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In collaboration with Krista Perreira, PhD, at the UNC School of Medicine, and Hannah Gill, PhD, at the UNC Institute for the Study of the Americas, the Urban Institute published a report titled, Supporting North Carolina’s Immigrant Families: Addressing Barriers and Promoting Solutions for a More Inclusive Safety Net.


Many immigrant families face an array of barriers to enrolling in safety net programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP). Some are universal structural barriers that many program applicants confront navigating complex enrollment systems. Others are unique challenges around immigration concerns and language access. Understanding who these families are is the first step for community leaders, including state and local policymakers and health and human services agencies, to ensure access to programs for those who are eligible and to provide culturally and linguistically responsive assistance to support immigrants and their children.

Hannah Gill, PhD

A new study led by co-Principal Investigators Hamutal Bernstein, PhD, senior fellow, and Jennifer Haley, MA, principal research associate, at the Urban Institute, in collaboration with Krista Perreira, PhD, professor of social medicine at the UNC School of Medicine, and Hannah Gill, PhD, at the UNC Institute for the Study of the Americas, explored these critical issues, with support from the Kate B. Reynolds Charitable Trust.

 

Findings are based on interviews with more than 40 state- and county-based stakeholders and four multilingual focus groups with immigrants. The authors identified common barriers to safety net participation for immigrant families in North Carolina and challenges faced by immigrant-serving organizations and health and human services agencies. They recommended solutions to create a more inclusive safety net for North Carolina’s immigrant families.

In a report, Urban and UNC-Chapel Hill researchers write:

  • Immigrant families in North Carolina face both broad structural barriers that many program applicants confront in navigating program enrollment and unique challenges around immigration concerns and language access.
  • Immigrant-serving CBOs and community health workers play an especially important role in supporting families’ safety net access – though they face key challenges to supporting immigrant clients related to capacity and funding.
  • State- and county-level Department of Health and Human Services (HHS) agencies supporting North Carolina’s immigrant families also have challenges supporting immigrants, related to staff capacity, variation across the state in resources, and difficulty staying up to date on changing rules and populations.
  • The research identifies a range of solutions to improve safety net benefit access for immigrant families, including customized engagement and outreach by government agencies, supporting language access needs beyond Spanish, partnership with immigrant-serving CBOs and community health workers, diversifying HHS agency staff, simplifying program enrollment and retention processes, and state action to expand eligibility to additional immigrant populations.

In an accompanying new data tool, researchers mapped North Carolina counties to spotlight characteristics of immigrant residents to inform more effective policy and practice. At a state level, the data tool shows that:

  • 12 percent of immigrant US citizens in North Carolina did not have health insurance, while 47 percent of immigrant non-US citizens in the state did not.
  • 26 percent of children in North Carolina in families with low incomes had one or more immigrant parent.
  • 31.6 percent of immigrant adults with limited English proficiency spoke a language other than Spanish.

Their findings are available in an Urban Institute report entitled “Supporting North Carolina’s Immigrant Families: Addressing Barriers and Promoting Solutions for a More Inclusive Safety Net,” as well as three fact sheets highlighting specific lessons for supporting Spanish, Hmong, and Swahili speakers. In addition, they developed an interactive county-level data tool to spotlight characteristics of immigrant residents to inform more effective policy and practice.