In the heart of downtown New Bedford, a city forged by the diversity of its fishing, merchant and whaling history, stands the New Bedford Community Health center. Its commitment to the city’s complex, multilingual fabric is deep: it provides health care regardless of a patient’s immigration status, and its website offers translation in more than 200 languages.
Immigrants have long faced unique hurdles to vaccine access, ranging from language barriers and unfamiliar health systems to lack of insurance.
Today, NBCH is on the frontlines of navigating health, policy and culture as it tries to serve these vulnerable populations.
The fear hurdle
Massachusetts has policies and the funding to provide free vaccines to all children. However, recent immigration enforcement actions in New Bedford appear to have had a swift ripple effect, Bartlett said.
“In the adult population, there hasn't been a significant drop in people coming in for appointments – but we have seen that in the pediatric population,” Bartlett said. “Some of it is related to family members that have been detained, and therefore, there isn't a parent to bring the child in or a guardian that can allow for the care to be approved.”
Since January, federal agents have detained at least 50 New Bedford residents with varying immigration statuses, according to reporting by the New Bedford Light.
“We have had to really reach out to our patients and try to ensure that they can come there and feel safe while they're inside our facility,” Bartlett said. “What we can't provide for them is a guarantee of any protection outside of the health center.”
A policy hurdle
In July, the Department of Health and Human Services (HHS) put out a policy directive stating that undocumented immigrants would no longer have access to taxpayer-funded programs, including community health centers.
For Cheryl Bartlett, a registered nurse and the CEO of New Bedford Community Health – which serves a majority immigrant population – this policy represents a profound professional and moral challenge.
“If this new directive were to be put into effect, then in essence, all the undocumented patients that we currently serve would have to be refused services,” Bartlett said. “I've been a nurse for over 50 years and the idea of turning people away is just sort of against my whole career.”
Bartlett was also the Commissioner of the state Department of Public Health in 2013 and 2014.
Attorneys general in Massachusetts, 19 other states and the District of Columbia challenged the directive in court. As a result, a federal judge issued a preliminary injunction, prohibiting the government from enforcing the directive until the case is heard.
Bartlett is hoping the legal process is drawn out.
“If it took long enough, maybe that would take us into 2026, and maybe we would have some new people making the rules in Washington,” she said.
New Bedford Community Health provides primary care, dental care, nutrition, behavioral health services and more – along with free medical translation services.
If the HHS directive were to go into effect, New Bedford Community Health would have to verify the citizenship or immigration status of all patients before serving them.
“We serve over 25,000 individuals [per year],” Bartlett said. “If every time they come in we have to verify what their status is, that would become challenging,” Bartlett noted.
She added that having to turn people away would likely increase the burden on already over-taxed emergency rooms.
Building herd immunity
According to Bartlett, many immigrants served by New Bedford Community Health come from countries where they do not have access to the vaccines that children routinely get in the United States. In addition to posing a health risk to the unvaccinated themselves, this also weakens herd immunity—the community-wide protection that keeps disease from spreading.
“So [for] kids coming into the school system, it's very critical that they get vaccinated because they're likely to have been exposed to conditions and could possibly bring them into a population that's been fairly well protected,” Bartlett said.
