Worrying about calling in to work in the face of a medical emergency because the costs of the visit will be more than this month’s rent. Fearing the questions the doctor may ask that could potentially jeopardize one’s ability to remain in the United States. These are just some of the many concerns residents living in the communities found along South Division Avenue in the Burton Heights and Garfield Park neighborhoods are faced with every day when attempting to address their health concerns.

For some residents in Burton Heights and Garfield Park, these concerns stem from barriers faced when dealing with documentation. Although the federal Affordable Care Act (ACA) has helped increase access to health care for many Michiganders, undocumented residents and those who have work permits under the Deferred Action for Childhood Arrivals, individuals brought to the United States at a very young age  without any legal status by their parents or legal guardians, are unable to purchase health insurance via the marketplace set up by the ACA.
 
Outside of the ACA, individuals who are undocumented also face overwhelming barriers to gaining health insurance, as they will often be legally barred from purchasing it and will almost always have to provide a social security number to apply for coverage. In Michigan, pregnant women who are undocumented may be able to receive prenatal and birth coverage by applying through a local health department or authorized health clinic. However, children without documentation are denied these resources, as lawful status is required when applying for  MI Child, a health insurance specifically for children without any other insurance. To be eligible for MI Child, a family's income bracket must fall between 150 percent and 200 percent of the poverty level.
 
In Kent County and Grand Rapids — and in Burton Heights and Garfield Park specifically — many people are faced with these barriers. While a little more than 10 percent of the total population in Kent County is Hispanic/Latinx (and 16 percent in Grand Rapids), the Hispanic/Latinx population represents 63 percent of the area along South Division in Burton Heights and Garfield Park, per U.S Census data. Many of those individuals are part of the 45 percent percent of all foreign born residents in Kent County. Because 40 percent of all foreign born residents in Kent County are currently not U.S citizens, avenues to accessing health care for these communities is very limited. Even though undocumented Michigan residents are contributing about $126 million per year in taxes, according to the Institute on Taxation and Economic Policy, they do not get to benefit from such taxpayer-funded programs as social security, food stamp benefits, or health insurance.  
 Cristian Rodriguez

For Cristian Rodriguez, who grew up in Burton Heights, receiving regular check-ups at the doctor, having a bi-annual teeth cleaning, and being able to receive affordable prescription medication was out of the question. To ensure the family was able to cover their basic needs, his father worked three jobs, and his mother not only had to care for him and his two brothers, but she also was faced with the responsibility of a full-time job. Neither parent received health insurance through their employer, and often times Rodriguez and his two brothers went without a medical check up for years at a time.
 
“When I was growing up here there weren’t many health care resources my family felt comfortable accessing,” explains Rodriguez.
 
Having spent much of his life in the Burton Heights neighborhood, Rodriguez understands what many of the families are faced with when attempting to access continuity of health care.

Now, Rodriguez is the Physician Assistant and Medical Provider at Burton Health Center and Associate Director of School Programs, which are housed under the umbrella of Cherry Health, an independent nonprofit offering quality health services to marginalized populations.
 
Burton Health Center located at Burton Elementary and Middle School
“Many of the area’s residents are uninsured, undocumented and are faced with a lack of access to transportation, making it more difficult for them to go to specialized health services,” states Rodriguez.
 
To help minimize barriers for these families, Cherry Health houses their healthcare services for the families living in Burton Heights at Burton Elementary and Middle School.
 
“This is the only health-based community clinic housed at a school in Grand Rapids that serves students, families and residents of the area,” explains Rodriguez.
 
On average, the clinic serves about 25 patients per day, many of whom are migrants and refugees without insurance or documentation. To help accommodate these individuals, they offer services on a sliding fee depending on household income — not individual income.
 
For Rodriguez, being at Burton Health Center made the most sense because he “wanted to service the community I was a part of.”
 
Health Intervention Services (HIS) located on the corner of S. Division and Andre Street SE.

In the same way, Samantha Orozco found a place to help her community as a Clinical Nurse at Health Intervention Services (HIS),  a comprehensive health clinic located on 15 Andre Street SE. 
 
Orozco was born in Delhi, California a couple of months after her mother, María Guadalupe Sevilla, made the treacherous journey into the United States from Guanajuato, Mexico.
 
“My mom was pregnant with me when she came to the United States. She was looking for a better life for her and I,” Orozco proudly states.
 
Eventually, the pair made their way up north and settled on the West Side of Grand Rapids. Being able to use her educational privilege to ensure the undocumented Latinx community in Grand Rapids is able to meet their health care needs is something Orozco feels called to do.
 
Samantha Orozco
“At the clinic I can help my community in the same way that Christ helps others,” states Orozco.
 
Orozco explains many of the residents of the area are undocumented, unemployed and uninsured.  “Fifty percent of our patients are uninsured and over 70 percent are undocumented,” she says.

Due to high costs, many of the clinic’s patients are unable to receive care from specialists.
 
“A lot of the time our patients will decide against seeing a specialist because of the cost,” explains Orozco.
 
To help address these gaps, HIS offers specialists on site. They house endocrinologists, ophthalmologists, dentists, psychotherapists, psychiatrists, insurance navigators, and even financial advisors to help patients come up with payment plans to pay for the costs of healthcare.
 
According to data compiled by the Dorothy A. Johnson Center for Philanthropy at Grand Valley State University, in the area along South Division in Burton Heights and Garfield Park alone, healthcare and social services make up less than four percent of all businesses. In comparison, residents of Heritage Hill have a variety of healthcare resources to choose from, with healthcare and social services making up 20 percent of all businesses there. This means residents along South Division have far fewer opportunities to meet their basic healthcare needs than their neighbors.
 
“This neighborhood doesn’t offer enough resources to help educate and empower the community to address their healthcare needs,” Orozco says.
 
For the residents of Burton Heights, South Division and Garfield Park, clinics like Burton Health Center and Health Intervention Services help minimize gaps while meeting basic health care needs. These spaces provide a host of services in one place, where each patient is greeted in their native language without the obligation of disclosing their legal status. In these spaces, patients are welcomed by people who look like them and understand their experiences. As stressed by health care workers in these communities, every resident of Grand Rapids deserves to have access to dental cleanings, affordable and regular check ups with their primary care physician, free birth control, and caring providers who educate, empower and advocate for them.

On The Ground GR
 
On The Ground GR is a new Rapid Growth series. This series will highlight and celebrate the communities found along South Division Avenue in the Garfield Park and Burton Heights neighborhoods. You can read all the On The Ground articles published to date here.
 
Over the next few months, On The Ground GR journalists will be knocking on doors and getting to know the neighbors and community members. We will dive deeper into topics concerning this neighborhood's residents and stakeholders while celebrating the diversity and strength found in this area.
 
Follow On The Ground GR's work via Twitter (use the hashtag #OnTheGroundGR), Facebook and Instagram. To connect with On The Ground GR's editor, Michelle Jokisch Polo, you can email her at [email protected] and follow her on Facebook and Instagram. Learn more about Michelle here.
 
On The Ground GR is made possible by the Frey Foundation, the Grand Rapids Community Foundation and Steelcase, organizations that believe democracy thrives when people and communities are informed and engaged.