poverty rates than the U.S.-born population, with the exception of Mexican immigrants (Chiswick & Sullivan, 1995).

Legal status explains important differences in the economic well-being of immigrants. Immigrants from source countries for illegal immigration (primarily Mexico, El Salvador, and Guatemala) earn significantly less than native- born Americans even after having lived in the United States for extended periods. People from refugee countries who are recent entrants earn slightly less but after lengthier stays in the country slightly surpass the U.S.-born populations (Fix & Passel, 1994). However, in a study of Southeast Asian refugees (the largest refugee group in the United States) in California, Potocky (1996) found that refugees were considerably worse off economically than all other ethnic groups when taking into account employment and occupational rates, housing conditions, and other measures of economic wellbeing, even up to 15 years after arrival.

Direct comparisons of the economic wellbeing of immigrants relative to U.S.-born individuals of the same ethnic background are more empirically valid than comparisons of immigrants to the general U.S.-born population or to general populations of other U.S. ethnic minority groups, because the processes of economic integration are unique to the history and societal incorporation of each group. Comparisons of immigrants with U.S.-born people of the same ethnic background show dramatic differences by recency of immigration and countries of origin. A detailed analysis (Borjas, 1994) controlled for age and educational levels showed that in 1990 white immigrant groups regardless of period of arrival had higher wages than comparable white U.S.-born groups. The same differential is true for Asian immigrants who have lived in the United States for an extended period, but not for recent arrivals. Finally, relative to U.S.-born Mexican Americans, the income of immigrants of the same age and educational background is significantly lower regardless of length of residence in this country. The reasons for this pattern among Mexican immigrants are not clear, because in the 1960s and 1970s they too were able to gain parity with their U.S.born counterparts within about 15 years (Chiswick, 1979; Padilla, 1996).

Nevertheless, the socioeconomic advancement of immigrants across generations shows that children of immigrants (the second generation) do considerably better than their parents and indeed surpass the earnings of other native- born people of the same national origin or ethnicity. Research on this topic is less extensive by country of origin because of data limitations. However, detailed multivariate analyses using longitudinal data show that this improvement is true not only for European immigrants, but also for Mexican, Cuban, and other Latino groups (Padilla, 1993). We have yet to see if this pattern will remain true for future generations of contemporary immigrants.

In summary, the socioeconomic status of current immigrants is quite complex and diverse. Immigrants who have entered the country illegally or as refugees or asylees, have arrived within the past 10 years, and have originated from developing countries are more likely to suffer economic hardship. At present, all of these groups represent significant proportions of the immigrant population resulting from demographic changes in the flows of immigration.

Federal Policy Factors Affecting Service Provision to Immigrants

Unlike immigration policy, which has been a central area of concern, immigrant policy has not been a priority in the United States. The current political context is characterized by a strong anti-immigrant sentiment. Although not substantiated by research, there is a growing concern that immigrants are a drain on the economy because of high welfare use and because they take jobs away from U.S.-born citizens and depress wages. As a result, there has been a push for reducing immigration, particularly illegal immigration (Illegal Immigration Reform and Immigrant Responsibility Act of 1996, P.L. 104-208). The most recent strategy to control immigration includes certain provisions of the 1996 welfare reform legislation that attempt to discourage new immigration by denying a range of social welfare benefits to all foreign-born noncitizens, legal or illegal, currently residing in the country.

U.S. welfare policies toward immigrants have been generally inconsistent and have resulted in a fragmented system of services (Rosenberg, 1991). The system of assistance involves a combination of services targeted specifically to immigrants and limited access to mainstream social services.

Lack of a Comprehensive National Immigrant Policy

Although the admission of immigrants to the United States has increased, federal support for programs targeted to assist immigrants has declined (Fix & Passel, 1994). Government assistance for immigrants has not responded to changing demographic trends. As the socioeconomic level of immigrant groups has declined over the past 40 years, government assistance has actually decreased. As a result, state and local communities have been forced to take a large role in providing health, education, and social services to immigrants (Fix & Passel, 1994). Furthermore, many of the services are provided through private voluntary agencies rather than public agencies, either through contractual agreements with government entities or through private and religious donations (LeDoux & Stephens, 1992).

