The Impact of Punitive Immigrant Laws on the Health of Latina/o Populations

The role of states in U.S. immigration: A study of population dynamics and subnational immigration laws

Legislative action on issues of immigration emerged prominently across and within US states throughout the 2000s. The emerging literature on this topic demonstrates the political motivations driving anti-immigrant laws that negatively impact the mobility of Hispanic/Latino and Foreign-born populations across US states. Considerable research identifies the political mechanisms driving restrictive state-level immigration policies. Despite the growth of this scholarly work, the impact of these laws within states requires further study. This paper broadens the approach to the study of restrictive state-level omnibus immigration laws (OILs) using a rich dataset to uncover the effects of these laws on compositional change for undocumented, foreign-born, and Hispanic/Latino populations from 2005 to 2017. Using a quasi-experimental design, I show that by passing omnibus immigration laws, states shape demographic patterns of Foreign-born populations. Specifically, I find that states that pass omnibus immigration laws experience a decrease in undocumented and Foreign-born populations relative to states that did not pass similar laws. Effects are estimated each year after the passage of OILs, providing additional insight into the temporal impact of omnibus immigration laws on the settlement patterns of these groups. I conclude by discussing the theoretical implications of the multiple interior immigration law and policies, specifically at the state level, and their salience in shaping population dynamics across the United States.

Structural interventions that affect racial inequities and their impact on population health outcomes: a systematic review

Structural racism is the historical and ongoing reinforcement of racism within society due to discriminatory systems and inequitable distribution of key resources. Racism, embedded within institutional structures, processes and values, perpetuates historical injustices and restricts access to structural factors that directly impact health, such as housing, education and employment. Due to the complex and pervasive nature of structural racism, interventions that act at the structural level, rather than the individual level, are necessary to improve racial health equity. This systematic review was conducted to evaluate the effects of structural-level interventions on determinants of health and health outcomes for racialized populations. A total of 29 articles are included in this review, analyzing interventions such as supplemental income programs, minimum wage policies, nutrition safeguard programs, immigration-related policies, and reproductive and family-based policies. Most studies were quasi-experimental or natural experiments. Findings of studies were largely mixed, although there were clear benefits to policies that improve socioeconomic status and opportunities, and demonstrable harms from policies that restrict access to abortion or immigration. Overall, research on the effects of structural-level interventions to address health inequities is lacking, and the evidence base would benefit from well-designed studies on upstream policy interventions that affect the structural determinants of health and health inequities and improve daily living conditions.

Immigrant-Related Policies and the Health Outcomes of Latinx Adults in the United States: A Systematic Review

BACKGROUND

US federal and subfederal immigrant-related policy activity has increased in recent years. We hypothesize that these policies are structural determinants of health for Latinx communities, operating through access to resources, discriminatory enforcement, and stress.

METHODS

We searched seven databases for quantitative studies, published as of September 2021, examining the association between the presence of federal, state, or local immigrant-related policy(ies), over time or cross-sectionally, and mental or physical health outcomes among immigrant or US-born Latinx adults. We rated studies on methodologic quality.

RESULTS

Eleven studies were included. Policies included federal and state policies. Health outcomes included mental health (seven studies), self-rated health (n = 6), and physical disability (n = 1). Among immigrant, noncitizen, or Spanish-preferring Latinx adults, exclusionary policies were associated with poor self-rated health, physical disability, and poor mental health. Inclusive policies were associated with better health, although null findings were more common than among studies of exclusionary policies. Only three studies separately examined policy effects on US-born or citizen Latinx adults and these findings were often null. All studies received a weak overall study quality rating; among quality domains, studies were strongest in confounding control and weakest in outcome information bias and reporting missing data approaches.

CONCLUSIONS

These results support the hypothesis that immigrant-related policies, especially exclusionary policies, are structural drivers of health for immigrant or noncitizen Latinx adults. However, evidence is scant among US-born or citizen Latinx adults. Studies of policies and physical health outcomes besides disability are lacking, as are results disaggregated by nativity and/or citizenship status.

State Preemption of Municipal Laws and Policies that Protect Immigrant Communities: Impact on Latine Health and Well-Being in North Carolina

BACKGROUND

Some U.S. municipalities have proclaimed themselves "sanctuary cities" and/or adopted laws and policies limiting local involvement in enforcement of federal immigration policies. Several states, however, have adopted laws that preempt municipal laws and policies designed to protect immigrants. We explored the consequences of House Bill (H.B.) 318, one such preemption law in North Carolina (NC), on the health and well-being of Latine immigrants.

METHODS

We conducted focus groups with Latine immigrants (n=49) and in-depth interviews with representatives from health, social service, and immigrant-serving organizations and local government (including law enforcement) (n=21) in NC municipalities that, before HB 318, adopted laws and policies supporting immigrants. Data were analyzed using constant comparison.

