Immigrant Service Access Needs & Recommendations in the U.S.-Mexico Border Region: A Qualitative Study

Background and Purpose: Immigrants in the United States, particularly those from Latin America, face numerous barriers to health and social services, including immigration-related stress, language barriers, cultural differences, legal status concerns, and restrictive policies creating persistent "chilling effects" on service utilization. In border regions, these challenges are compounded by geographic isolation and militarized border enforcement that limits mobility and access. This qualitative study examines service access in the U.S.-Mexico border region, to identify community-defined recommendations for reducing service access barriers in a complex context, where welcoming local politics contrast with heavily surveilled border communities.

Methods: This community-based participatory study consisted of in-person surveys with immigrant caregivers of children under 8 years old (n=240) and 5 follow-up focus groups with 36 survey participants. Using purposive and snowball sampling, participants were recruited between 2022-2023, with focus group participants selected based on interest and availability. Spanish-language focus groups lasting approximately 90 minutes were conducted by bilingual, bicultural field interviewers. Translated and transcribed interviews were coded using Dedoose software and analyzed through thematic analysis by the research team.

Results: Three primary themes emerged: (1) structural and organizational limitations, including prohibitive costs, provider shortages, inconvenient hours, language barriers, and transportation challenges—all exacerbated by the border checkpoint presence that restricts access to centralized services; (2) persistent "chilling effects," where participants reported continued fear of immigration consequences, discrimination, public charge concerns, and policy uncertainty despite federal administration changes and post-pandemic policy shifts; and (3) community-generated solutions, including increased local service availability in rural areas, expanded service hours, improved information dissemination through trusted community networks, development of "one-stop-shop" service models, creation of mobile service units, and policy recommendations for pathways to legal status, work authorization, and more inclusive eligibility requirements.

Conclusions and Implications: Our findings reveal how federal immigration enforcement undermines local inclusion initiatives, creating enduring access barriers even in historically bilingual, immigrant-friendly communities. Service access challenges persist despite strong linguistic and cultural infrastructure, with border militarization disproportionately affecting rural communities, especially colonias. "Chilling effects" on service utilization continue through presidential administration changes and even in supportive jurisdictions, indicating deeply embedded systemic barriers. Community-informed solutions point toward integrated service centers and mobile service units that address both geographic and sociopolitical barriers while building on existing community strengths. This research demonstrates that improving immigrant service access requires multi-level approaches addressing both structural barriers and implementation challenges, providing critical insights for social workers and policymakers seeking to enhance service delivery in border regions, where competing institutional pressures impact immigrant family wellbeing.