{"id":14925,"date":"2018-01-09T10:45:54","date_gmt":"2018-01-09T16:45:54","guid":{"rendered":"https:\/\/www.thechicagoschool.edu\/?post_type=insight_posts&#038;p=14925"},"modified":"2019-06-24T09:44:39","modified_gmt":"2019-06-24T14:44:39","slug":"public-health-nightmare","status":"publish","type":"post","link":"https:\/\/www.thechicagoschool.edu\/insight\/health-care\/public-health-nightmare\/","title":{"rendered":"When the American dream becomes a public health nightmare"},"content":{"rendered":"<section class=\"clearfix\"><p>America\u2019s culture has assigned gender roles within marriages for centuries. It\u2019s been a simple concept: Men go to work. Women tend to the home. And although this way of thinking is steadily changing\u2014<a href=\"https:\/\/www.psychologytoday.com\/blog\/fighting-fear\/201301\/changing-gender-roles-in-marriage\" target=\"_blank\" rel=\"noopener noreferrer\">there are fewer assigned gender roles in marriage today<\/a>\u2014it remains a cultural issue, not a legal one.<\/p>\n<p>The same can\u2019t be said for immigrant spouses of the U.S.\u2019s H1-B visa program that allows companies to employ exceptionally skilled workers in specialty occupations. For years, through the H4 visa program allowing dependents of H1-B visa holders to accompany them, the spouses (often Indian women) of these workers have been restricted by the U.S. government from obtaining employment, and thus legally assigned the role of housewife.<\/p>\n<p>\u201cIt\u2019s not particularly a health policy,\u201d says Dr. Mudita Dave, program chair of the <a href=\"https:\/\/www.thechicagoschool.edu\/online\/programs\/master-of-public-health\/\" target=\"_blank\" rel=\"noopener noreferrer\">Master of Public Health program<\/a> at The Chicago School, who recently spoke about the impact of these policies on the health of Asian-Indian women at the <a href=\"https:\/\/www.apha.org\/annualmeeting\" target=\"_blank\" rel=\"noopener noreferrer\">2017 APHA conference<\/a>. \u201cBut it does have a tremendous impact on health and well-being of these women.\u201d<\/p>\n<h3>A history of the H4 visa<\/h3>\n<p>Widely utilized in the 90s, the H4 visa program provided immigrant couples a way to remain together if one was to find temporary, and often lucrative, work in the U.S. through an H1-B visa. However, it did not authorize the spouse of the H1-B visa holder to gain employment.<\/p>\n<p>Male Indian citizens have traditionally comprised the majority of H1-B visa applicants and recipients, specifically through work in the information technology sector (about 195,000 H-1B visa openings annually for IT). So, naturally, the majority of spouses seeking H4 visas were Indian women. In fact, <a href=\"http:\/\/nytlive.nytimes.com\/womenintheworld\/2016\/05\/20\/wives-of-silicon-valleys-immigrant-engineers-speak-of-loneliness-and-frustration\/\" target=\"_blank\" rel=\"noopener noreferrer\">90 percent of H4 visa holders are women<\/a>.<\/p>\n<p>Many of them are trained professionally and academically in various fields or were entrepreneurs back in India. But because they didn\u2019t want to rip apart their family, they decided to come to the U.S. with their husbands. But an inability to gain employment can lead to frustration and isolation, while the stigma of being labeled \u201cdependent\u201d has a negative effect on self-esteem.<\/p>\n<p>\u201cMany more women accompany men on these visas than vice versa,\u201d Dr. Dave says. \u201cIt becomes a very gendered pattern of people not being able to use their education skills and training.\u201d<\/p>\n<p>One of the first women interviewed during Dr. Dave\u2019s research is a prime example. She held a master\u2019s degree in chemistry from an Indian university, but upon moving to the U.S. after her husband obtained an H1-B visa she felt her career was put on hold. Even worse, she was forced to move three times within two years, until her husband\u2019s work was complete and they returned to India. This lack of stability is especially challenging for families that arrive with children.<\/p>\n<p>Upon her second venture to the U.S. (again, because of her husband\u2019s pursuit of work) she decided to further her education; seeking to be productive in some way. Even this became a burden due to restrictions on spouses accepting paid positions as research assistants, forcing them to pay for any education costs out-of-pocket.<\/p>\n<p>\u201cSo many of these women don\u2019t feel accepted and wonder why they are trying so hard to contribute to a system that doesn\u2019t seem to want them,\u201d Dr. Dave says.<\/p>\n<h3>Progress for immigrant spouses<\/h3>\n<p>To address these issues, the <a href=\"https:\/\/www.uscis.gov\/working-united-states\/temporary-workers\/employment-authorization-certain-h-4-dependent-spouses\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. Citizenship and Immigration Services<\/a> began allowing H-4 visa holders to <a href=\"https:\/\/www.uscis.gov\/working-united-states\/temporary-workers\/employment-authorization-certain-h-4-dependent-spouses\" target=\"_blank\" rel=\"noopener noreferrer\">obtain employment under specific conditions<\/a> on May 26, 2015, in response to an executive action implemented by the Obama administration. This was estimated to give eligibility to 179,600 H4 visa holders in the first year, and 55,000 annually thereafter.<\/p>\n<p>Additionally, it eased the burden of maintaining a single-income household, increased the incentive for the highly skilled H1-B visa workers to remain with their companies, and, most importantly, empowered thousands of women to begin seeking employment opportunities or continue their education; it gave them a sense of purpose.<\/p>\n<p>Although not all spouses are eligible, this was a step in the right direction, Dr. Dave says. But the future of this progress hangs in the balance.<\/p>\n<p>The struggles that recipients of the H4 visa face are a perfect example of how public policy impacts public health in unexpected, yet clear, ways. As thousands of immigrants continue to wait on policy decisions that will affect their future, Dr. Dave says a unique determination to succeed has helped many of those affected.<\/p>\n<p>The woman she first interviewed decided to pay for her education out of pocket, spending $50,000 to get her master\u2019s degree from an American university. Her husband applied for permanent residency, and she was authorized a work permit after a nearly 10-year struggle.<\/p>\n<p>But according to Dr. Dave, stories of immigrants overcoming the hardships they face is why people will continue applying for a program they know requires so much sacrifice.<\/p>\n<p>\u201cEven though the U.S. is still widely considered a land of opportunity, lived experiences of my study\u2019s participants throw light on a relationship that is not commonly considered or well understood,\u201d Dr. Dave says.<\/p>\n<p>&nbsp;<\/p>\n<hr \/>\n<p><strong>Learn more about The Chicago School\u00a0<\/strong><\/p>\n<p>Are you interested in learning more about the Master of Public Health program at The Chicago School? Fill out the information below to request more information.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>A study conducted by Dr. Mudita Dave shows how the plight of Asian-Indian women immigrants demonstrates immigration policy\u2019s effect on public health.<\/p>\n","protected":false},"author":5,"featured_media":107347,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[114],"tags":[],"coauthors":[1039],"class_list":["post-14925","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-care","insight_authors-blake-pinto"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>When the American dream becomes a public health nightmare<\/title>\n<meta name=\"description\" content=\"A study conducted by Dr. Mudita Dave shows how 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