Patients wait in line for treatment at a California clinic. Credit: AP Photo/Damian Dovarganes/File

Donald Trump vilified immigrants during his presidential campaign and has continued to do so since being sworn into office, signing executive orders that target undocumented immigrants, among other measures. As federal immigration officials emboldened by Trump’s executive orders seek out and detain undocumented immigrants, their communities are experiencing an increase in fear that can impact their health.

“We noticed that there’s a lot of mental health needs and specific health problems that people face when they’re undocumented,” says Wendy Mironov, a registered nurse with Salud Sin Papeles (Health Without Papers). The grassroots group has been around for two years and focuses on improving the health of and access to health care for undocumented immigrants, families, and communities by educating undocumented immigrants on their rights.

Often undocumented persons don’t seek medical care or apply for financial assistance at hospitals or clinics because they’re afraid their personal information will be shared with immigration officials or the police. Trying to navigate insurance and hospital bureaucracies without having a valid form of identification or fluency in English also can be a challenge.

Salud Sin Papeles advises people who attend its workshops never to use false identification to get health care but to avoid sharing their immigration status with their health-care provider if possible, or if it’s not, to ask them to not record their status on their medical chart. The group also gives undocumented people strategies they can use to negotiate payment plans with hospitals and recommends going to a clinic or medical facility that offers free or low-cost care.

An estimated 307,000 undocumented immigrants lived in Cook County as of 2014, according to a report commissioned by the Illinois Coalition for Immigrant and Refugee Rights. Many can turn to the Cook County Health and Hospitals Systems when sick without fear of being turned over to ICE.

“We do not ask patients about their immigration status,” says Monifa Thomas, a CCHHS spokesperson in an e-mailed statement.

Another resource Salud Sin Papeles recommends for undocumented patients is Carelink, a financial assistance program established to help Cook County residents who are uninsured or underinsured relieve their financial responsibility for their health-care services.

“The stress of being undocumented has a huge health-care impact in terms of access to health care and in terms of stress on the body,” Mironov says.

Rosa Aramburo came to the United States from northern Mexico 15 years ago. She’s now 27 and, thanks to the Deferred Action for Childhood Arrivals (DACA), a medical student at Loyola University Chicago’s Stritch School of Medicine. Before DACA, she was uninsured.

“My mom started feeling ill. We went to a health fair and they told us her blood sugar was high, so they told her to go to a doctor to confirm if she had diabetes and get it treated,” she says. “But we didn’t have insurance, so my mom said she felt fine and we didn’t go.”

Eventually she convinced her mother to go to a free clinic, which recommended Aramburo take her mother to a hospital for treatment. Her mother was still resistant, but once there they learned she qualified for an affordable emergency care plan, Aramburo says. At the hospital she was diagnosed with diabetic ketoacidosis, which can lead to the impairment of the heart, muscles, and nerves as well as brain swelling, according to the Mayo Clinic.

“The doctor told us she could have died had we had waited another day,” says Aramburo.

That experience inspired her to make time when she’s not in school to volunteer with Community Health, an organization that offer free health-care services in Chicago’s West Town and Englewood neighborhoods.

“They help Polish and Hispanic immigrants. I want to help people like me, like my parents,” Aramburo says. “They come from another country and they’re kind of lost, just like I was.”

And while she has some protections under DACA, she fears for her undocumented parents because they have nothing preventing immigration officials from deporting them.

“I don’t think people who support these [immigration] policies have ever faced the fear that you’ll never be able to see someone you love ever again,” she says.

This constant state of fear can have far-reaching medical implications, and not just for the undocumented community.

“There was a really interesting study about the impact of the raid in Postville, Iowa, eight years ago,” says Salud Sin Papeles’ Mironov. “Nine months after this raid the birth weight of all children born to Latina mothers, regardless of immigration status, decreased dramatically. So that raid had such a huge health-care impact on the entire state.”

The study, published by the University of Michigan’s School of Public Health and Institute of Social Research team earlier this year, found that in the 37 weeks after the raid Latino babies born had a 24 percent greater risk of lower birth weight than babies born the previous year. (Low birth weight is associated with increasing a baby’s chance of dying or having long-term health and academic problems.)

The study concluded that psychosocial stressors, like the Postville raid, cause pregnant mothers to shift stress hormone balances in ways that affect a developing fetus.

“I think we’re just starting to learn the medical impact that being undocumented can have on someone,” Mironov says. “It’s this huge health-care issue in terms of both access and how it affects the body.”