The Best Way to Reach People in the Shadows

By Victor Landa, NewsTaco

The remarkable thing about a recent Latino Decisions survey titled “Healthcare in the Shadows” is that it identifies people who live under a cloud of fear: those who are reluctant to talk to police, to apply for a driver’s license, to travel by airplane, use public transportation, drive a car, visit a doctor or talk to school teachers are living in the shadows. It’s something we know intuitively, but are hard-pressed to define accurately.

I learned about the shadows and the people who live in them by following my mother.

She was a public health nurse by profession and a caregiver by vocation. I remember following her to the large lines and the many people at the immunization clinics she organized in Laredo, Texas. And I remember watching her feed the travelers who came to our front door in Nuevo Laredo, Mexico. We lived two blocks from the river and the travelers came at nightfall, asking for food before they crossed north.

I learned by watching my mother that the only way to reach people who live in the shadows is by going into the dark places with a flashlight.

The Latino Decisions survey shows us where to point the light.

It’s as if someone followed mom to the clinics or to the front door. It’s as if they asked the people they found if they avoided talking to police or riding the bus. Mom’s public health side would have appreciated the survey: 13 percent of the respondents said they avoid talking to the police, 10 percent avoid the DMV, another 10 percent don’t travel by plane, nine percent don’t use public transportation, drive a car or visit a doctor and seven percent don’t talk to their children’s teachers. All because they fear being asked about their citizenship.

Those are the shadows, defined.

The Latino Decisions survey points to an intersection of immigration and public health.

It’s a place where health care is deficient because fear is abundant. I learned from mom that to reach the people in the shadows you have to go where they live. She worked in schools where the children of the border colonias went, where the migrant kids attended on their special harvest-centered calendars, where her work entailed building trust as well as improving bienestar.

Every public heath worker in the trenches knows this. The Latino Decisions survey points to it so that now everyone else knows as well. The authors of the survey put it succinctly, mom couldn’t have said it better, “immigration policy is health policy, and health policy is immigration policy.” We can’t separate the two, mom never did.