Promoting the Health of Immigrants and Refugees

July-August 2017


As Catholic health care providers, we have a special responsibility to serve the least among us and be a voice for the poor and vulnerable. This includes our brothers and sisters who move to the United States as refugees and immigrants. Inspired by the Declaration of Independence promise of "life, liberty and the pursuit of happiness," they come in search of better futures for themselves and their children.

That's why my parents immigrated to America from Italy and Austria in the 1950s. They arrived here with next to nothing in their pockets, but they understood the intrinsic value of hard work. They labored tirelessly for our family and instilled a strong work ethic in my brother and me at a young age.

When you're an immigrant or the child of an immigrant, you never forget what it's like to be poor or to feel like an outsider. You also never forget the compassion shown to you and the opportunities you were given. That's what makes this country great. It's the fabric of who we are.

Like other Catholic health systems, we at Providence St. Joseph Health, based in Renton, Washington, embrace refugees and immigrants as dear neighbors in our communities, and we serve them without regard to their legal or socioeconomic status. Our medical facilities are a sanctuary for all in need of healing — a safe place where everyone can expect to be treated with compassion and respect. We continue to believe that every human being deserves quality health care. Fundamentally, we see it as a right, not a privilege.

I fully support national security as a clear priority for our country. However, I urge us not to lose sight of the human dignity inherent in every person who lives within our borders, whether they were born here or came from a foreign land, whether they are citizens or not. The United States must continue to be a beacon of hope for those fleeing war-torn nations and oppression, and we must welcome people from other shores who offer talent and expertise urgently needed, and sometimes in short supply, here at home.

Welcoming and serving one another makes us a better, more enriched nation. We are, after all, a land of immigrants. As Pope Francis reminds us, "Many of us were foreigners once." And as the Catholic social teachings call us to remember, "We are one human family."

At Providence St. Joseph Health, we seek to connect with our dear neighbors in each of the seven states we serve, and beyond. We especially stand in solidarity with those living along the margins of society, including immigrants, refugees and migrant workers. Here are a few thoughts and concerns about additional vulnerabilities and threats facing this population:

Undocumented individuals avoiding medical care due to fear of deportation. Providence St. Joseph Health is proud to operate safety net clinics and partner with other providers in our communities to offer free or discounted care to poor and vulnerable populations, including noncitizens. It's one way we are narrowing disparities in health outcomes between the rich and the poor.

In several of the states we serve, for example, we provide prenatal care to pregnant undocumented migrant workers, who often face poor living and working conditions that can lead to high-risk pregnancies. Best-practice prenatal care helps to ensure healthier outcomes for mothers and babies. It also helps save precious health care resources by avoiding costs that would have been spent caring for severely ill newborns.

 Yet, with concerns over increased deportation enforcement, we are hearing reports that some patients are afraid to go to medical appointments for fear they will be met by immigration officials and be deported and separated from their families. It is critical that we put this fear to rest and reassure patients that when they are in our care, they are in a safe environment, and that their personal information is protected.

The U.S. Department of Homeland Security currently includes medical treatment and health care facilities among the "sensitive locations" at which enforcement actions "should generally be avoided, and that such actions may only take place when (a) prior approval is obtained from an appropriate supervisory official, or (b) there are exigent circumstances necessitating immediate action without supervisor approval."1

Providence St. Joseph Health strongly maintains that the health care setting is and always will be a place of privacy and intimate human encounters that must be respected and kept sacred.

An estimated 4.6 million children are U.S. citizens with undocumented mothers or fathers, and we are receiving some reports that parents from these families are removing their eligible kids from Medicaid programs for fear of sharing too much information about their family's mixed residency status and risking deportation. Maintaining coverage for these and all children is vital to the public health of our communities. We must promote a society where families feel safe to keep their children out of the shadows and to ensure they get the health care they need.

The alarming prevalence of human trafficking. Immigrants and individuals from impoverished nations are at risk for human trafficking, which is essentially a contemporary form of slavery. Victims can be coerced or misled into everything from prostitution, domestic servitude, sweatshop factories and farm work.

The statistics are startling. In the U.S., there were 26,727 calls to the National Human Trafficking Hotline in 2016. California reported the highest number of human trafficking cases, followed by Texas and then Florida.

Worldwide, an estimated 20.9 million victims are being trafficked at any given time, according to the International Labor Organization's statistics for 2014. Of this alarming number, 26 percent are children, and 55 percent are women and girls. It is an unthinkable injustice that victimization of this nature still happens in today's world.

But we, as health care workers, are in a position to do something about it. An astounding 87 percent of human trafficking survivors said health care personnel were the only professionals they had contact with while they were enslaved, which means we have an important responsibility to recognize the signs of this abuse and help victims escape their situation.

The Catholic Health Association has been a leading voice in the imperative to end human trafficking, and Providence St. Joseph Health is proud to be part of this cause. We are training our emergency department and labor and delivery unit caregivers to identify people possibly involved in human trafficking. We also are forming community partnerships in order to provide essential resources and support for vulnerable people who leave or escape from traffickers.