Social welfare policy was first linked to immigration policy with the Migration and Refugee Assistance Act of 1962 (P.L. 87-510) (Tienda & Liang, 1994). This act provided for cash, medical, and educational assistance to refugees. All in all, however, federal immigration policies have not included significant provisions for resettlement assistance. Currently, specific policies for many social welfare provisions are limited to refugees under the 1980 Refugee Resettlement Program and until 1994 to newly legalized people under the Immigration Reform and Control Act of 1986.

Created under the Refugee Act of 1980, the Refugee Resettlement Program guaranteed access to social support, including transportation, relocation allowances, job training, and public assistance programs (such as Aid to Families with Dependent Children, Supplemental Security Income, and Medicaid) (Rolph, 1992). The Refugee Resettlement Program is administered by the Office of Refugee Resettlement, Family Support Administration of the U.S. Department of Health and Human Services. The program provides funding to the states, which then contract with local entities to provide resettlement services. Funding is allocated to provide employment-related services and to help localities that are heavily affected by refugee populations, including grants to states to fund self-help indigenous organizations (Le-Doux & Stephens, 1992).

The second most important immigrant policy is the State Legalization Impact Assistance Grants (SLIAG) provision of the IRCA. The IRCA created a mechanism to help states and local governments provide public health, public assistance, social services, and education exclusively to previously undocumented immigrants who under this act were granted legal status in the United States (Rolph, 1992). Although the SLIAG provision ended in 1994, it was unprecedented in its inclusion of targeted immigrant services.

Given the limited federal policies, the trend is for states to increasingly take responsibility for assisting immigrants. Not only has federal funding for immigrant programs been curtailed, but the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193), signed into law by President Bill Clinton on August 22, 1996, severely cuts federal services to immigrants. All immigrant groups other than naturalized citizens-primarily undocumented people and refugees, but also legal immigrants-are likely to be affected. Regardless of the course of implementation of this legislation, the move toward block grants will also place the states in the lead. Currently, state programs for immigrants vary widely depending on the state's political characteristics, economy, and immigrant composition (Zimmermann & Fix, 1994). Besides the programs implemented under current federal policies, states have also provided bilingual education for children with limited English (under the Bilingual Education Act, P.L. 89-10) and emergency and prenatal medical services to undocumented immigrants (under the Medicaid public assistance program) (Rosenberg, 1991).

Several state initiatives illustrate the roles state and local governments have played in addition to implementing federally mandated programs. Such initiatives include the development of a campaign to provide basic orientation services to all immigrants in New York (Rosenberg, 1991) and the coordination of services for immigrant children, youths, and families in the areas of mental health, child welfare, public health, and social services in Massachusetts (de Monchy, 1991). In Texas immigrants have been eligible to receive medical assistance and other primary health care services through local and state indigent health care programs regardless of legal status (Zimmermann & Fix, 1994).

Nevertheless, the lack of federal reimbursement for the provision of services has prompted states with large immigrant populations-such as California, Florida, and Texas-to question the extent of their responsibility for helping immigrants. Although rural areas in southern states often provide special services (for example, migrant school programs, health care, and community-based services) to seasonal migrant farm worker communities who relocate there on a temporary basis, they often lack the resources and infrastructure to assist permanent immigrants.

Eligibility for Mainstream Social Services In addition to services targeted specifically to immigrants, immigrant policy also includes qualifications for mainstream social programs (Fix & Zimmermann, 1994). On the basis of a complex set of rules, immigrants are eligible to receive services under certain federal programs. Social workers play a pivotal role in the delivery of available government services to immigrants. In providing services to immigrants, there are two key policy-related issues to keep in mind. The first is identifying the person's legal immigration status, and the second is determining what government benefits the person is eligible to receive.

Immigrant legal classification is far more complex than a simple legal-illegal dichotomy. In addition to naturalized U.S. citizens and undocumented individuals, immigrants can be classified as lawful permanent residents, people fleeing persecution, aliens with work authorization, and people allowed to enter the United States with special-purpose visas (also called "nonimmigrants") (National Immigration Law Center, 1994). There are even more specific immigrant statuses within these broad categories (National Immigration Law Center,1994). For example, people fleeing persecution can be classified as refugees or asylees, depending on whether they sought admission while still in their country of origin or after having entered the United States. Lawful permanent residents include people who were legalized under the IRCA and conditional permanent residents (that is, people married to U.S. citizens for less than two years).

