Healthcare for Illegal Immigrants Serves the Public Interest

Illegal immigration is one of the more contentious social issues facing Americans in the last several decades, dominating political discourse and affecting other social debates including the economy, education, unemployment, equality, and often, healthcare.  The illegal immigration debate is fueled by a resurgent nativist movement in the United States that argue illegal immigrants are responsible for a variety of social ills as they take American jobs, fail to pay taxes, and use a disproportionate share of scarce community resources.  From a healthcare point of view, the rhetoric against illegal immigrants is fierce and misunderstanding is prevalent as many Americans are worried that illegal immigrants are overburdening the healthcare system at taxpayer expense (Blum, 2012; Bush, 2012; Eviatar, 2009).  Rather than appeal to historical arguments that describe the U.S. as a country of immigrants, economic arguments the demonstrate the economic contributions of illegal immigrants, or moral arguments that the U.S. has a moral responsibility to provide care for those who contribute to society, this paper will argue the practical merits of providing healthcare access to illegal immigrants, including improvements in overall public health and the reduction of healthcare costs.

Despite arguments that illegal immigrants are a burden to the U.S. public healthcare system, subsidized care for illegal immigrants represent a tiny fraction of overall healthcare spending and in particular, publicly funded healthcare.  Mohanty, Wolhandler, Himmelstein, Carrasquillo, and Bor, (2005) found that all immigrant healthcare expenditures in 1998 were  7.9% of total U.S. healthcare expenditures, and government funded healthcare for both legal and illegal immigrants was a mere 2.3% of total expenditures.  Another study by Goldman, Smith, and Neeraj (2006) found that because the “foreign-born are relatively healthy and have less access to health insurance, they are disproportionately low users of medical care” (p. 1710); also finding that in 2000, government funded healthcare for undocumented immigrants amounted to $1 billion dollars.  Besides lack of health insurance and overall health, there are a variety of additional social and economic reasons that illegal immigrant use of healthcare is far below that of U.S. citizens, including the Personal Responsibility and Welfare Reform Act of 1996, that prevents illegal immigrant access to federally-funded healthcare, the fear of deportation, limited English language proficiency, and social stigma (Derose, Escarce, & Lurie, 2007).  In essence, the liminal legality of many immigrants often prevent them from seeking access to healthcare (Menjivar, 2006).

While opponents of illegal immigration might consider the limited use of U.S. healthcare resources a positive outcome of tougher immigration policy, existing policies create a number of socioeconomic problems.  For example, the lack of access to basic preventative care exacerbates emergency room costs.  Mohanty, et al. (2005) found that emergency room costs for uninsured immigrant children were three times as high as those for U.S. born insured children, while annual per capita healthcare expenditures for immigrant children were 86% lower.  Medical practitioners suggest that while U.S. hospitals have an obligation to provide care without regards to income or immigration status, that the “early diagnosis and treatment in a primary care setting are both medically preferable and a better use of resources” (Okie, 2007, p. 526).  Consequently, in order to reduce healthcare expenditures for illegal immigrants, while improving outcomes, public policy should seek to improve illegal immigration access to primary care by providing low-cost, basic coverage for illegal immigrants and creating national legislation that creates a safe harbor for illegal immigrants in healthcare settings.

Another serious policy concern in the illegal immigrant healthcare debate is that of public health.  Opponents of illegal immigration argue that illegal immigrants “come most often from countries with endemic health problems [and] the rapidly swelling population of illegal aliens in our country has also set off a resurgence of contagious diseases that had been totally or nearly eradicated by our public health system” (Federation for American Immigration Reform, 2009, p. 1).  There is truth in their argument, insofar as “laws and bureaucratic barriers reduce their use of key preventive health services, such as immunizations and screenings for infectious disease” (Okie, 2007, p. 526).  However, while FAIR advocates for a public policy of immigration enforcement and deportation as the solution, there are serious flaws in their policy position, including high enforcement costs, labor shortages, and damage to the economy (Immigration Policy Center, 2012).   Rather, policy should encourage immunizations and infectious disease screenings for every uninsured person, immigrant or otherwise, within U.S. borders as a matter of public health.  Indeed, the U.S. Congress has provided significant funding to the Centers for Disease Control global fight against contagious disease, recognizing that “infectious disease knows no boundaries” (Centers for Disease Control and Prevention, 2011, p. 1).  In addition, since 2002, the United States has spent over $19 billion in the global fight against AIDS, TB, and Malaria (USAID, 2010).  It stands to reason that nativist sentiment and anti-immigrant rhetoric should not prevent the U.S. from implementing rational public health policy to prevent the spread of contagious disease within its borders.

