RESOURCES:
Washtenaw County Health Department
Washtenaw County Immigrant Health Assessment: August 2025
TRANSCRIPTION:
Caroline MacGregor: You're listening to 89.1 WEMU. I'm Caroline MacGregor. And today, we're talking about a health assessment carried out by the Washtenaw County Health Department. In 2023 through 2024, the Washenaw County Health Department took an in-depth look at the health concerns of the local immigrant community in Washtenaw County. They held interviews. They held focus groups with service providers and immigrant community members. And I'm here talking with Ruth Kraut. She's the Deputy Health Officer for Washtenaw County Health Department. Welcome, Ruth!
Ruth Kraut: Hello! Happy to be here!
Caroline MacGregor: So, Ruth, tell me a little bit, first of all, about what prompted this health assessment here locally in Washtenaw County for immigrants.
Ruth Kraut: Yes, thanks for asking. So, we started thinking about this really in 2021, 2022, just because we saw that we had a lot of immigrants coming into our various programs, and we wanted to make sure that we were serving them well. And we knew that they were not all coming from one community, but from all over the world. So, we started thinking about how we could best identify needs, and that ended up being this assessment.
Caroline MacGregor: Who are the Washtenaw County immigrants? You know, can you tell us a bit more about the different people that are here from various countries and just a little bit about maybe the percentage of how many live here?
Ruth Kraut: Well, about 12% of county residents, and that's over 46,000 people, were born outside of the United States. About half of these immigrants are already citizens--people who were born in another country and have a long-term intent to stay in the United States. This really includes like a 90-year-old who maybe came over when they were two years old, somebody who came to study at the University of Michigan or Eastern Michigan University and ended up getting a job in the auto industry and staying, people who have crossed the border fleeing gang violence or war. And we have a lot of refugees right now from Afghanistan and many other countries around the world.
Caroline MacGregor: So, a very interesting and diverse population group bringing their own cultural norms with them, but, obviously, who want to assimilate into American culture. Why was this health assessment necessary?
Ruth Kraut: During COVID, we saw that some of our immigrant communities were not necessarily getting the information they needed in their language of choice, their social media of choice, and that is a way that misinformation can proliferate. We really wanted to figure out a way to serve people well.
Caroline MacGregor: I know that toward the top of the list of things that came up on your assessment was this navigating access to health services, which you just mentioned, and how challenging it is. What makes it so much more difficult? Is it the language barrier for people?
Ruth Kraut: Yes. Language is one of those things, but most other countries do not have health care systems that are set up the way the United States is. A third piece is that, depending on your immigration status, you might be eligible for different kinds of insurance. And this is an area that under the current administration is changing rapidly, and we've got to keep a close eye on.
Caroline MacGregor: Right.
Ruth Kraut: And I'm going to say that for a lot of people born in the U.S., they have similar problems as well. Health care is confusing.
Caroline MacGregor: It is, and it's a highly challenging area for everybody, it seems. But supporting immigrants with the application process is obviously critical here for people who've come to the country.
Ruth Kraut: Yes. And we are very lucky that our partner organization, the Washtenaw Health Project, can help people figure out what they are eligible for, help people apply for Medicaid or for the marketplace, tell them what is the difference between a deductible and a copay. So, the Washtenaw Health Project is a great resource for everybody!
Caroline MacGregor: And I'm sure that even gaining access or learning how to navigate the area of getting prescriptions filled with pharmacies, et cetera, that's got to be also difficult and possibly could even complicate matters following visits for people who don't know how to navigate the system.
Ruth Kraut: Yes. In fact, one of the providers said that he has had patients who had prescriptions, the pharmacy had them in stock, but the person did not know how to understand to go pick up the prescription from the pharmacy--a simple example of how language on a different health system can confuse people.
Caroline MacGregor: Absolutely! And now with the heightened clampdown instigated by the federal government, by ICE, obviously, a lot of immigrants are quite afraid. And I would think possibly many are concerned about accessing health care or social services because they fear it may affect their citizenship or asylum status. How do you as a county health department help people in this area?
