2022

Citizenship, policy barriers limit access to healthcare for some California Latino, Asian immigrants


UCLA studies, co-authored by three UCLA FSPH faculty, find those who have been undocumented experience even greater levels of unequal work conditions.

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Two new studies, both co-authored by UCLA Fielding School of Public Health facultyexplore the link between citizenship status and access to health care among Latino and Asian immigrants in California. The studies are part of an on-going project led by the Fielding School's UCLA Center for Health Policy Research, the Research on Immigrant Health and State Policy Study, or RIGHTS, which analyzed the experiences of Latino and Asian immigrants in the state from 2018 to 2020.

In the first study, led by Dr. May Sudhinaraset, UCLA Fielding School of Public Health associate professor of community health sciences, researchers compared job opportunities and workplace conditions for immigrants based on whether they had ever had undocumented status.

Among immigrants who had ever been undocumented, 49.5% said they had been unable to apply for a job because of their status, compared to 21.6% of immigrants who had never been undocumented. In addition, immigrants who had ever been undocumented had significantly higher rates of:

  • Settling for a job that paid less than what they deserved (47.3% compared with 29.3% for those who were never undocumented).
  • Being injured at work (36.7% versus 22.1%).
  • Not getting paid for hours worked (28.1% versus 14.2%).
  • Being asked to perform dangerous job duties (22.1% versus 8.1%).

“Immigration status is an important factor not only in whether an individual gets hired and gains health insurance, but in terms of how they are treated at work and how that can harm their health,” said Sudhinaraset, a faculty associate at the center and lead author of the study. “Our research showed that many undocumented immigrants felt pressured to keep working while sick so they wouldn’t lose their jobs.”

The second study, co-authored by Dr. Michael Rodriguez, UCLA Fielding School of Public Health professor of community health sciences, and Dr. Nadereh Pourat, UCLA Fielding School of Public Health professor of health policy and management, examined perceptions of the so-called public charge rule among the state’s Latino and Asian immigrants, based on their immigration status — whether they were naturalized citizens, noncitizens with green cards or and noncitizens without green cards — and race. The federal government defines an immigrant who relies on specific types of public aid as a “public charge,” and that person can be denied a green card and the opportunity to become a U.S. citizen.

The researchers found that 67% of all respondents had negative perceptions and negative experiences related to the public charge rule.

The researchers also found:

  • 52% of Latino immigrants had negative perceptions of the public charge policy, but not negative experiences; compared to 44% of Asian immigrants who said they had negative perceptions only.
  • 26% of Latino immigrants reported having both negative perceptions and negative experiences related to the rule, compared to just 11% of Asian immigrants.
  • 21% of Latino immigrants said they had neither negative perceptions nor experiences related to the public charge rule, compared with 45% of Asian immigrants.

“Some immigrants are afraid to use public aid such as health care and food programs because of the public charge rule,” said Rodriguez, a faculty associate at the center and the lead author of the second study. “Although most immigrants in the U.S. are here legally and ‘public charge’ doesn’t apply to them, this confusing policy leads them to believe they will lose their path to permanent citizenship, and as a result they forgo benefits that affect their health and well-being.”

Both studies demonstrate that restrictive immigration policies affect immigrants’ experiences in California, regardless of their legal status. The authors write that federal and other government officials could tailor policies that avoid having adverse impacts such as deterring access to health care.

The new study draws data from the 2018, 2019 and 2020 California Health Interview Surveys, which also were conducted by the center.

In fall 2021, the Center for Health Policy Research published two fact sheets on immigrants’ experiences with law and immigration enforcement and their perceptions of the immigrant experience.

by Elaiza Torralba


The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 761 students from 26 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.

Faculty Referenced by this Article

Dr. May Sudhinaraset
May Sudhinaraset
Community Health Sciences
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Nadereh Pourat
Nadereh Pourat
Health Policy and Management
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Paul Chung
Paul Chung
Health Policy and Management
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Annette Maxwell
Health Policy and Management
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Emmeline Chuang
Health Policy and Management
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Dana Hunnes
Dana Hunnes
Community Health Sciences
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Michael Ong
Michael Ong
Health Policy and Management
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Dr. Jonathan Fielding
Jonathan Fielding
Health Policy and Management
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Dr. Michael Goldstein
Michael Goldstein
Community Health Sciences
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Burt Cowgill
Burt Cowgill
Health Policy and Management
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Cathy Lang
Cathy Lang

Assistant Dean for Research & Adjunct Associate Professor of Community Health Sciences

Community Health Sciences
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Dr. Michael Rodriguez
Michael Rodriguez
Community Health Sciences
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Clifford Ko
Clifford Ko
Health Policy and Management
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Dr. Chandra Ford
Chandra Ford
Community Health Sciences
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Dr. Aria Fallah
Aria Fallah
Health Policy and Management
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Michelle Keller
Michelle S. Keller

Dr. Michelle S. Keller is a health services researcher whose research focuses on the use and prescribing of high-risk medications.