The rise of nativist sentiment, fueled by anti-immigration groups like FAIR and others, has led to an irrational policy debate over public healthcare that is replete with misinformation and emotional appeals suggesting illegal immigrants are the cause of a disproportionate share of the problems in the U.S. healthcare system.  There is no room in the healthcare debate for scapegoating, given the U.S. has the highest healthcare spend in the world and the lowest quality of care in the developed world (Altarum Institute, 2012; Davis, Schoen, & Stremikis, 2010).  While illegal immigrants use disproportionally less healthcare than U.S. citizens, there remain problems with public policy that increase healthcare costs for illegal immigrants beyond what they should be, and increase public health risk.  Illegal immigrants live and work in the United States; it is simple fact.  Rather than continue to decry their presence or support unrealistic policy positions, the U.S. should work to implement pragmatic policy solutions that reduce healthcare costs and improve the public health by improving illegal immigrant’s access to primary care, immunizations, and infectious disease screening in a safe, and stigma-free environment.


Altarum Institute. (2012). Health Sector Economic Indicators: Spending Brief (pp. 1-2). Ann Arbor, MI: Center for Sustainable Health Spending.

Blum, S. (2012, February 20, 2012). week eight discussion [online forum comment]  Retrieved February 25, 2012, from

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Centers for Disease Control and Prevention. (2011, November 28, 2011). Global Vaccines and Immunizations  Retrieved February 25,, 2012, from

Davis, K., Schoen, C., & Stremikis, K. (2010). Mirror, mirror on the wall:  How the performance of the U.S. health system compares internationally (pp. 1-22). Washington DC: The Commonwealth Fund.

Derose, K. P., Escarce, J. J., & Lurie, N. (2007). Immigrants and healthcare: Sources of vulnerability. Health Affairs, 26(5), 1258-1268. doi: 10.1377/hlthaff.26.5.1258

Eviatar, D. (2009, August 14, 2009). Anti-Immigration Activists See Opportunity in Health Care Debate  Retrieved February 25, 2012, from

Federation for American Immigration Reform. (2009, 2009). Illegal Immigration and Public Health  Retrieved February 25, 2012, from

Goldman, D. P., Smtih, J. P., & Sood, N. (2006). Immigrants and the cost of medical care. Health Affairs, 26(6), 1700-1711.

Immigration Policy Center. (2012, February 16, 2012). Bad for Business  Retrieved February 25,, 2012, from

Menjivar, C. (2006). Liminal legality: Salvadoran and Guatemalan immigrants’ lives in the United States. American Journal of Sociology, 111(4), 999-1037.

Mohanty, S. A., Woolhandler, S., Himmelstein, D. U., Carrasquillo, O., & Bor, D. H. (2005). Health care expenditures of immigrants in the United States: A nationally representative analysis. American Journal of Public Health, 95(8), 1431-1438. doi: 10.2105/AJPH.2004.044602

Okie, S. (2007). Immigrants and health care: At the intersection of two broken systems. The New England Journal of Medicine, 357, 525-529.

