Medical legal violence

An urgent study on how punitive immigration policies undermine the health of Latinx immigrants

Of the approximately 20 million noncitizens currently living in the United States, nearly half are “undocumented,” which means they are excluded from many public benefits, including health care coverage. Additionally, many authorized immigrants are barred from certain public benefits, including health benefits, for their first five years in the United States. These exclusions often lead many immigrants, particularly those who are Latinx, to avoid seeking health care out of fear of deportation, detention, and other immigration enforcement consequences. Medical Legal Violence tells the stories of some of these immigrants and how anti-immigrant politics in the United States increasingly undermine health care for Latinx noncitizens in ways that deepen health inequalities while upholding economic exploitation and white supremacy.

Meredith Van Natta provides a first-hand account of how such immigrants made life and death decisions with their doctors and other clinic workers before and after the 2016 election. Drawing from rich ethnographic observations and in-depth interviews in three states during the Trump presidency, Van Natta demonstrates how anti-immigrant laws are changing the way Latinx immigrants and their doctors weigh illness and injury against patients’ personal and family security. The book also evaluates the role of safety-net health care workers who have helped noncitizen patients navigate this unstable political landscape despite perceiving a rise in anti-immigrant surveillance in the health care spaces where they work. As anti-immigrant rhetoric intensifies, Medical Legal Violence sheds light on the real consequences of anti-immigrant laws on the health of Latinx noncitizens, and how these laws create a predictable humanitarian disaster in immigrant communities throughout the country and beyond its borders. Van Natta asks how things might be different if we begin to learn from this history rather than continuously repeat it.

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WHAT PEOPLE ARE SAYING

  • “This insightful, accessible ethnography reveals the broad and deep reach of the punitive immigration regime, which enlists even the medical personnel whose goal is to heal people. It is an excellent contribution to several fields and will be read widely.”

    — Cecilia Menjívar, author of Enduring Violence: Ladina Women's Lives in Guatemala

  • “Comparing immigrant-serving clinics across red, blue, and purple states, Meredith Van Natta captures with clarity and conviction the urgency of reforming both the US medical and immigration policy landscapes. Her careful analysis is both striking and humanizing, as she tells the stories of healthcare providers’ and patients’ heartache, fear, persistence, and triumph during critical political moments under the Obama and Trump eras. Medical Legal Violence is a must-read for anyone interested in immigration and healthcare policy in the United States.”

    — Leisy J. Abrego, author of Sacrificing Families: Navigating Laws, Labor, and Love Across Borders

  • “For decades, punitive federal immigration policy, rising interior enforcement, and a social welfare system that treats healthcare as a consumer good has wielded ‘medical legal violence’ onto the lives of Latinx immigrants. In this timely book, Van Natta deftly shows how the situation became even worse after 2016, as both immigrants and the mission-driven safety-net clinicians and staff working to treat them faced new and uncertain “decision-scapes” to accessing treatment. The results – more people blocked from and foregoing care, more people forced to let their illness progress to the point of acute and costly emergency care, and more providers torn between their personal and medical ethics and the U.S. laws and bureaucracies that prioritize insecurity over health – are no less than a national disaster.”

    — Helen B. Marrow, author of New Destination Dreaming Immigration, Race, and Legal Status in the Rural American South

  • “This vividly written book tells the painful story of how US anti-immigrant policies have permeated the nation’s medical system, making it increasingly difficult to meet the health care needs of an impoverished population who often lack English fluency and legal documentation. Rich in ethnographic and environmental detail, Medical Legal Violence highlights the political struggles between two broken systems in need of reform--health care and immigration—and the chilling effects this battle has on the health outcomes and well-being of migrants. An invaluable resource for public officials, as well as academics, Van Natta’s work powerfully addresses the dire health care needs of our most vulnerable yet essential members in our society.”

    — Jacqueline Hagan, author of Migration Miracle: Faith, Hope, and Meaning on the Undocumented Journey