Immigrant Health Assessment Reveals Barriers and Strengths in Washtenaw County

New assessment outlines barriers to health care, mental health services, food access, and legal support for local immigrants

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A new Washtenaw County Health Department assessment highlights the challenges immigrants face in accessing health care, mental health support, healthy food, and other essential services and offers recommendations to improve equity and inclusion.

The Immigrant Health Assessment, conducted in 2023–2024, included interviews, focus groups, demographic analysis, and a literature review. The report draws on the experiences of immigrants, nonprofit workers, health providers, and county staff, painting a detailed picture of life for the county’s 46,000 foreign-born residents, about 12% of the population, the second-highest percentage in Michigan.

Health Care Access and Navigation

Immigrants reported difficulties understanding the U.S. health care system, from making appointments to obtaining prescriptions. Immigration status often impacts eligibility for insurance or assistance programs, and mixed-status families face different program rules for each member. Language barriers, cultural differences, and fears that seeking care could affect asylum or citizenship applications further complicate access.

One nonprofit staff member described “the bravery of these kids” starting school without knowing English, while others recounted challenges for adults with disabilities and women seeking gender-sensitive care.

Mental Health Strains

The report found that trauma, uncertainty over legal status, and concern for family in conflict zones weigh heavily on mental health. Stigma and lack of culturally appropriate services keep many from seeking help. Even Spanish-speaking residents face limited access to therapy in their language, with even fewer resources for other languages. Transportation, cost of living, and social isolation compound these struggles.

Food and Housing Access

Many immigrants are ineligible for federal food assistance programs, even when their children qualify. Food pantries may not offer culturally familiar foods or information in multiple languages. Stable, affordable housing is also a pressing concern, with small programs like Michigan’s Newcomer Rental Subsidy providing only limited relief.

Language and Legal Barriers

Language gaps often place children in the role of family interpreters, creating stress and missed details. Some immigrants avoid legal processes — including asylum hearings — out of fear, especially after recent enforcement actions by immigration authorities. Legal representation is not guaranteed in immigration court, and limited funding for services like citizenship application support leaves many without help.

Community and Economic Contributions

Since 2017, Washtenaw County and Ann Arbor have participated in the national Welcoming Communities initiative, promoting unity and respect across racial, ethnic, and religious lines. The report also stresses immigrants’ role in driving job growth, entrepreneurship, and local investment.

Recommendations

The Health Department calls for:

• Expanding in-person interpretation and culturally sensitive training for staff.
• Supporting legal aid organizations.
• Using multiple languages and social media platforms like WhatsApp and WeChat to share resources.
• Making health services available regardless of immigration status.
• Supporting immigrant-owned businesses and restaurants.

“Anti-immigrant sentiment and hate does not have a place here,” the report concludes, emphasizing that maintaining and increasing support is vital amid federal policy shifts and enforcement actions.

The full Immigrant Health Assessment is available at bit.ly/wchdiha.