USAID. (2010, October 29, 2009). Global Fund to Fight AIDS, Tuberculosis, and Malaria  Retrieved February 25,, 2012, from


Social Dominance Theory: The U.S. Minority Experience

The United States is often viewed as a classless society (Fiske-Rusciano, 2009), where everyone has an equal opportunity to be successful and yet, despite significant legislation intended to provide equal rights and opportunities, there continue to be disturbing disparities that are suggestive of systematic problems that prevent equal participatation in U.S. society by minorities. African-Americans and Hispanics have less wealth than whites (Kochhar, Fry, & Taylor, 2011), earn less income than whites (U.S. Census Bureau, 2009), have lower rates of participation in higher education (U.S. Census Bureau, 2011), and have unequal representation in the U.S. Congress (U.S. Congress & Manning, 2011). In the 19th century, De Tocqueville (1839), described his observations of U.S. democracy, concerned over the “tyranny of the majority” or the ability of the majority to hold unequal power over the minority. While De Tocqueville was not explicitly worried over ethnic or racial minorities, the observations appear nonetheless prophetic. The white majority has dominated nearly every aspect of social life in the United States since the country’s inception, holding economic, political, legislative, and religious power (Zinn, 2003). In addition, white majority perspectives have dominated U.S. cultural life including language, art, media, and history (Zinn, 2003). It is plausible to believe that minorities, have long been in a subordinate relationship to the dominant white society in the United States, and are members of a near-permanent underclass enforced by white institutions and individuals, to maintain their dominant social status, and justify unequal distribution of resources.

Social Dominance Theory

Social Dominance Theory is the lens through which the experiences of African- Americans and Hispanics will be examined in this paper, and as such; require a brief review of its major tenets. Developed by Pratto and Sidanius (1999), Social Dominance Theory (SDT) describes the observation that all human societies with a resource surplus are structured as group- based social hierarchies with dominant and subordinate groups, whereby the dominant groups control access to resources; a condition the authors consider universal to humanity. Pratto and Sidanius (1999) argue that the common structure for the group hierarchy is trimorphic and based on three distinct systems that include an age system, gender system, and an arbitrary-set system that can be class, race, ethnicity, religion, origin, or otherwise, and that the group structures are created from the combined effects of discrimination from individuals, institutions, and intergroup processes. The coordination of discrimination occurs across individuals and institutions, through the notion of legitimizing myths; the ideas or values that are shared between dominants and subordinates alike (Sidanius & Pratto, 1999). SDT is a valuable lens through which to examine minority experiences, using race and ethnicity as the arbitrary-set systems, in the hopes of shedding light on the ways in which individual and institutional discrimination combine with legitimizing myths to maintain inequality in the U.S.

SDT and the African-American Experience

from the earliest arrival of African slaves to America’s shores in 1619, the African- American experience in the United States has been one of subjugation and subordination (Zinn, 2003). During slavery, a common legitimizing myth of the time was “the argument that slavery was actually benevolent and in the interest of Blacks because they were simply incapable of attending to their own affairs suggesting that slavery was not only economically advantageous but morally compelling (Zanna & Olson, 1994, p. 309)”. Whereas the combined effect of the Emancipation Proclamation and the Union victory should have begun a new era of freedom for slaves, instead, whites continued to dominate African-Americans using institutions besides slavery. Laws took away African-American voting rights, like poll taxes, property qualifications, and literacy tests (Zinn, 2003); additionally, there were Jim Crow segregationist laws and practices that “extended overt racism against African-Americans into the middle of the twentieth century (Fiske-Rusciano, 2009, p. 173)”.

