Study exposes plight of deported noncitizen veterans

A study examining the effects of deportation on the health and well-being of noncitizen veterans who served in the United States military has found that this group is a vulnerable and often unrecognized health disparity population.

Overseen by Ann Cheney, an associate professor of social medicine, population, and public health in the School of Medicine at the University of California, Riverside, the study reports the post-deportation economic, social, and political conditions of living abroad harm veterans' physical and psychological health. Many prioritize returning to the U.S., the country they served, to improve their quality of life.

The study, titled "Social Determinants of Health among Noncitizen Deported US Veterans: A Participatory Action Study," and published in PLOS Global Public Health, involved interviews conducted in Tijuana, Mexico, from December 2018 to January 2019.

A total of 12 male veterans who were returned to this "deportation city" participated in the research and were included in the analysis. The study used photovoice, a research method that uses photography and narrative text, to capture the veterans' experiences. Each participant took photos and selected two or three to represent the experience of a deported veteran and was invited to comment on how the photos could inform policymakers about the social and health needs of deported veterans.

Study participants were at least 18 years of age, U.S. veterans of any service era, Mexican citizens by birth, lived in the U.S. for at least 10 years, were deported to Mexico in the last 20 years, and resided in Tijuana. The average age of the participants was 56 years and the average age at entry into the U.S. was six years.

"Our analysis of their photos and narrative text indicates that deportation caused them social, economic, and political insecurities," Cheney said. "We found that after they were deported from the U.S., these veterans struggled to maintain access to necessities. With disruptions in their social networks, and the removal from the country many considered home, they experienced chronic stress and poor health outcomes."

The U.S. has a total of 19 million veterans. Latinos of Mexican and Central American origin are over-represented in the veteran population deported from the U.S. More than 80% of deported veterans report medical issues and nearly 75% lack access to health care after deportation. Poor physical and mental health and the effects of combat-related violence and trauma can increase homelessness, strained interpersonal relationships, substance use, legal trouble, and difficulty in maintaining employment.

"Veterans often struggle to assimilate to civilian life post-discharge, but this transition is especially risky for noncitizen veterans," Cheney said. "It is no wonder half of our participants reported that returning to the U.S. was most important for their quality of life—many had been living in the U.S. since childhood, spoke English only, and had no family or friends in Mexico. Securing income and accessing health care were their next highest priorities. Our findings highlight how deportation places such groups in vulnerable positions, contributing to their stress and harming their health."

The study also found the deported veterans:

• Voiced disbelief about how the U.S. could dispose of them after they risked their lives to protect, what they considered, their country
• Remained loyal to the U.S., with many indicating they would serve again in the U.S. military
• Self-identified as "American" and believed the U.S. is their home
• Described their situation as being stuck in "limbo," with their lack of Spanish proficiency hindering their ability to assimilate
• Experienced loss of food, housing, and medical care
• Were often homeless and food insecure
• Reported challenges finding and securing jobs in Mexico, with public transportation issues being a common barrier to employment
• Could not contact their families for extensive periods of time, often because they felt guilty
• Frequently experienced depression, loneliness, and anxiety due to feelings of helplessness and despair
• Experienced chronic illness and disease, such as hypertension and diabetes
• Used substances to cope with deportation.

"Without change in our nation's policies, noncitizen veterans will continue to be present in our immigration system and face deportation charges," Cheney said. "Attention needs to be urgently paid to addressing behavioral health conditions in this population. In Mexico, deported veterans need to be trained to speak Spanish and develop skills needed for employment. They also need immediate access to free health care services, specifically mental health care services, to cope with loss, grief, and isolation linked to the trauma of deportation."

Cheney stressed that deported veterans need to continue their connection with their family and friends in the U.S. and establish new networks in Mexico. By connecting these veterans to community-based peer support groups, they can find community and identity with other veterans, she said.

"Non-citizen military personnel often think entering the military automatically puts them on the path to citizenship," Cheney explained.

"But that's not true. They often think this because they are misinformed. Too often military leadership and recruiters do not know the naturalization process for non-citizen service members and misinform them, leading them to believe they are already or will become citizens. Military leaders and recruiters need training on the naturalization process, so they communicate correctly with recruits and service members."

"Additionally, we need reform to the immigration process to facilitate the pathway to citizenship for service members and veterans who served in the U.S. military."

Cheney was joined in the research by project co-leader Frances Tao of UCLA, Cassidy T. Lee of the School of Osteopathic Medicine in Arizona, and Edgar Castelan of the California State Senate, San Bernardino.