“I fell down from where we used to live, a 2 story home. I suffered
dizziness and fell. Then I hurt my arm falling [pointing to
her right arm]. I went to the hospital and they never treated me
because of not having money [to pay for care]. I spent all day
there and then I had to come back [home without any care] and
so I took my husband's medicine for pain.”
Rosa uses Juan's prescription painkillers in order to manage her
injury after being turned away at a local private hospital for lacking
insurance or a down payment. Drawing on her husband's prescription
resources, Rosa mobilizes social capital to receive drugs
despite exclusion from a formal healthcare institution. Rosa's case
is a very clear example of how healthcare strategies using nondominant
kinds of CHC, here social capital, are activated in
response to exclusion from mainstream healthcare resources like
emergency rooms.
Using social networks to facilitate prescription drug access is
also a feature of following strategies for navigating healthcare on
the margins. Although many times patients themselves devise
ways of seeking prescription medication despite lacking health
insurance and other resources, often family and friends play a role
in nurturing health and navigating institutions. The common nature
of accounts like Rosa's and Louria's in the study illustrate how
familial and social capital are crucial parts of CHC in South Texas
Mexican American communities.
4.2. Seeking prescription drugs in Mexico
Given relatively higher prices of U.S. pharmaceuticals (Fullerton
and Miranda, 2011) and U.S. healthcare access barriers identified in
Latina/o immigrant health research, many South Texas border
residents (insured and uninsured) travel to Mexico for prescription
medication (Su et al., 2010). Two policies complicate the widespread
local practice of seeking medications in Mexico: pharmaceutical
importation policies and passport policies. Importation
policies outlined by the U.S. Food and Drug Administration and
enforced by Customs and Border Patrol require a U.S. physician's
prescription for most drugs (even non-narcotic basic health
maintenance drugs) and limit the amount and types of importable
drugs (21 C.F.R. x1301.26 (2004); CBP 2012; FDA 2011). Immigration
control policies requiring passports at border ports of entry add
costs to crossing to Mexico for prescription drugs ($55 per adult
and $40 per child for a passport card). Passport policies also mean
border crossing for prescription drugs is nearly impossible for unauthorized
immigrants living in Texas who lack appropriate visas to
reenter the U.S. after such a journey (Madden, 2013).
Mexican Americans in South Texas employ a range of strategies
that use familial, social, navigational, and linguistic capital to either
follow or undermine border policies. Mari is a 56-year-old unemployed
permanent U.S. resident from Mexico who has trouble