A person's immigration classification denotes under what circumstances they entered the country (for political or economic reasons), the conditions for remaining in the country (length of time they can stay or ability to bring family members into the country), and whether they are allowed to be employed in the United States. Some immigrant categories are in effect only for restricted periods of time and are based on specific legislation.

More important for human services providers, immigrant status determines what government benefits a client may qualify for. At the federal level the eligibility system for immigrants is quite complicated and exclusionary (Board on Children and Families, 1995; Fix & Passel, 1994; Rolph, 1992). Before passage of the Personal Responsibility and Work Opportunity Reconciliation Act, immigrants across general categories, including some undocumented individuals, were covered by several programs for the poor, including the Special Supplemental Food Program for Women, Infants, and Children (WIC); school lunch and breakfast; emergency Medicaid services; and Head Start. However, eligibility for most federal programs depended on immigrant status, as well as fulfillment of the same program eligibility requirements as U.S. citizens. Furthermore, the level of assistance varied widely. For example, cash assistance for refugees was limited to eight months, and the payment amounts were lower than regular welfare assistance (personal communication with Caitriona Lyons, director of refugee programs, Refugee and Resettlement Services, Austin, Texas, May 21, 1996).

Immigrants eligible for assistance before passage of the Personal Responsibility and Work Opportunity Reconciliation Act could be in the following selected categories:

* lawful permanent residents

* people granted permission to enter the country for humanitarian reasons

* refugees and asylees, including those granted "paroled" refugee status ("parolees") when the number allowed to enter the country has been exceeded

* family members of people granted legal status under the IRCA (family unity provision)

* people allowed to remain in the United States under temporary protected status because of unsafe conditions in specific countries of origin

* undocumented immigrants. (For a detailed description of immigrant classification and eligibility for federal social services programs, see National Immigration Law Center, 1994, 1996.)

Immigrant Provisions of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996

Some important changes in immigrant eligibility criteria for a number of mainstream social services will take place once the provisions of the Personal Responsibility and Work Opportunity Reconciliation Act begin to take effect in April 1997 (Center for Public Policy Priorities, 1996). Under the new guidelines, most legal ("qualified") immigrants will no longer be eligible to receive food stamps and SSI. States will have the option of maintaining AFDC (changed to Temporary Assistance for Needy Families [TANF] under the new legislation) and Medicaid coverage for current legal immigrants. Otherwise, legal immigrants will remain eligible for other selected federal benefits but will have access to some of the programs only after five years of residence in the United States.

In addition, certain categories of legal residents will, along with undocumented immigrants, be considered "unqualified" for the purposes of eligibility for needs-based assistance: spouses and children of people who sought legal status under IRCA family unity provisions and people in temporary protective status. However, unqualified people will continue to be eligible for emergency Medicaid services and limited grandfathering of current federally subsidized housing. Children of unqualified aliens will continue to receive school breakfast and lunch benefits. States will have the option of providing WIC for these children. Overall, however, state or locally funded programs may provide services to undocumented people only if the state passes a law providing for their eligibility.

Social Welfare Needs of Immigrants

Current knowledge of immigration classification is essential for social workers for several reasons. First, social workers can help clients obtain appropriate lawful immigration status, because this is a first step in becoming eligible for social welfare services. Second, by keeping abreast of changes in program eligibility requirements for immigrants, social workers can provide more accurate information and referral services. Third, social workers need to be aware that the unqualified use of public services by certain categories of immigrants can be a cause for deportation or future denial of lawful permanent resident status under the "public charge" rule. The public charge rule refers to the expectation that immigrants will obtain support from family members or other sponsors rather than from government sources during the initial years after arriving in the United States. Consequently, social workers may need to focus on finding alternative nongovernment sources of support for specific immigrant clients in need.

The challenge for both policymakers and social work practitioners is to respond to the needs of immigrants by designing appropriate social services that will contribute to a smooth social and economic transition in an environment of limited government resources. Furthermore, in evaluating the role of social work practice, it is also relevant to understand the alternative immigrant household survival strategies used in the absence of welfare assistance.

