Abstract
We examine the interaction between the immigration and health systems of the United States on the basis of a study of forty health care delivery institutions in Florida, California, and New Jersey. We list and examine barriers to care encountered by the foreign-born, especially unauthorized immigrants, and the systemic contradictions of widespread demand for their labor with absence of legal channels to regulate the flow and provide it with a modicum of legal protection. The inaccessibility and high costs of the American health system have forced the uninsured poor into a series of coping strategies. Our study uncovered a set of coping mechanisms specific to the immigrant population. We describe them and examine their interaction with U.S. commercial medicine. The analysis concludes with a focus on regional differences that highlight the importance of local politics and history in ameliorating or hardening the precarious health situation confronted by the foreign-born and the ways in which this situation plays back on the communities where they settle.