Monday, December 7, 2009

In Commemoration of Human Rights Day 2009: Immigrants Have Rights Too... Right?

Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. ~World Health Organization, 1948

If you don't have your health, then almost nothing else matters. From the smallest of injuries to grave illnesses, poor health disrupts daily life and can threaten your livelihood or even your survival. What so many of us take for granted - a healthy body, access to health care, and an environment conducive to good health - remains inaccessible for many of today's immigrants.

This Thursday, December 10, is Human Rights Day, which commemorates the 61st anniversary of the creation of the Universal Declaration on Human Rights. This year, as health care reform advances in Congress and immigration reform is around the corner, let's take a moment to consider whether immigrants deserve to be in good health.

This should seem like a no-brainer, right? Of course immigrants deserve to be healthy, just like everyone else. But this notion, that people have rights based on their common humanity, is actually not yet well accepted in the United States. It is time for the U.S. government to recognize that the right to health is an essential and basic human right.

Immigrants face multiple barriers to good health. Conflicts abroad can force them from their homelands, sending them on a circuitous journey across national borders with few resources. Environmental destruction can dry up wells, destroy crops, and send people out in search of a better life. Economic disparities and governmental policies can deny immigrants and other marginalized populations access to basic health care even when it is widely available to the rest of the population.

The premise of human rights like the right to health is that people deserve to live with a certain level of dignity, and if they are unable to achieve that on their own, then their government will step in and help them out. Human rights law is a way of holding governments responsible to their people.

International human rights law clearly supports health as a human right. The Universal Declaration on Human Rights and the International Covenant on Economic, Social, and Cultural Rights both state that all peoples have the right to a standard of living that promotes physical and mental health and well-being. In addition, the United States, as a signatory to the Charter of the Organization of American States, is committed to development efforts that promote a healthful life for all.

But how do these international commitments translate on the ground?

If the state of the current health reform legislation is any indicator, then the United States has a long way to go in ensuring that all of its residents - including immigrants - have access to adequate health care. Even with the upcoming reforms, immigrants face significant and unfair restrictions. Undocumented immigrants may not be able to buy coverage in the health insurance exchange even with their own money. Immigrants with green cards, who are in the country legally, would still face a 5-year ban for Medicaid.

From a public health standpoint, it just makes sense to want as many people as possible to have good access to health care. Healthy people make for healthy and productive communities. This is a common-sense solution to a shared problem. From a human rights standpoint, immigrants deserve health care coverage just as much as anyone else.

But the broken U.S. immigration system prevents immigrants from demanding their rights. Undocumented immigrants, unable to adjust their legal status, are particularly at risk of human rights abuses.

One of the most prominent sites of human rights abuses is the immigration detention system. The Department of Homeland Security will detain more than 440,000 immigrants annually by the end of 2009. Most of these immigrants are non-criminal and are suspected only of immigration violations, yet they are detained in jail-like settings and routinely denied access to basic and timely health care. Cases have been documented in which regularly taken medication was withheld, follow-up treatment for cancer was denied, and sick call requests were ignored. At least 104 immigrants have died in detention since 2003. This is unacceptable.

Just about everyone agrees that the U.S. immigration system is broken and needs fixing. Immigrants and their families need workable solutions that make it possible to live with dignity, in a way that is consistent with this country's values of equality and opportunity. Health is an essential part of this equation.

In honor of Human Rights Day and in recognition of health as a human right, Congress should include immigrants in the final health reform bill and work toward passing humane and comprehensive immigration reform in early 2010.

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