“An immigrant’s avoidance of the healthcare system is not just about whether they are documented or not,” says Oswaldo Mendoza, an intern in medical case management at TPAN who’s here on a student visa from Colombia. “They usually face two problems: fear and concern about economic resources.” 

Mendoza notes that in many cases, immigrants from Mexico and from Central or South America have such a low level of education, they don’t know how to read or write in Spanish, much less English. On top of which, he says, the healthcare system is much more complicated in the United States than in their home countries. As a result, whether they’re from rural regions or from urban—more sophisticated—areas, they may prefer to avoid clinics because they fear the complexity and the language barriers as well as the potential costs. They just don’t know how the system here works.

“So they only move in Latino circles, where they can speak Spanish and be understood. They’ll go straight to La Villita [Little Village, a well-established Mexican neighborhood in Chicago] for medical care,” he says.

They will also rely on friends, family and acquaintances for information and advice. “So if those people don’t have accurate information, that can hurt them,” he says.

Lots of things here can be scary. “I’m here legally and I’m afraid of the cops,” Mendoza admits.

For people who say “learn English,” I told him about the year I worked part-time at Instituto del Progreso Latino, between the border of my predominantly Mexican neighborhood, Pilsen, and Little Village. I was astounded at the hundreds of Spanish-speaking immigrants who worked all day long and then came to Instituto four days a week to study English from 5–9 p.m., Monday through Thursday. These were invariably people who were married and raising children. They were killing themselves—as I saw it—with this exhaustive schedule to make a better life for themselves and their families. Learning a foreign language is just not that easy, especially for people who are working. It’s because of their amazing fortitude that my heart breaks every time I hear the words “learn English.” I realized too, from my own parents and other immigrants (my parents are from Puerto Rico but I see our community as immigrants as well though they are U.S. citizens), that they know how to speak a lot of English, but are afraid to use it because they often stumble over their words when they do. It was something I also noticed among the highly educated students from around the world at the University of Wisconsin at Madison where I attended journalism school as an undergraduate. Their English was magnificent, but it was never to the level of their native language and that bothered them. And that’s why my mother would ask me to translate for her.

So please stop saying “they should learn English.” Many already know it.