The birth of the twentieth century saw African-Americans continue to be subordinate to the white dominant class (Zinn, 2003). In the period between the 1870s and 1940s, religious institutions in the South were segregated and “the southern religious community often gave aid and comfort to the forces that adopted disenfranchisement, legal segregation, and proscription (Hill, Lippy, & Wilson, 2005, p. 715)”. The segregation of churches served to create exclusively African-American churches that developed into socially distinct institutions of African-American faith and served as rallying points for social justice (Hill, et al., 2005). African-American churches are an example of what Pratto and Sidanius (1999) would call a hierarchy-attenuating institution, or an institution that works to moderate the influence of institutions that enhance inequality, like a white dominated justice system, white schools, or white religious institutions. Other hierarchy-attenuating institutions that took form in the early twentieth century include the National Association for the Advancement of Colored People and later, during the Civil Rights movement, equally transformative organizations formed, supporting social justice for African- Americans, like the Congress of Racial Equality, the Student Nonviolent Coordinating Committee, and the Southern Poverty Law Center (Zinn, 2010). The civil rights era saw rapid change beginning with the landmark case, Brown vs. the Board of Education, which “held that segregated schools were inherently unequal because of the message that segregation conveyed: that African-American children were an untouchable cast, unfit to go to school with white children (Lawrence, 1990, p. 446)”. The era culminated in the latter half of the sixties with the Civil Rights Act of 1965, a series violent racial conflagrations in cities across the United States in 1967 that pitted white police officers against African-Americans, and the Civil Rights Act of 1968 (Zinn, 2010). These examples of from the civil rights movement serve to illuminate the SDT concept of a collaborative intergroup processes, or process shared by dominants and subordinates alike, that are supported by legitimizing myths (Sidanius & Pratto, 1999). The riots can be considered self-debilitating behavior given they affected primarily African-American neighborhoods, while the behavior may have reinforced the bias of white police officers, suggestive of a collaborative intergroup process that reinforces the existing hierarchy.

While the end of the Civil Rights era saw significant changes in legislation ending years of overt discrimination, as we take stock over forty years later, we find that institutionalized discrimination still exists. In The 2000 Presidential Election in Black and White, Rusciano (2008) notes that votes in largely black districts were invalidated at a higher rate than those in largely white districts, likely because of dilapidated voting machines in poorer black neighborhoods. Campbell (1984) describes in To Be Black Gifted and Alone, the plight of a successful black women attempting to deal with the pressure and resentment of living a liminal existence, not at home with former friends that occupy a different social class, while equally not at home with white colleagues.

Of course, the numbers speak for themselves, the 2010 Census indicate that African- Americans make up 12.6% of the U.S. population (U.S. Census Bureau, 2010), and yet only make up 1.5% of the total number of households in the top income quintile and nearly 33% of the bottom 20% income quintile (U.S. Census Bureau, 2009). In addition, the African-American unemployment rate in the United States remains twice the rate of their dominants white counterparts (U.S. Department of Labor, 2011). In spite of legislation guaranteeing equal rights under the law, African-Americans have yet to attain anything resembling full equality, as measured by access to positive social value, “or desirable material and symbolic resources such as political power, wealth, protection by force, plentiful and desirable food, and access to good housing, health care, leisure, and education” (Sidanius & Pratto, 1999, p. 272). Rather, African- Americans continue to have a disproportionate share of negative social value, things like underemployment, disproportionate punishment, stigmatization, and vilification. For example, the U.S. Department of Justice statistics demonstrate the disproportionate African-American share of capital punishment, making up 41.5% of prisoners on death row in the United States (U.S. Department of Justice & Snell, 2010).

To conclude the view of the African-American experience in the United States, African- Americans continue to have a lower share of resources representing positive social value and a significantly higher share of resources representing lower social value. Inequality likely continues because of the combined effect of individual discrimination, institutional discrimination, and collaborative intergroup processes that maintain the existing hierarchy.

SDT and the Hispanic Experience

As established in the introduction, people of Hispanic origin in the United States suffer from many of the same socioeconomic disparities as African-Americans, with unequal access to wealth, income, and power. For purposes of contrast, the Hispanic experience will be reviewed with a focus on the violence of arbitrary-set systems, the role of hierarchy-enhancing legitimizing myths in the continue subordination of Hispanics in the United States, and an examination of hierarchy-enhancing and hierarchy-attenuating cultural institutions that allow the exploration of the impact of white culture on the minority experience.