Statistical data are available on the demographic characteristics of immigrants, but national data on their needs are much more limited (Board on Children and Families, 1995). Some studies focusing on certain groups of immigrants identify important areas of need among immigrant children and families.

Socioeconomic background and the reasons for immigrating influence the social services needs of immigrants. Some immigrants who have professional backgrounds come to improve their careers or businesses and bring with them access to sources of capital. However, the largest group of immigrants to the United States are labor migrants, who are concentrated in manual, low-paying jobs and often come to escape poverty (Portes & Rumbaut, 1990). Political refugees and asylees who leave their countries because they fear persecution are often also economically disadvantaged. Regardless of socioeconomic status, resettlement always requires support in locating housing; finding work; and connecting to schools, churches, and other institutions in the new society.

Ethnographic studies show that the settlement process involves the development of social, institutional, and economic ties (Massey, 1986). When migrant communities are established, for example, they often provide the social networks necessary to help new immigrants reach their destination, find work, and adapt to the new environment (Massey, 1986; Portes & Rumbaut, 1990). To the extent that immigrants lack access to their own economic resources and networks of social support, they require other sources of assistance. Resettlement Assistance

Clearly, material resources are a major need among new arrivals, especially among labor migrants; low incomes translate into very poor living conditions for families and children. Over 10 percent of immigrants live in areas of concentrated poverty, a figure that has increased much more rapidly between 1980 and 1990 than that of U.S.-born citizens (Fix & Passel, 1994). Thus, meeting the basic needs of immigrant clients for adequate housing, food, and clothing is a priority for social work. The provision of emergency shelter is often necessary for refugees and asylees, who sometimes flee their countries unexpectedly and unprepared. As a result, they may lack supportive social networks in receiving communities.

The wide range of economic needs among immigrants is related to other areas requiring assistance, including education and language needs. Immigrants with low levels of education and lower occupational status need help obtaining job skills training that will prepare them to work in better-paying jobs. In addition, social workers can be of great assistance in helping clients overcome language barriers. They can advocate for clients by offering bilingual services, serving as translators to other organizations, or providing information and referral services to help secure English instruction.

Although the scarcity of bilingual social workers is a real problem (Harrison, Wodarski, & Thyer, 1992), some communities are developing innovative methods to serve their growing immigrant populations. The state Department of Human Services in Texas, for example, initiated a program-the Volunteer Interpreter Service-that trains bilingual people to serve as volunteer translators for social workers working with clients who have limited English fluency.

Mental Health Services

For refugees and asylees, mental health problems are a critical concern that often goes unaddressed. To different degrees refugees and asylees suffer trauma associated with having experienced or witnessed violent crimes and deprivation in wars in their countries of origin. Not surprisingly, according to Portes and Rumbaut ( 1990) and de Monchy ( 1991), extensive research has shown that refugees have significantly higher rates of need for mental health services than the population in general. Research on the mental health problems of nonrefugee immigrants is much less extensive, but it suggests that mental health is associated with the conditions of settlement-that is, how supportive the new environment is.

Studies among Mexican Americans indicate that mental health problems, such as depression, are indeed greater among immigrants but that they are lower for immigrants who have higher incomes, kin and family support, and strong cultural attachments (Portes & Rumbaut, 1990). Effective mental health intervention by human services providers requires at least four elements: ( 1 ) the use of trained bilingual and bicultural staff; (2) training in disorders associated with the immigrant experience, including posttraumatic stress disorder; (3) linkages between social services programs and members of the immigrant community; and (4) integration of traditional methods of healing with other therapeutic approaches (de Monchy, 1991).

Health Care

Because the immigrant population is disproportionately young-29 percent are under age 20 (Rolph, 1992)-child and maternal health care is critical. Yet the data show that immigrant children and their families do not receive adequate health care (Board on Children and Families, 1995; Plascencia & Wong, 1991). Overwhelmingly, the reason for this is the lack of private or public health insurance. Contrary to what the public might think, many immigrants are not eligible for publicly supported health care services, except in emergencies. For example, people seeking asylum, undocumented people, and some categories of legal immigrants are not eligible for Medicaid. In addition, several categories of legal immigrants who are not naturalized citizens risk being denied citizenship for having a record of public service use. Although some believe that immigrants do not seek health services primarily for cultural reasons, there is no empirical evidence to support this belief.

