Rural Minnesotans of color skipping medical care out of fear of ICE
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Olivia worked with a rural northern Minnesota family for months to line up appointments with medical specialists in the Twin Cities for their 18-month-old son. Olivia is an occupational therapist who works with children with disabilities. The boy is legally deaf and blind and relies on a permanent oxygen tube to help him breathe.
But Olivia says as ICE and border patrol activity escalated, the family feared that going to the appointments would put them in danger. The parents and child are all U.S. citizens, but as people of color, they were scared they could be stopped and detained by federal agents as they made their way to and through the Cities.
“We had arranged hotel stay, transportation, multiple appointments at multiple providers for a lot of different specialty things for him,” said Olivia. “And they all had to be canceled.”
Olivia says some of her other clients of color are cancelling appointments too.
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MPR News agreed to not identify Olivia’s last name and the town in which she works because she fears that her clients could be identified and targeted. She says it’s really hard to be a provider right now.
“It makes me feel so helpless,” Olivia said. “I love these children, and I love these families, and I want what's best for them, and the idea that delaying medical care might actually be the wisest choice that they can make is really painful – but also true.”
Medical care providers tell MPR News that all across Minnesota, people of color have been skipping medical appointments because they fear being stopped and arrested by federal immigration agents.
It’s especially troubling in rural parts of the state, where it is much more difficult for people to schedule appointments for specialized care because they must drive long distances to see the specialists, and medical providers are worried about the long term consequences to the health of their patients.
White House “border czar” Tom Homan announced Thursday that the immigration enforcement surge in Minnesota is ending, but there’s little sense for when border patrol activity will truly die down and, for many Minnesotans, the damage has already been done.
Olivia’s 18-month-old client, for one, was scheduled to get hearing aids. Now that’ll be postponed – likely for months — as appointments with specialists are difficult to schedule under normal circumstances.
“This is an extremely critical time for language development, and he is not able to receive the verbal information that a child his age really needs in order to make those neurological connections,” Olivia said. “Even though this is not a life or death thing, it is something that could impact him for his entire life.”
And for some, the delays in care could be life threatening.
Dr. Lane Miller, an oncologist at Children’s Minnesota in Minneapolis, said he is seeing the dire impact of what happens when patients’ care is delayed or skipped care altogether.
One of his leukemia patients lives in a rural area more than an hour away from Minneapolis. With intensive therapy, she had been doing well. But when ICE activity began to increase in the Twin Cities she stopped coming for treatment.
“When she finally presented to care here just a few weeks ago, she was in complete liver failure,’ Miller said. “We have had her chemotherapy on pause for weeks now, and it's an indefinite pause. I have no idea when we're going to be able to start her treatment again. She’s extraordinarily sick.”
Miller said far too many of Children’s patients who are medically vulnerable and need critical care have stopped coming in for surveillance, imaging, blood work, and examinations out of fear they’ll be arrested and detained by immigration authorities.
“These are patients with brain tumors, who have brain cancer, and we have no idea what the status of their tumors are right now,” Miller said. “These are children. We have patients who are not actively getting chemotherapy that we know need it because they have not been able to leave their home.”
Several general practice and family physicians in rural parts of greater Minnesota tell MPR News that they are trying to meet those specialized care needs of their medically vulnerable patients who are too afraid to go to specialists in the Twin Cities, Rochester or other metro areas, by working with specialists like Miller remotely.
One of those doctors is a family medicine physician in rural southwest Minnesota.
“I have one infant who has a congenital condition,” the doctor said. “And right now, the family has said very kindly that they just don't feel that they can safely do that [travel for care], and so I'm talking on the phone and working at a distance with some of our specialist providers to try and help guide me.”
That means he’s doing lots of phone and Zoom calls with the team, which is advising him on what can be done from afar.
But it’s not ideal. And in many of these rural communities, patients are even scared to attend local doctors’ appointments, as ICE activity heats up there, too.
The doctor says he's treated patients who were assaulted by officers and others whose asthma was exacerbated by being detained outside in the bitter cold. One patient missed a well-child visit because federal agents were standing guard outside their house. Another patient's husband is now in the process of being deported.
"For my patients in rural Minnesota, regardless of where they come from or how long they lived here, what they look like,” he said. “This is taking a real toll."
About an hour north in west central Minnesota, another family medicine doctor said she’s been working to come up with alternatives to get her patients the care they need.
MPR News has agreed not to name either of these doctors nor their hospital because the hospitals did not authorize them to speak with us, and because they fear federal agents will target immigrants and people of color in their areas even more.
One of her patients, a 17-year-old, was having the symptoms of a vaginal infection, but she didn’t want to come into the clinic out of fear. The physician said in cases like this, she’s talking to patients about bringing testing supplies directly to their homes or even working through intermediaries like community paramedics.
But she’s doing this on her own, without authorization from her employer.
“When some of the health systems don't feel the matter is maybe as pressing as those of us on the front lines are feeling, it's difficult to say, ‘No, we need to’,” the physician told MPR News “We need to meet our patients where they're at, and for those of us willing to do it, to be supported in that endeavor.”
This family medicine doctor said she’s deeply concerned about the long-term effects of the federal immigration enforcement operation. But she wants Minnesotans to know that physicians like her understand the gravity of the situation and they are doing what they can to meet their patients’ care needs.
“There is a community and an alliance building of physicians across Minnesota, across all the corners who are talking about this outside of the office, outside of their hospitals, and really trying to find ways to get people the care and support they need,” the doctor said.