In the debate over Hispanic immigration to the United States, many Americans appear to lose sight of the historical context of the Hispanic experience in the United States, particularly that of Mexican-American Hispanics whose families have geographical roots that predate their lands annexation by the United States. In the early 1800s, Mexico was a large country that won independence from Spain, whose national territory included what today is Mexico, Texas, New Mexico, Arizona, California, Utah and parts of Colorado (Zinn, 2003). Half of Mexico was taken by force following the successful U.S. invasion of Mexico, the same war that ironically sparked Henry David Thoreau’s act of civil disobedience that later became one of the seminal works outlining the duty of citizens to resist unjust civil government (Zinn, 2003). The invasion of Mexico was a violent and aggressive act that included not only the violent subjugation of the Mexican people, but widespread violence, theft, and rape of the civilian population.

Reviewing the conquest of Mexico in light of SDT, one observes the interplay between gender systems and arbitrary-set systems described by Pratto and Sidanius (1999), who note that only in arbitrary-set systems is the extreme type of violence described by Zinn (2003) found. Pratto et al., (2006) describe the lethality of arbitrary-set system violence:

Arbitrary-sets are the only type of system in which total annihilation is found. That is, there are cases in which one clan or race or ethnic group has exterminated another. There are no known cases in which adults killed all the children, or men killed all the women, in a society. Finally, while by definition, the age system is focused on the control of children by adults, and the gender system is focused on men’s control of women, social dominance theory argues that arbitrary-set hierarchy primarily focuses on the control of subordinate males by coalitions of dominant males. This, in fact, is a primary reason that arbitrary-set hierarchy is associated with extraordinary levels of violence. (p. 274)

While the rape of Mexican women and girls might appear to be gender system domination, SDT concludes that rape is used primarily as a tool of arbitrary-set system violence to further enhance subordination (Pratto, et al., 2006). While the conquest was Mexico was a violent affair, there was a significant debate in the United States on the righteousness of the war, with Americans on both sides of the debate. Proponents of the war argued primarily for the legitimizing myth of “manifest destiny” and to save the Mexican people from their vices (Zinn, 2003). According to Zinn (2003), one newspaper, the Congressional Globe, wrote, “we must march from ocean to ocean…It is the destiny of the white race, it is the destiny of the Anglo-Saxon race (p. 171)”. So there is considerable irony in the modern immigration debate, given the historical context for the U.S. relationship with Mexicans, began as one of territorial conquest, and racism as a pretext for social domination.

As we consider the modern immigration debate in terms of the hierarchy-enhancing legitimizing myths that frame the debate, there are several related myths. The first myth to address is the notion that immigrants are responsible for U.S. economic problems. The Federation on American Immigration Reform, a special interest group with racist origins (The Pioneer Fund, 2011; Zeskind, 2005), frame the myth by distributing reports that suggest illegal immigrants that cross the border from Mexico are tax-evaders, heavy users of social services, have high rates of criminality, and take American jobs (FAIR, 2010), costing U.S. taxpayers $113 billion dollars annually (Martin & Ruark, 2010) Unbiased reports and peer reviewed research tell a different tale, suggesting that illegal immigration is an economic wash, neither helping nor hurting the economy (Hanson, 2007) and that illegal immigrants actually pay significant social security taxes whose benefit they can never claim, roughly $500B in 2005 (O’Carroll, 2006). Reports of higher incarceration rates are true, but that does not necessarily mean that Hispanic illegal immigrants engage in higher rates of criminal activity, because institutional discrimination in the justice system accounts for higher incarceration rates as subordinates absorb a higher share of negative social value. One study found, that after adjusting for institutional bias, Hispanic illegal immigrants had lower rates of criminal activity and surmised that questionable legal status was a contributing factor (Hagan & Palloni, 1999). Despite significant evidence to the contrary, the hierarchy-enhancing legitimizing myth that Hispanic illegal immigrants are the cause of U.S. economic problems, serves to allow dominant institutions, namely the U.S. government, to attempt to legislate discriminatory immigration policies that maintain the dominant hierarchy. For those that believe that a discriminatory immigration policy is unlikely to pass, a quick review of the last one hundred years tells a very different story, as both the Mexican “Repatriation” Campaign and “Operation Wetback” were the result of hierarchy-enhancing immigration policies that forcibly deported millions of Mexicans, many of them U.S. citizens (U.S. Commission On Civil Rights, 1980). Those policies had as much to do with immigration as does the immigration debate today, meaning the debate simply continues the tradition of social domination that began with the conquest of Mexico.