Information on the specific physical health needs of the foreign-born individuals is inconclusive. In some cases, the health of immigrants who have lived in this country longer actually deteriorates (Board on Children and Families, 1995). However, it is not clear what aspects of immigrants' lives result in positive outcomes. Supportive social services can be a key factor in promoting the health of immigrants. Given that the main factor preventing immigrants from obtaining medical care is lack of access to public and private health insurance, social services workers face a touch challenge in the current political environment. Social workers can be a source of information and referral services to connect clients with available programs. For example, many local and state publicly or privately funded medical assistance programs do not restrict immigrant eligibility.

Second, social workers can be supportive of and receptive to immigrant health care practices that produce healthy outcomes. For instance, Hispanic women, particularly immigrant women, tend to have markedly healthier birth outcomes than the general population. At the same time, research shows that they are less likely to smoke during pregnancy and tend to have healthier diets (National Coalition of Hispanic Health and Human Services Organizations, 1995). One way of being supportive of positive health practices is for social workers to collaborate with and serve as a resource to indigenous health promoters, who are found in many immigrant communities.

Patterns of Social Services Use

Given the limited availability of government assistance in adjusting to life in the United States, where do immigrants turn for help? Field studies of selected immigrant communities shed light on some of the coping strategies immigrant families use to meet their needs. According to a study of undocumented Mexican immigrants in a Southern California community, families combine different means (Hondagneu-Sotelo, 1994). First, immigrant families have as many wage earners as possible, including children. Second, they often share their residences with relatives or even with other families. Third, kin networks are an important source of support. Families share and borrow resources and services, such as child care, among kin.

The presence of these types of coping mechanisms was substantiated in ethnographic studies of undocumented Mexicans and Central American immigrants (Chavez, 1990) and Vietnamese and Laotian refugees (Benson, 1990). Some immigrant groups are able to secure work from organized ethnic businesses or enclaves, which serve as a safety net, particularly for those who are unskilled (Light & Bonacich, 1988; Tienda & Liang, 1994).

Implications for Social Work

Contrary to popular belief, research shows that immigrants, including those who qualify for services, vastly underutilize government programs in comparison with the U.S.-born population (Bean, Van Hook, & Glick, 1994-95; Tienda & Liang, 1994). Thus, there is good reason to believe that many of the needs of immigrant clients have gone unmet, given their generally lower incomes and the need for institutional resources associated with resettlement.

In working directly with clients, social workers need to be cognizant of the pressures on family members associated with their common coping strategies, such as overcrowded living conditions, long work hours, school dropout by older children to work, and gaps in the availability of help. Pryor (1992) suggested that school-based services could be useful in linking families to a wide range of community resources. Community-level services could promote small businesses by securing technical assistance for ethnically diverse entrepreneurs, because they are often a source of employment for immigrants. At the research and policy level, social workers can intervene by highlighting the adverse impact of unmet needs on the longterm social, educational, and economic outcomes of immigrants and the negative effect these difficulties are likely to have on the broader U.S. economy.

Although levels and types of need vary across different socioeconomic classes of immigrants, their overrepresentation among labor migrants and among poor people points to the relevance of social services availability for this population. In assessing the problems of immigrant clients, social workers can build on the strengths that have been shown to sustain the viability of immigrant families, particularly reliance on cultural attachments and values and social support from family, kin, and community. At the same time, such strategies do not begin to fill the holes in the weak government safety net for this segment of the U.S. population.

Social workers need to

* take a national political stance on social welfare legislation that threatens to adversely affect children and other vulnerable immigrant populations through actions such as the recent motion passed by NASW against California's Proposition 187 ("Nation's Social Workers," 1995).

* become involved in the legislative process. With the current move to block grants, states will be redesigning major social programs and under federal legislation will often have the option of providing

services to immigrants. Social workers who serve immigrants can provide firsthand testimony on the needs of this population.