"We have an opportunity to help rescue these victims. Sometimes it's just asking a simple question: 'Can I call someone you trust?' or 'Can I call your family?'" said Lori Eastman, LCSW, manager of patient and family services at Providence Little Company of Mary Medical Center in Torrance, California.

 When caregivers recognize signs of human trafficking and how to broach the topic in a safe, nonthreatening way, they can be a vital lifeline to those in need. This important work is helping to save lives and reconnect loved ones with families.

The need for reasonable treatment of immigrants and refugees. Citing the need to protect the American people from terrorist attacks by foreign nationals, President Donald J. Trump's Jan. 23, 2017, executive order barred U.S. entry to individuals from seven African and Middle Eastern countries (later amended to six countries). More than 300 of the Providence St. Joseph caregivers are nationals or dual nationals of the seven countries, and these individuals are valued members of the Providence St. Joseph Health family.

When Pope Francis visited the United States in 2015, he shared an important message with the immigrants who live here: "By contributing your gifts, you will not only find your place here, you will help to renew society from within," he said.

That is true of the diverse workforce we celebrate at Providence St. Joseph Health. Whether some of our caregivers are here on work visas or hold dual citizenship or green cards, they play a vital role in the health of those we serve. They bring highly needed, highly technical skills to our communities. Their work literally saves lives, and we express our profound gratitude for the contributions they make every day.

These individuals also include physicians who come here to learn the latest medical techniques, which in turn, allows them to advance health care in their home countries. It's part of our commitment to improving health around the globe, especially in developing nations.

In addition, executive orders limiting refugees concern us as a matter of social justice. The Catholic social teachings remind us: "We are one human family whatever our national, racial, ethnic, economic, and ideological differences. We are our brothers' and sisters' keepers, wherever they may be. Loving our neighbor has global dimensions in a shrinking world. … Our love for all demands that we promote peace in a world surrounded by violence and conflict."2

While we support sensible immigration reform and agree that national security is paramount, Providence St. Joseph Health stands with all who seek to escape violence and injustice, both at home and abroad. We believe our success and health as a nation comes from building bridges and breaking down cultural walls.

The Statue of Liberty embodies Catholic social teachings. It's easy to take for granted Emma Lazarus' sonnet for the Statue of Liberty. We have heard it so often. But the words ring true today, more than ever, 134 years after they were written.

"Give me your tired, your poor, your huddled masses yearning to breathe free, the wretched refuse of your teeming shore. Send these, the homeless, tempest-tost to me, I lift my lamp beside the golden door!"3

The words embody what we are called to do as Catholic health care and social service providers. They also align with the heritage of Providence St. Joseph Health and other Catholic health systems. Our purpose is to show love and compassion for every person we encounter, and in our capacity as health care providers, we have an opportunity to support healing in mind, body and spirit.

Like our fellow Catholic health systems, Providence St. Joseph Health takes this calling to heart. Reaching out to the less visible and forgotten members of our society is a core part of our mission. For example, Providence St. Joseph Health offers safe, affordable housing to hundreds of low-income individuals in our communities, including refugees and immigrants. We also work closely with other nonprofits and social service agencies to address food insecurity, and we have made access to mental health care an urgent priority. These issues represent persistent needs in our communities, especially for refugee and immigrant populations.

Leading with compassion. As lawmakers deliberate policies on immigration and health care, it is important for those of us in Catholic health systems to continue to be a voice for the poor and vulnerable. When the path forward is uncertain, we know we are going in the right direction if we lead with compassion and if we return over and over again to our core values.

Throughout this article, I have used the word "population" to describe the immigrants and refugees we serve. But we will do well as a nation if we think of them as individuals with their own personal struggles, who have faced the difficult challenge of leaving their home country and coming to a new land.

To quote Pope Francis again, he reminded us when he visited the U.S. in 2015 that thousands of people are led here in search of opportunities and a better life for themselves and their families.

"Is this not what we want for our own children?" he asked. "We must not be taken aback by their numbers, but rather view them as persons, seeing their faces and listening to their stories, trying to respond as best we can to their situation."

Our values as Catholic health care professionals call us to welcome the stranger and the newcomer — just as my parents were welcomed — so they can share their God-given talents with us and make our country a better place for all.

ROD HOCHMAN is president and CEO of Providence St. Joseph Health in Renton, Washington.



  1. U.S. Immigration and Customs Enforcement, "Sensitive Locations FAQs," Department of Homeland Security website. www.ice.gov/ero/enforcement/sensitive-loc 2.
  2. United States Conference of Catholic Bishops, "Seven Themes of Catholic Social Teaching," USCCB website. www.usccb.org/beliefs-and-teachings/what-we-believe/catholic-social-teaching/seven-themes-of-catholic-social-teaching.cfm.
  3. Emma Lazarus, "The New Colossus," 1883.


Promoting the Health of Immigrants and Refugees

Copyright © 2017 by the Catholic Health Association of the United States

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