Ruth Kraut: Yeah, this is a very challenging area. Previously, the federal government had said that locations like hospitals, government agencies, the courts, the schools were sensitive locations. And now, they've said that they won't treat them that way. And that does make some immigrants nervous about coming to make their doctor's appointments. We have signs up that say "all are welcome here," and we really mean it. We want people to feel like they can come to the health department. That it is a safe place. At the same time, we don't control the federal government. So, fear and intimidation is very difficult in the immigrant community.
Caroline MacGregor: And it seems that Washtenaw County is quite a friendly place to immigrants, which is one positive. But still, there's been raids by ICE where the Sheriff's Department hasn't been informed. It's just a scary situation overall. And especially for those, I would think, who've come from countries where they've already experienced enormous trauma, where there's violence and things going on that have just left them traumatized, leading to major stressors. How do you help people deal with this trauma and fear that we're experiencing?
Ruth Kraut: Yeah. One of the things that we really learned is that many immigrants have trauma, not just those who are legally labeled as refugees or as asylees, but many other immigrants are fleeing war, fleeing hunger, and bringing with them stories of trauma. They also worry about their family back home. And so, mental health becomes a really important thing. Of course, language barriers can be an issue with community mental health, but there are other things that become issues too. One of our focus group participants, she had a client who needed a birth certificate to apply for disability, but how do you get a birth certificates when a country doesn't exist anymore?
Caroline MacGregor: Gosh, yes!
Ruth Kraut: And so, that was shocking to me. There are challenges that we don't really think about.
Caroline MacGregor: I was just going to say, psychologically speaking, this has to be unbelievably traumatic for people in those circumstances that you're just talking about.
Ruth Kraut: Yes. But one thing that was very interesting is that a lot of the concerns is about access to food, access to mental health, access to health care, but the same things that are concerns for most people in the county.
Caroline MacGregor: Okay. And just quickly, because we're almost out of time, but something that comes into play is cultural norms and even gender issues. Does this make it quite difficult for the health department and other entities trying to help immigrants navigate the system, for example, with food pantries or even with how medical treatment is offered to immigrants?
Ruth Kraut: So, yes, immigrants don't necessarily feel like they have enough money for food. Immigrants may be nervous about accessing a SNAP or food stamp benefits, if they are eligible or if their children are eligible. They may be anxious about visiting a food pantry if they need that support. In some countries, you only go to a doctor if you're very ill. There is a lot of cultural norms that is definitely significant, and there's a learning curve.
Caroline MacGregor: Okay. So, unfortunately, we're out of time, but just to wrap up, what is going to happen following this assessment? How will the health department take into consideration all that it's found to help immigrants moving forward?
Ruth Kraut: That is a great question. So, we're basically operating on sort of two different fronts. What can we do? How can we reduce language barriers? How can align our work so that it includes immigrant concerns? And we are working with other county departments on Welcoming Washtenaw, which is really an initiative to make people feel welcome. Immigrants are important economic drivers to the county. They add a lot of diversity and interest. We are also working with some of the other nonprofits and government agencies on ways to reduce language barriers. And it's baby steps on each area, but, hopefully, we keep moving in the right direction.
Caroline MacGregor: I've been speaking with Ruth Kraut. She is the Deputy Health Officer for the Washtenaw County Health Department. And we've been talking about a new report that assesses immigrant health here in Washtenaw County. Thank you so much for joining me today, Ruth!
Ruth Kraut: Thank you so much for having me!
Caroline MacGregor: This is 89.1 WEMU-FM Ypsilanti.
Non-commercial, fact based reporting is made possible by your financial support. Make your donation to WEMU today to keep your community NPR station thriving.
Like 89.1 WEMU on Facebook and follow us on X (Twitter)
Contact WEMU News at 734.487.3363 or email us at studio@wemu.org
