The Documentation Status Continuum and the Impact of Categories on Healthcare Stratification

Public discourse on immigration and social services access has been contentious in immigrant-receiving countries. Scholars have examined immigrants’ marginalization as a form of civic stratification, where boundaries based on documentation status affect immigrants’ experiences and benefits granted b...

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Main Author: Tiffany Denise Joseph
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Social Sciences
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Online Access:https://www.mdpi.com/2076-0760/14/1/41
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author Tiffany Denise Joseph
author_facet Tiffany Denise Joseph
author_sort Tiffany Denise Joseph
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description Public discourse on immigration and social services access has been contentious in immigrant-receiving countries. Scholars have examined immigrants’ marginalization as a form of civic stratification, where boundaries based on documentation status affect immigrants’ experiences and benefits granted by the state. This scholarship lacks a framework outlining existing documentation status categories and does not fully answer three research questions I pose in this article: (1) what is the alignment of documentation status categories relative to each other, (2) how does policy (re)configure those categories over time, and (3) how have documentation status categories shaped access to health care in the United States? This article answers those questions and argues that the documentation status continuum (DSC) framework fills these gaps. In the DSC, undocumented immigrants are at one end and citizens are at the other, with many documentation statuses in between. Public policy creates these statuses and generates stratification through allocating benefits based on one’s DSC position. Policy also shapes movement along the continuum, which shapes benefits eligibility. Using the 2006 Massachusetts Health Reform and national 2010 Affordable Care Act (ACA) Reform as policy examples and interviews conducted with 207 immigrants, healthcare professionals, and immigrant organization employees in Boston, this article demonstrates how healthcare access is stratified along the DSC between citizens and noncitizens. This has implications for various outcomes that social scientists examine amid increasing anti-immigrant sentiment in the US and beyond.
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spelling doaj-art-cd9e530a4c7041db8901fec1153cbff82025-01-24T13:49:45ZengMDPI AGSocial Sciences2076-07602025-01-011414110.3390/socsci14010041The Documentation Status Continuum and the Impact of Categories on Healthcare StratificationTiffany Denise Joseph0The College of Social Sciences and Humanities, Northeastern University, Boston, MA 02115, USAPublic discourse on immigration and social services access has been contentious in immigrant-receiving countries. Scholars have examined immigrants’ marginalization as a form of civic stratification, where boundaries based on documentation status affect immigrants’ experiences and benefits granted by the state. This scholarship lacks a framework outlining existing documentation status categories and does not fully answer three research questions I pose in this article: (1) what is the alignment of documentation status categories relative to each other, (2) how does policy (re)configure those categories over time, and (3) how have documentation status categories shaped access to health care in the United States? This article answers those questions and argues that the documentation status continuum (DSC) framework fills these gaps. In the DSC, undocumented immigrants are at one end and citizens are at the other, with many documentation statuses in between. Public policy creates these statuses and generates stratification through allocating benefits based on one’s DSC position. Policy also shapes movement along the continuum, which shapes benefits eligibility. Using the 2006 Massachusetts Health Reform and national 2010 Affordable Care Act (ACA) Reform as policy examples and interviews conducted with 207 immigrants, healthcare professionals, and immigrant organization employees in Boston, this article demonstrates how healthcare access is stratified along the DSC between citizens and noncitizens. This has implications for various outcomes that social scientists examine amid increasing anti-immigrant sentiment in the US and beyond.https://www.mdpi.com/2076-0760/14/1/41documentation statusimmigrationpolicyinequalitycitizenshipstratification
spellingShingle Tiffany Denise Joseph
The Documentation Status Continuum and the Impact of Categories on Healthcare Stratification
Social Sciences
documentation status
immigration
policy
inequality
citizenship
stratification
title The Documentation Status Continuum and the Impact of Categories on Healthcare Stratification
title_full The Documentation Status Continuum and the Impact of Categories on Healthcare Stratification
title_fullStr The Documentation Status Continuum and the Impact of Categories on Healthcare Stratification
title_full_unstemmed The Documentation Status Continuum and the Impact of Categories on Healthcare Stratification
title_short The Documentation Status Continuum and the Impact of Categories on Healthcare Stratification
title_sort documentation status continuum and the impact of categories on healthcare stratification
topic documentation status
immigration
policy
inequality
citizenship
stratification
url https://www.mdpi.com/2076-0760/14/1/41
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