Media portrayals of Hispanics are another element of how cultural institutions support discrimination. The National Association of Hispanic Journalists for many years published the Network Brownout Report, studying Latino portrayal in the national media (Montalvo & Torres, 2006). The report demonstrates the role of the media as a hierarchy-enhancing institution, with nearly 30% of images analyzed depicting negative images of Latinos, where “images of day laborers standing in a parking lot or immigrants crossing the border often provide viewers with a negative, menacing and stereotypical depiction of Latinos (Montalvo & Torres, 2006, p. 13)”. While white dominated media institutions use legitimizing myths and stereotypes to enhance the existing hierarchy, Latino social justice organizations work to moderate the impact of mainstream media by providing an altogether different view.

The National Council of La Raza (NCLR) is a Latino social justice organization born out of the civil rights movement that seeks to combat discrimination and advocate for Latino rights, using media to educate the Latino community, challenge discriminatory stereotypes, and help the community take action (Rock, 2011). NCLR challenges stereotypes by providing alternative views in the mainstream media and through social media, using public service announcements and the NCLR ALMA Awards, a nationally televised awards show similar to the Oscars, but with a distinct focus on Latino entertainers, to promote “fair, accurate, and representative portrayals of Latinos in entertainment (Murgia, 2011, p. 1)”. NCLR, a hierarchy-attenuating organization, attempts to use media to provide a dramatically different media portrayal of Latinos in order to attenuate the effects of the dominant hierarchy.

The Hispanic experience illuminates how the extreme violence possible within arbitrary- set systems male groups, created dominant hierarchies allowing the dominant group to control resources, like territory, and subordinate other male-groups. In addition, the Hispanic experience has allowed a view into how the legitimizing myths described in SDT have had a significant impact on Hispanics through their use in promoting both war and discriminatory laws to justify the maintenance of the existing hierarchy. Finally, it is possible to view the current immigration debate and understand the role that both hierarchy-enhancing and hierarchy-attenuating institutions play in framing both dominant and subordinate views of the legitimizing myths that surround the debate.


Our national and social history, viewed from two very different perspectives, tells two very different stories. The U.S. remains dominated by whites controlling the institutions of power that define our cultural and historical context, therefore, our history is replete with legitimizing myths that justify the behaviors, both noble and heinous, that led the U.S to this place in history. American exceptionalism, Manifest Destiny, the United States as a beacon, and the American Dream, are powerful stories through which current and past events are framed. From the viewpoint of subordinate groups, America’s legitimizing myths are debilitating, and create a situation where both dominants and subordinates act in concert to maintain white domination over institutions, wealth, income, and items of positive social value.

Individuals in the subordinate group can achieve success in the United States, however, there are often consequences for subordinates that access resources of positive social value, such as in the story mentioned earlier by Campbell (1984), about Leanita McLain, a successful black journalist. McLain could not handle the pressures of deviating from the existing gender-set and arbitrary-set systems, as social forces from both dominant and subordinate institutions and individuals became too much to handle, so rather than continue to existing in the space between dominants and subordinates, she took her own life (Campbell, 1984).

Social Dominance Theory is useful to understand the complex interplay of forces, both institutional and individual, that combine to preserve existing hierarchies. This theory allows sociologists and historians to examine the past and present, not through the lens of either dominants or subordinates, but rather, to take a step back and examine our past and present using the holistic viewpoint of our shared humanity, and perhaps in doing so, inform a better future where resources are shared more equally.