Health Policy and Management
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Olivia Jung
Olivia Jung
Health Policy and Management
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Dr. William McCarthy
William J. McCarthy
Health Policy and Management
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Comanor, Bill
William Comanor
Health Policy and Management
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Kimberly Gregory
Kimberly Gregory
Community Health Sciences
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Mangione, C
Carol Mangione
Health Policy and Management
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Bo-Kyung Elizabeth Kim
Community Health Sciences
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Charlotte Neumann
Charlotte G. Neumann
Community Health Sciences
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Kadiyala, Srikanth
Srikanth Kadiyala
Health Policy and Management
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Corrina Moucheraud
Corrina Moucheraud
Health Policy and Management
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Ty Robbins
Health Policy and Management
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Sarah Blenner
Sarah Blenner

Director of Field Studies and Applied Professional Training

Community Health Sciences
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Pamela Davidson
Health Policy and Management
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Dr. Jennifer Wortham
Jennifer Wortham
Health Policy and Management
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May C. Wang
Community Health Sciences
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Dr. Anne Pebley
Anne Pebley
Community Health Sciences
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Sangeeta Ahluwalia
Sangeeta Ahluwalia
Health Policy and Management
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Dr. Kenneth Wells
Kenneth Wells
Health Policy and Management
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halbert, ronald
Ronald Halbert
Community Health Sciences
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Robert Kaplan
Robert Kaplan
Health Policy and Management
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Dr. John Lu
Z. John Lu
Health Policy and Management
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Robert Kim-Farley
Robert J. Kim-Farley

Robert J. Kim-Farley, MD, MPH, is a Professor-in-Residence with joint appointments in the Departments of Epidemiology and Community Health Sciences

Community Health Sciences Epidemiology
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Julie A. Elginer

EMPH Academic Program Director with expertise in healthcare marketing, finance, and reproductive health policy, teaching in the EMPH, MPH, MHA program

Health Policy and Management
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Diana Hilberman
Diana Hilberman
Health Policy and Management
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Emily Abel
Emily Abel
Health Policy and Management
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Freund, Deborah
Deborah Anne Freund
Health Policy and Management
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Jody Heymann
Jody Heymann
Epidemiology Health Policy and Management
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Roshan Bastani
Health Policy and Management
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Brennan Spiegel
Health Policy and Management
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glik, deborah
Deborah Glik
Community Health Sciences
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Ron D. Hays
Ron D. Hays

@UCLA since 1997

Health Policy and Management
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Philip Massey
Community Health Sciences
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Dr. Stephanie Taylor
Stephanie L. Taylor

Nationally recognized health services researcher and sociomedical scientist with 25+ years' experience in effectiveness and implementation research.

