Immigrant new destinations in the U.S. South have some of the fastest-growing immigrant populations in the country, but many mainstream hospitals in these settings struggle to lower barriers to care for immigrants. These barriers contribute to social disparities of health affecting immigrants, and the pandemic has exacerbated this problem. Some research suggests that local health clinics and immigrant-serving organizations (ISOs) help to bridge this gap by connecting vulnerable immigrant communities to the resources they need. Drawing on the theory of organizational brokerage, this exploratory study examines how health clinics and ISOs adjusted to the rapidly-evolving challenges associated with meeting the needs of immigrant communities during the first six months of the COVID-19 pandemic. We focus on clinics and ISOs in three immigrant new destination states—North Carolina, South Carolina, and Kentucky—to address the following question: How did local clinics and ISOs broker information and resources to assist vulnerable immigrants during the pandemic? Findings from our study have implications for how we understand the future of social service work with immigrant communities navigating a fragmented safety net.
Data for this exploratory study come from interviews with executive directors and program coordinators of health clinics and ISOs in KY, NC, and SC (N=31). We built our sample from existing directories of social service organizations and clinics in the counties where immigrants tend to concentrate in each state. All interviews were conducted over the phone from June – September 2020. Interviews lasted approximately 30 minutes and used a semi-structured interview guide informed by the theory of organizational brokerage. All interviews were audio recorded and professionally transcribed. NVivo was used to assist with thematic coding.
Across our sample, organizations and clinics made it clear that immigrant communities were hit hard by both the pandemic and the economic fallout that it generated. Some organizations reported that immigrants in industries like meat processing, construction, and agriculture felt pressured to take advantage of “essential worker” status and keep working, even when employers did not always abide by COVID safety guidelines. We find that ISOs were often the first point of contact for immigrants seeking information and basic supports during COVID, and that they fulfilled a crucial brokerage role in helping immigrant communities connect to mainstream healthcare services.
Conclusion and Implications
Findings from this study affirm prior research showing that ISOs facilitate access to social services and healthcare for immigrant communities. However, the pandemic highlights that ISOs also communicate and distribute resources in a timely and culturally responsive manner amidst a public health crisis. As we look forward to a post-COVID future, it is crucial for social workers working with and within ISOs to expand their appreciation for the brokering role these organizations have in immigrant communities. Social workers must raise awareness about the organizational brokerage accomplished by ISOs to formally legitimize their role within the safety net. Social workers must also partner with ISOs to raise awareness about the systemic problems that create the need for these entities in the first place.