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FAIR. (2010). Federation for American immigration reform 2010 annual report (pp. 32). Washington DC.

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Hagan, J., & Palloni, A. (1999). Sociological criminology and the mythology of Hispanic immigration and crime. Social Problems, 46(4), 617-632.

Hanson, G. H. (2007). The economic logic of illegal immigration. Council on Foreign Relations, 26(April 2007), 1-52.

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Kochhar, R., Fry, R., & Taylor, P. (2011). Wealth Gaps Rise to Record Highs Between Whites, Blacks, Hispanics Pew Social & Demographic Trends. Washington DC: Pew Research Center.

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Growing up Guatemalan in the United States

In 1964, Guatemala was being run by a military junta, violence was a part of every day life, the economy was in shambles, and jobs were scare (Rock, 2011).  It was in this setting that a young man, my future father-in-law, took a chance at a better life for he and his family.  Enticed by rumors of prosperity in the United States, Alex and his brother Rene saved their money to journey to Chicago, leaving their families behind in a search for hope that was borne of desperation.  Alex left his wife Ruth with 20 Guatemalan Quetzal, the equivalent of $20 dollars, and their three children, Vivien, 5, Ingrid, 3, and Marvin, a newborn baby.  What experience lay in store for he and his family?  How would they fare in an unknown country, without family, friends, assets, or even command of the language?  Their experience, like so many immigrants, was one of lifetime poverty, sacrifice, and hard work, for the opportunity that living in the United States promised for their children.

Immigrant Work and Wage Experience in the United States

            When Alex and Rene first came to Chicago, they were able to secure a job at a local Chicago candy factory, where they were responsible for cleaning the candy belts.  While they made less than the minimum wage, they earned enough to bring their families to the United States.  Alex stayed in Chicago for 7 years working the same job for the same low pay, never improving his situation because of constant fear of deportation.  In fact, often immigrants without legal status face similar forms of subjugation, where the fear of deportation forces them to remain in low-wage jobs that don’t meet basic needs (Coutin, 2000)

During their years in Chicago, Alex and Ruth had two more children, Ruth and my wife, Orpha, both born U.S. citizens. Ruth and Orpha, so-called “anchor babies”, allowed Alex and Ruth to apply for and obtain Green Cards, allowing the family to remain in the United States permanently.  Freed from the constant fear of deportation, Alex moved his family to Los Angeles, where his family would better fit, given the large Hispanic population.  In Los Angeles, Alex obtained a job with Pan-American Underwriting Company as a file clerk, making roughly $1000 per month.  Alex worked there for twenty years, without receiving a promotion or raise, before finally being laid off without receiving any retirement benefits.  My wife cries as she recounts how she helped her father to get a job as a delivery driver where she worked, after he had been laid of at Pan-American; she cries in a mix of emotions that include anger, embarrassment, shame, and deep anguish for her father’s wounded pride (Rock, 2011).  Alex’s experience is like so many immigrants in the United States, where uncertain legal status combined with other factors, like language barriers serves to lock them into low-wage jobs that often lack benefits (Massey, Durand, & Malone, 2002).  While living in poverty in the United States was an improvement over the situation in Guatemala, Alex’s status as illegal immigrant and poor command of the English language all but assured a life of poverty in the United States.

Health Care

            My wife is quite capable of handling many basic health care needs all on her own.  Growing up without access to health care due to Alex’s lack of benefits required the use homeopathic treatment techniques handed down from previous generations.  Traditional health care was simply not an option given the high cost of treatment.  Vaccines were provided by the local welfare office, while for dental work and medications, the family would drive down to Mexico where the care was affordable.  My wife recalled that for years, her mother Ruth had severe undiagnosed chest pains and she and the family would regularly light a candle and pray for the pain to go away (Rock, 2011).  Once my wife entered the work force, she paid for a doctor’s visit where her mother was diagnosed with Angina and given a prescription for nitroglycerin, which eased her suffering (Rock, 2011).   Ruth is not alone in her silent suffering, as many immigrants lack access to health care and will not seek health care even when needed (Menjivar, 2002).