* organize for community-based services and form coalitions to respond to the immediate impact of the current welfare reform legislation. Policy analysts project that approximately 500,000 elderly poor and disabled legal immigrants will lose their SSI benefits, that about 900,000 will lose their food stamp benefits, and that many others will lose other forms of assistance necessary to meet their basic needs (Center for Public Policy Priorities, 1996).

Conclusion

Immigrants are a significant proportion of the U.S. population, and immigration entails a resettlement process that requires support. Immigrants have been shown to be a revitalizing force in ethnic communities and in the broader society by adding highly motivated workers and small and large business enterprises to the labor market, enriching and maintaining cultural traditions, and strengthening networks of social support (Light & Bonacich, 1988; Moore & Pinderhughes, 1993).

Nevertheless, the adaptation of immigrants presents special challenges related to settling in the new society. The availability of employment and the presence of networks in an existing ethnic community are key factors, but government policies that facilitate resettlement are just as important (Portes & Rumbaut, 1990). Social work plays a crucial role in the social and economic integration of immigrants through the provision of social services and resources. In the context of the limited support currently provided by government to this segment of American society, social workers must respond with creative community-based initiatives that draw directly on the vitality of immigrant families and communities.

Original manuscript received June 5, 1996 Final revision received October 2, 1996 Accepted November 9, 1996

References

References

Bean, F. D., Chapa, J., Berg, R., & Sowards, K. A. (1994). Educational and sociodemographic incorporation among Hispanic immigrants to the United States. In B. Edmonston & J. S. Passel (Eds.), Immigration and ethnicity: The integration of America's newest arrivals (pp. 73-100). Washington, DC: Urban Institute Press. Bean, F. D., Cushing, R. G., & Haynes, C. W. (199495). The changing demography of U.S. immigration flows: Patterns, projections, and contexts (Paper No. 94-95-16). Austin: University of Texas at Austin, Population Research Center. Bean, F. D., Van Hook, J.V.W., & Glick, J. (199495). Mode-of-entry, type of public assistance and patterns of welfare recipiency among U.S. immigrants and natives (Paper No. 94-95-17). Austin: University of Texas at Austin, Population Research Center.

Benson, J. E. (1990). Households, migration, and community context. Urban Anthropology, 19, 9-29. Bilingual Education Act, P.L. 89-10, 102 Stat. 274 to

293.

Board on Children and Families. (1995). Immigrant children and their families: Issues for research and policy. The Future of Children, 5, 72-89. Borjas, G. J. (1994). The economics of immigration. Journal of Economic Literature, 32, 1667-1717. Center for Public Policy Priorities. (1996, October 1). Analysis of federal welfare reform (Special issue). Policy Page. Austin, TX: Author. Chavez, L. R. (1990). Coresidence and resistance: Strategies for survival among undocumented Mexicans and Central Americans in the United States. Urban Anthropology, 19, 31-61. Chiswick, B. R. (1979). The economic progress of immigrants. In W. Fellner (Ed.), Contemporary economic problems (pp. 357-399). Washington, DC: American Enterprise Institute. Chiswick, B. R., & Sullivan, T. A. (1995). The new immigrants. In R. Farley (Ed.), State of the union: America in the 1990s (pp. 211-270). New York: Russell Sage Foundation.

de Monchy, M. L. (1991). Recovery and rebuilding: The challenge for refugee children and service providers. In F. L. Ahearn, Jr., & L. L. Athey (Eds.), Refugee children: Theory, research, and ser

References

vices (pp. 163-180). Baltimore: Johns Hopkins University Press.

Drachman, D. (1992). A stage-of-migration framework for service to immigrant populations. Social Work, 37, 68-72.

Edmonston, B., & Passel, J. S. (1994). Ethnic demography: U.S. immigration and ethnic variation. In B. Edmonston & J. S. Passel (Eds.), Immigration and ethnicity (pp. 1-30). Washington, DC: Urban Institute Press.

Fix, M., & Passel, J. S. (1994). Immigration and immigrants: Setting the record straight. Washington, DC: Urban Institute.