Health Policy and Management
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Dr. Elizabeth D'Amico
Elizabeth D’Amico
Community Health Sciences
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Mark Litwin
Health Policy and Management
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Moira Inkelas
Moira Inkelas
Health Policy and Management
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Dr. Ninez Ponce
Ninez Ponce
Health Policy and Management
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Dr. Jessica Gipson
Jessica Gipson
Community Health Sciences
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Jeanne Miranda
Jeanne Miranda
Health Policy and Management
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Neal Halfon
Health Policy and Management
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Dr. Randall Kuhn
Randall Kuhn
Community Health Sciences
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Kimberley Shoaf
Community Health Sciences
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Dr. Felicia Hodge
Felicia Hodge
Health Policy and Management
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Warren Scott Comulada
Warren Scott Comulada
Health Policy and Management
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Dr. Arturo Vargas Bustamante
Arturo Vargas Bustamante
Health Policy and Management
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Dr. Dylan Roby
Dylan Roby
Health Policy and Management
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Lori Pelliccioni
Health Policy and Management
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Alan Tomines
Health Policy and Management
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Ilan H. Meyer
Ilan H. Meyer
Community Health Sciences
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Dr. Frederick Zimmerman
Frederick Zimmerman
Health Policy and Management
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Dr. Elizabeth (Becky) Yano
Elizabeth (Becky) Yano
Health Policy and Management
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Dr. Donald Morisky
Donald E. Morisky
Community Health Sciences
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Barbara Berman
Health Policy and Management
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Vickie Mays
Vickie Mays
Health Policy and Management
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Laura Erskine
Laura Erskine
Health Policy and Management
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Dr. Shira Shafir
Shira Shafir
Community Health Sciences Epidemiology
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David Eisenman
David Eisenman
Community Health Sciences
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Dena Herman
Dena Herman
Community Health Sciences
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Paula Tavrow
Paula Tavrow
Community Health Sciences
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Dr. Xi Zhu
Xi Zhu
Health Policy and Management
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Jack Needleman
Jack Needleman
Health Policy and Management
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Courtney S. Thomas Tobin
Community Health Sciences
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Wendelin Slusser
Community Health Sciences
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Ondine S. von Ehrenstein
Community Health Sciences Epidemiology
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Dr. Anthony Schiff
Anthony Hunter Schiff
Health Policy and Management
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Sheba George
Community Health Sciences
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Robert Brook
Health Policy and Management
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David Hayes-Bautista
Health Policy and Management
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Dr. Joann Elmore
Joann G. Elmore
Health Policy and Management
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Virginia C. Li
Virginia C. Li
Community Health Sciences
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Jennifer A. Wagman
Jennifer A. Wagman
Community Health Sciences
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Dr. Lillian Gelberg
Lillian Gelberg
Health Policy and Management
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Dawn Upchurch
Community Health Sciences
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Susan Ettner
Health Policy and Management
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Isomi Miake-Lye
Isomi Miake-Lye
Health Policy and Management
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Dr. Hiram Beltrán-Sánchez
Hiram Beltrán-Sánchez
Community Health Sciences
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Dr. Kristen Choi
Kristen Choi
Health Policy and Management
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Leah Vriesman
Leah Vriesman
Health Policy and Management
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Dr. Thomas Rice
Thomas Rice
Health Policy and Management
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Natalie Muth
Community Health Sciences
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Dr. Alina Dorian
Alina Dorian
Community Health Sciences
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Dr. Samuel Sessions
Samuel Sessions
Health Policy and Management
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Aronberg, Sandra
Sandra Aronberg
Health Policy and Management
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Dr. Elizabeth Yzquierdo
Elizabeth Yzquierdo
Community Health Sciences
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Linda Rosenstock
Environmental Health Sciences Health Policy and Management
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Thomas D. Gordon
Health Policy and Management
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Dr. Samuel Stratton
Samuel Stratton
Community Health Sciences
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Arlene Fink
Health Policy and Management
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Jose J. Escarce
Health Policy and Management
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James Macinko
James Macinko

Professor of Community Health Sciences & Health Policy and Management, and Associate Dean for Research

Community Health Sciences Health Policy and Management
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Sean Darling-Hammond
Sean Darling-Hammond
Biostatistics Community Health Sciences
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Patricia Ganz
Patricia Ganz
Health Policy and Management
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Thomas Priselac
Health Policy and Management
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Dr. Beth Glenn
Beth Glenn
Health Policy and Management
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Dr. Dana Rose Garfin
Dana Rose Garfin
Community Health Sciences
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Gerald Kominski
Gerald Kominski
Health Policy and Management
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Dr. Gilbert Gee
Gilbert C. Gee
Community Health Sciences
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Marjorie Kagawa-Singer
Marjorie Kagawa-Singer
Community Health Sciences
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Jean Balgrosky
Health Policy and Management
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Ron Andersen

Dr. Ron Andersen is the Wasserman Professor Emeritus in the UCLA Departments of Health Policy and Management.

Health Policy and Management
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Avram Kaplan
Avram Kaplan
Health Policy and Management
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Dr. Yvonne Flores
Yvonne Flores
Health Policy and Management
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Steven Teutsch
Health Policy and Management
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Paul Fu, Jr.
Health Policy and Management
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Yusuke Tsugawa
Yusuke Tsugawa
Health Policy and Management
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Dr. Risha Gidwani
Risha Gidwani
Health Policy and Management
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Dr. Alice Kuo
Alice Kuo
Health Policy and Management
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Dr. Michael Prelip
Michael Prelip
Community Health Sciences
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Dr. Daniel Eisenberg
Daniel Eisenberg
Health Policy and Management
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Dr. Judith M. Siegel
Judith M. Siegel
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Michael Galper
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Naomi Zewde
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