Occupational Therapy - 2015

12 riers faced by unauthorized immigrants pursuing the American Dream, a focused review of the literature was conducted, using CINAHL, Google, and Google Schol- ar databases and the following search terms: illegal, un- documented, immigrants, barriers, housing, employ- ment, transportation, finances, healthcare, education. The literature revealed that one of the greatest barriers that unauthorized immigrants face when try- ing to start a new life in the United States is their lack of legal documentation. Although most immigrants are able to show proof of their identity using passports and/ or birth certificates from their country of origin, these documents alone will not grant them access to and par- ticipation in many aspects of American society. In fact, using a foreign passport or birth certificate instead of a U.S.-issued form of identification may actually raise suspicion about an immigrant’s legal status. A driver’s license or state identification card is the most common- ly accepted proof of identification across the U.S. and is typically used when obtaining employment, renting an apartment, or opening a bank account or credit card (NumbersUSA, 2015). However, most unauthorized immigrants in the United States are not able to obtain a state-issued form of identification, given that only 12 states, Washington D.C., and Puerto Rico issue them without requiring proof of legal residency status (Na- tional Immigration Law Center, 2015). Without proof of legal residency and authoriza- tion to work in the United States, immigrants face sig- nificant challenges in gaining employment. Upon being hired for a job, new employees are required to produce evidence of a social security number. Although some immigrants, such as those who were previously autho- rized to work and then overstayed their visas, may have a social security number of their own, most do not. As a result, many have turned to using fraudulent docu- ments to apply for a social security number or use a number belonging to someone else (Gallegly, 2012; Var- gas, 2011). Many employers have been known to turn a blind eye to unauthorized immigrants’ paperwork and legal status, but in return they have ended up exploiting their workers, with long hours, low pay, and little regard for their safety (Hall & Greenman, 2014). Yet, despite the challenge of proving legal eligibility for employ- ment, as many as 8 million unauthorized immigrants were estimated to be contributing to the U.S. workforce as of 2010 (Passel & Cohn, 2011). Another barrier that unauthorized immigrants face when coming to the United States is a lack of ac- cess to transportation. Many cities do not have adequate public transit systems, leaving immigrants with no choice but to drive themselves to their jobs and other places around the community. However, those with- out a driver’s license are at risk every time they drive, in that if they are pulled over, even for a minor traffic violation, they may be subject to arrest for driving with- out a license and subsequently faced with deportation. The risks associated with driving without a license lead many unauthorized immigrants to refrain from unnec- essary travel, which can therefore limit their opportuni- ties for community participation and access to educa- tion and healthcare (Bailliard, 2013; Waslin, 2013). Many unauthorized immigrants also encounter financial barriers that can prevent them from achiev- ing the life they had imagined. Low-paying jobs lead to many immigrants living in poverty and struggling to make ends meet, yet immigrants’ legal status deems them ineligible for government assistance programs, including access to subsidized housing, childcare, food, and most healthcare (Holan, 2012). Even those who are better off financially may face challenges if they try to buy a home, as very few lenders are willing to provide home loans to immigrants without a social security number (Jordan, 2008). Finances can also serve as barriers to accessing healthcare and higher education for unauthorized im- migrants living in the United States. Although approxi- mately 70% of the unauthorized population contributes to the U.S. workforce (Passel & Cohn, 2011), their low- wage jobs rarely provide them with health insurance. And among those who have the financial means to pur- chase their own insurance plans, their legal status pre- vents them from qualifying under the Affordable Care Act. Federal law does require that any individual who arrives at a hospital with an emergent medical condition be treated, regardless of legal status or health insurance coverage. However, most unauthorized immigrants do not have a regular healthcare provider, and when they do require services, they must pay entirely out of pocket (Sommers, 2013). When it comes to pursuing a postsecondary education, unauthorized immigrants face a number of financial barriers that can limit their participation. Al- though they have rarely been denied access to attend college, unauthorized immigrants are viewed as inter- national students by most states, and as a result, they face tuition rates that are three to seven times higher OCCUPATION: A Medium of Inquiry for Students, Faculty & Other Practitioners Advocating for Health through Occupational Studies November 2015, Volume 1, Number 1

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