Fix, M., & Zimmermann, W. (1994). After arrival: An overview of federal immigrant policy in the United States. In B. Edmonston & J. S. Passel (Eds.), Immigration and ethnicity (pp. 251-281). Washington, DC: Urban Institute Press. Harrison, D. F., Wodarski, J. S., & Thyer, B. A. (1992). Cultural diversity and social work practice. Springfield, IL: Charles C Thomas. Hondagneu-Sotelo, P. (1994). Gendered transitions: Mexican experiences of immigration. Berkeley: University of California Press. Illegal Immigration Reform and Immigrant Respon

sibility Act of 1996, P.L. 104-208, 110 Stat. 3009. Immigration Act of 1990, P.L. 101-649, 104 Stat. 4978.

Immigration and Nationality Act of 1965, P.L. 89

236, 79 Stat. 911 to 920, 922. Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603, 100 Stat. 2099. Jacob, A. G. (1994). Social integration of Salvadoran

refugees. Social Work, 39, 307-312. Le-Doux, C., & Stephens, K. S. (1992). Refugee and immigrant social service delivery: Critical management issues. In A. S. Ryan (Ed.), Social work with immigrants and refugees (pp. 31-45). New York: Haworth.

Light, I., & Bonacich, E. (1988). Immigrant entrepreneurs: Koreans in Los Angeles 1965-1982. Berkeley: University of California Press. Massey, D. (1986). The settlement process among Mexican migrants to the United States. American Sociological Review, 51, 670-684. Migration and Refugee Assistance Act of 1962, P.L.

87-510, 76 Stat. 121.

Moore, J., & Pinderhughes, R. (1993). In the barrios: Latinos and the underclass debate. New York: Russell Sage Foundation.

References

National Coalition of Hispanic Health and Human Services Organizations. (1995). Meeting the health promotion needs of Hispanic communities. American Journal of Health Promotion, 9, 300-311. National Immigration Law Center. (1994). Guide to alien eligibility for federal programs. Los Angeles: Author.

National Inimigration Law Center. (1996). Immigrants and the '96 welfare law: A resource manual. Los Angeles: Author.

Nation's social workers oppose Prop. 187: Ethics may force social workers to break law. (1995, January). NASW Network, p. 7.

Padilla, Y. C. (1993). The effect of geographic mobility on the socioeconomic achievement of young Hispanic men. Dissertation Abstracts International, 54-03, 1113. (University Microfilms No. 93-19, 602)

Padilla, Y. C. (1996, August). The effect of social background on the long-term economic integration of Mexican immigrants. Paper presented at the meeting of the Society for the Study of Social Problems, New York.

Personal Responsibility and Work Opportunity Reconciliation Act of 1996, P.L. 104-193, 40 U.S.C. 1305 (Note).

Plascencia, F., & Wong, P. (1991). Survey of newly legalized persons in Texas: Executive summary. Austin: University of Texas at Austin, LBJ School of Public Affairs, Center for the Study of Human Resources.

Portes, A., & Rumbaut, R. G. (1990). Immigrant America: A portrait. Berkeley: University of California Press.

Potocky, M. (1996). Toward a new definition of refugee economic integration. International Social Work, 39, 245-256.

Pryor, C. (1992). Integrating immigrants into American schools. Social Work in Education, 14, 153-159. Refugee Act of 1980, P.L. 96-212, 94 Stat. 102. Rolph, E. (1992). Immigration policies: Legacy from the 1980s and issues for the 1990s. Santa Monica, CA: Rand Corporation.

Rosenberg, D. E. (1991). Serving America's newcomers: States and localities are taking the lead in the absence of a comprehensive national policy. Public Welfare, 49, 28-37.

Sherraden, M. D., & Martin, J. J. (1994). Social work with immigrants: International issues in service delivery. International Social Work, 37, 369-384.

References

Tienda, M., & Liang, Z. (1994). Poverty and immigration in policy perspective. In S. H. Danziger, G. D. Sandefur, & D. H. Weinberg (Eds.), Confronting poverty: Prescriptions for change (pp. 330364). New York: Russell Sage Foundation. Zimmermann, W., & Fix, M. ( 1994). Immigrant policy in the states: A wavering welcome. In B. Edmonston & J. S. Passel (Eds.), Immigration and ethnicity (pp. 287-315). Washington, DC: Urban Institute Press.