Home Ownership

Home ownership is part of the American Dream and yet, for so many in poverty, home ownership can appear to be only a dream.  Alex and Ruth lacked the income to be considered for a mortgage, particularly in such a heavily populated area such as Los Angeles, where average home prices often exceed the national average.  Although, they eventually purchased an 848 square foot home in Tujunga, California, a low-rent suburb of Los Angeles, by combining their resources as a family.  According to my wife, it is part of the Hispanic culture to have many kids so that they can take care of their parents.  In order to purchase the home, Alex and Ruth, along with their oldest daughter Vivien, her husband Mike, and the other two working children, Ingrid and Marvin, all co-signed the bank loan, while Vivien and Mike came up with the down payment.  Pooling resources was the only way the family could hope to own a home given their modest income, a fact that made secondary education a distant dream as well.


            So many lower and working class families often hope for intergenerational class mobility as the way out of poverty, hoping that through education, their children can have a better life than they did (Hodson & Sullivan, 2008).  Unfortunately, economic circumstances force young adults into the workforce at an early age, particularly when cultural forces have a strong influence, as was the case with my wife’s family.  While all of the Cuevas children graduated from high school, most did not seek secondary education.  When I asked my wife why she never considered college, she said that it was never really an option.  Her parents never encouraged college; both because of the high-perceived costs and the need to have the children contribute to the economic well being of the family.  Additionally, she felt that her parents lacked the needed language schools to work cooperatively with teachers on their children’s educational attainment and were ignorant of how to take advantage of financial aid, scholarships, or grants (Rock, 2011).  The Cuevas family missed out on the best opportunity for intergenerational class mobility they had because of language, cultural, and economic barriers.

Cultural Significance of Growing up Guatemalan

            When my wife Orpha was a small child, she used to pretend her name was Kim, that she lived in a two-story house, and her mother had blonde hair.  She grew up trying to hide being Hispanic, instead choosing to blend in with her American friends, rejecting her cultural heritage, because of the shame of their poverty and her embarrassment of their social class (Rock, 2011).  Her parents had also rejected Guatemala because of all it represented; the violence, extreme poverty, repressive regimes, all they had chosen to leave behind, often telling people they were Puerto Rican.   In many ways, the shared experience as United States has forever marked the Cuevas family, making them both quintessential Americans and yet wholly unique.


            The experiences of the Cuevas family are similar to the experiences of so many other Hispanic immigrants to the United States, whose act of immigration and ethnic background confer upon them a lower class than most Americans, due to the economic hardships associated with immigration, questionable legal status, language barriers and other factors. Many have difficulty improving their social class, lacking even intergenerational class mobility because of pervasive economic and cultural barriers that prevent that attainment of secondary education.  In many ways, this paper has been harder for my wife that it has for me.  She softly weeps as she tells me that not until adulthood, did she realize how proud she was of her parents, for their bravery at risking everything for a chance at a better life and for their years of sacrifice to make a better life reality for their family (Rock, 2011).   I try to comfort her, but know that my words will be inadequate, when compared with the experiences of growing up Guatemalan in the United States.




Coutin, S. (2000). Legalizing moves: Salvadoran immigrant’s struggle for U.S. residency. Ann Arbor: University of Michigan Press.

Hodson, R., & Sullivan, T. A. (2008). The social organization of work (4th ed.). Belmont, CA: Wadsworth.

Massey, D. S., Durand, J., & Malone, N. J. (2002). Beyond smoke and mirrors: Mexican immigration in an era of economic integration. New York: Russel Sage Foundation.

Menjivar, C. (2002). The ties that heal: Guatemalan immigrant women’s networks and medical treatment. International Migration Review, 36(2), 437-466.

Rock, O. (2011, Juy 30, 2011). [Personal Communication].