Promoting Citizenship and Expanding Immigrant Essential Workers’ Access to Health Care, Public Benefits and Services in New York City

Executive Summary

New York City has inclusive healthcare and social programs compared to other municipalities in the United States. Despite this, immigrants are at greater risk of poor health outcomes than US-born New Yorkers and remain disadvantaged in accessing healthcare. Part of this is the nature of employment opportunities available to many immigrants in New York City; compared to the US-born population, a higher percentage of New York City immigrants work in essential occupations (71 percent immigrant vs. 56 percent US-born). The gap between these percentages becomes even greater when focusing on low-income essential workers. Of 578,500 citywide low-income essential workers, 64 percent are immigrants (compared to 36 percent who are US-born). These New Yorkers, vital to the basic functioning of the City, are vulnerable along a number of socioeconomic indicators, of which health coverage is among the most crucial. However, many at-risk immigrant essential workers cannot access healthcare and the other benefits they need because they lack the legal status necessary to do so.

Approximately 600,000 New Yorkers are eligible to become naturalized citizens. They have lived, on average, 20 years in the US, 15 years longer than the 5-year residency requirement. Acquiring citizenship provides enormous advantages, allowing immigrants greater access to the formal labor market which in turn provides higher wages and safer more regulated working conditions. Naturalized citizens also become eligible for all public benefits that native-born citizens have access to. Prior CMS research found that naturalized citizens have health profiles more similar to the native-born population than noncitizens.

This study focuses on two immigrant populations at risk of poor health outcomes: immigrants who are eligible to naturalize but have not yet done so and low-income immigrants working in essential occupations. Detailed estimates are produced by the Center for Migration Studies (CMS) using methodology developed by Warren (2014). Findings from this report confirm well established research that identifies immigrant legal status as an important predictor of health and wellbeing as well as socioeconomic status. Temporary status yields less opportunity for good jobs and eligibility for participation in public benefits. Citizenship, both by birthright and through naturalization, provides the most opportunity to fully integrate into society on all levels.

The report presents detailed demographic and socioeconomic estimates for both immigrant populations, analyzes residential patterns by exploring neighborhoods where immigrants live, and provides important information on legal status, countries of birth, and languages spoken. Findings from this report can be used as a roadmap to help New York City agencies and immigrant-serving community-based organizations (CBOs) develop strategies to address barriers common to both groups.

Key Findings:

Eligible to Naturalize

• There are 589,000 immigrants in New York City who are eligible to become citizens but have not done so. This represents 41 percent of the 1.4 million noncitizens living in New York City.
• Immigrants who are eligible to naturalize have been in the country, on average, 20 years – 15 years more than is required to apply for naturalization.
• This population is more likely to come from Mexico and South and Central America while immigrants from Europe and non-Hispanic Caribbean countries are more likely to have already naturalized.
• Immigrants who are eligible to naturalize are a very diverse group coming from all over the world, with no one group claiming a majority. Dominican immigrants are the largest group (108,000 immigrants eligible to naturalize), followed by those from China, with 82,100. These two groups account for one-third of the total eligible population.
• The cost to naturalize is often cited as a significant barrier in the citizenship process; however, 45 percent (263,000) of the eligible population could qualify for some kind of financial assistance.
• Those eligible to naturalize have a diversity of educational experience: 38 percent have attended at least some college whereas 34 percent have yet to achieve a high school degree. The remaining 23 percent are high school graduates without any post-high school education.
• 57 percent of the eligible population are not proficient in English. Of those, 49 percent speak Spanish and 23 percent speak Chinese, either Cantonese or Mandarin.
• Ten percent of those eligible to naturalize are uninsured, twice the rate of immigrants who have already attained citizenship.
• Immigrant workers who are eligible to naturalize earn 71 percent of median earnings for naturalized citizens ($30,100 compared to $42,200).
• The eligible population is dispersed widely across the City with no neighborhood accounting for more than five percent of the total. The top neighborhoods with more than 20,000 eligible immigrants are: Flushing (Qn CD 7), Jackson Heights (Qn CD 3), and Washington Heights (Mn CD 12).
• Dominican immigrants who are eligible to naturalize are most likely to reside in the Bronx (50 percent) and upper Manhattan. Eligible Chinese immigrants tend to settle in the three Chinatowns of the City: Flushing (CD 7) in Queens, Sunset Park (CD 7) and Bensonhurst (CD 11) in Brooklyn, and Manhattan’s Chinatown (CD 3).
• Outreach efforts to promote citizenship are greater for Mexican, Dominican, and Chinese immigrants who have the highest percentages that are eligible to naturalize and less so for immigrants from West Indian and European countries because higher proportions from those countries have already naturalized.
• The naturalization-eligible population is more likely to resemble the profile of undocumented immigrants in the following characteristics: lower educational attainment, limited English proficiency, higher poverty rates, lower share of home ownership, and higher rates of living in overcrowded housing.

Low-Income Immigrant Workers

• There are 370,300 low-income foreign-born workers employed in essential occupations. They comprise 64 percent of all low-income essential workers in the City (578,500).
• 80,300 low-income immigrant workers are eligible for naturalization.
• Almost half of low-income essential workers come from three countries: the Dominican Republic (74,500,) China (49,800), and Mexico (45,400).
• 61 percent of low-income undocumented workers are without health insurance (64,000), while only 13 percent of those eligible to naturalize and eight percent of naturalized citizens are without healthcare coverage.
• Of low-income immigrant workers, 48 percent were employed in service occupations where Citywide median earnings are $25,300, the lowest of all occupational groups. The largest number and share within this category are employed as healthcare support workers, followed by food preparation and service-related occupations.
• There are notable differences between native- and foreign-born low-income essential workers. Native-born low-income workers are more likely to have an advantage in obtaining employment in higher paying occupational categories and much less likely to live in overcrowded housing conditions. Additionally, native-born essential workers are younger and more likely to be female compared to their foreign-born counterparts. Median age for native-born workers was 32, ten full years younger than foreign-born median age of 42.
• The geographic distribution of low-income workers reflects the well-known contours of poverty writ large across NYC. The Bronx, long recognized as one of the poorest counties in the US, has a much larger share of immigrant low-income essential workers relative to their overall share of foreign-born population.
• Queens, while distinguished for its large immigrant population, has a lower share of low-income essential workers relative to the overall share of their total foreign-born population.
• These finding suggest that even though the Bronx does not have the absolute numbers of immigrants found in other boroughs, its share of low-income essential workers highlights a need to focus on this borough to address unique needs of these low-income workers.

DOWNLOAD REPORT