“Putting Band‐Aids on Things That Need Stitches”: Immigration and the Landscape of Care in Rural America

Growing numbers of immigrants work and live in rural, geographically isolated areas throughout the United States, places without previously settled immigrant populations. Rapid immigration to such areas already struggling with poverty, weak public infrastructures, and high concentrations of uninsured residents has given way to an increasingly precarious landscape of care. The neoliberal logics of American health care and contentious debates over immigration reform shape this landscape and condition relations among providers, immigrants, and others. Through what I call “band‐aid” care and the informal transactions that characterize it, such as rationing, bartering, hoarding, willful noncompliance, and goodwill, providers and immigrants counter these logics of exclusion and inequality by participating in the dynamic improvisation of care considered illicit and often prohibited under the market‐based economic rationale of health‐care provision. Social obligations and moral legitimacy benefit otherwise marginalized providers who engage in this landscape of care, while vulnerable immigrants gain entry and access to vital resources within this landscape through sociality and interdependence, which engender opportunities (however fraught) for living. Yet providers and immigrants understand band‐aid care to be necessary, just, moral, and legitimate in response to precarity characterized by geographical isolation, economic scarcity, civic inequality, market‐based health care, and exclusionary policies. [ immigration, health care, exclusion, social inequality, United States ]