RESULTS

Twelve themes emerged, including the positive impacts of municipal sanctuary laws and policies are limited by preemption and other state and federal actions; laws and policies like HB 318 are confusing, have a chilling effect on health services use, and make life harder overall for Latine communities; intensified federal immigration enforcement has increased fear among Latine communities; Trump administration policies worsened anti-immigrant climates; and use of community identification cards and greater information dissemination and inter-organization coordination can lessen the consequences of preemption and other restrictive laws and policies.

CONCLUSION

State preemption of protective municipal laws and policies negatively and profoundly affects immigrant health and well-being. However, creative strategies have been implemented to respond to preemption. These findings provide critical data for decision-makers and community leaders regarding the detrimental impacts of preemption laws and mitigation of these impacts.

Recasting the Immigrant Health Paradox Through Intersections of Legal Status and Race

Immigrant health research has often noted an "immigrant health paradox", the observation that immigrants are "healthier" compared to their native-born peers of similar demographic and socioeconomic profile. This paradox disappears as immigrants stay longer in the host country. Multiple arguments, including migrant selectivity and cultural and behavioral factors have been proposed as reasons for the apparent paradox. Recently, the field has focused on immigrant legal status, especially its racialization. We review the literature on the immigrant health paradox, legal status, and racialized legal status to examine how this debate has taken a more structural approach. We find that immigrant health research has taken a needed intersectional approach, a productive development that examines how different markers of disadvantage work concurrently to shape immigrants' health. This approach, which factors in immigration enforcement practices, aligns with explanations for poor health outcomes among other racialized groups, and promises a fruitful avenue for future research.

Public Benefit Use and Social Needs in Hospitalized Children With Undocumented Parents

BACKGROUND AND OBJECTIVES

Studies supporta recent decline in public benefit enrollment among immigrant families. We aimed to describe health and resource use, barriers to use, and immigration-related fear in families with undocumented parents compared with families without undocumented parents. We also aimed to assess associations with discontinuation of public benefits and fear of deportation.

METHODS

We assessed immigration concerns and enrollment in Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with an 89-item anonymous, cross-sectional survey of English- and Spanish-speaking caregivers of hospitalized children. Multivariable logistic regression was used to assess associations with discontinuation of public benefits and fear of deportation.

RESULTS

Of 527 families approached, 399 enrolled (105 with 1 or more undocumented parent, 275 with no undocumented parent, and 19 with undisclosed immigration status). Compared with families without undocumented parents, families with undocumented parents had higher levels of poverty and food insecurity. Controlling for perceived eligibility, public benefit use was similar across groups. Of families with undocumented parents, 29% reported public benefit discontinuation because of immigration concerns, and 71% reported fear of deportation. Having an undocumented parent was associated with public benefit disenrollment (odds ratio: 46.7; 95% confidence interval: 5.9-370.4) and fear of deportation (odds ratio: 24.3; 95% confidence interval: 9.6-61.9).

CONCLUSIONS

Although families with undocumented parents had higher levels of poverty and food insecurity compared with families without undocumented parents, public benefit use was similar between groups. Immigration-related fear may be a barrier to public benefit use in this population.

COVID-19 Imperils Access to Health and Human Services in El Paso, Texas and New York City: Perspectives from Hispanic Parents

Low-income Hispanic communities are disproportionately impacted by the COVID-19 pandemic through exacerbated financial vulnerabilities and health challenges. The aim of this study is to assess and compare the self-reported impact and challenges caused by COVID-19 in Mexican-origin parents in New York City (NYC), NY and El Paso, TX. Data is based on routine follow-up calls used to assess uptake of the HPV vaccine and COVID-19 concerns conducted between March and August 2020. Three salient themes emerged: (1) financial insecurities; (2) emotional distress associated with COVID-19; and (3) limited access to health and human services. This study revealed increased financial insecurities and emotional distress, and disruptions to health and human services to low-income Mexican-born parents during the pandemic.

Immigration status as a health care barrier in the USA during COVID-19

In the context of the United States of America (U.S.), COVID-19 has influenced migrant experiences in a variety of ways, including the government's use of public health orders to prevent migration into the country and the risk of immigrants contracting COVID-19 while in detention centers. However, this paper focuses on barriers that immigrants of diverse statuses living in the U.S.—along with their families—may face in accessing health services during the pandemic, as well as implications of these barriers for COVID-19 prevention and response efforts. We report findings from a scoping review about immigration status as a social determinant of health and discuss ways that immigration status can impede access to health care across levels of the social ecology. We then develop a conceptual outline to explore how changes to federal immigration policies and COVID-19 federal relief efforts implemented in 2020 may have created additional barriers to health care for immigrants and their families. Improving health care access for immigrant populations in the U.S. requires interventions at all levels of the social ecology and across various social determinants of health, both in response to COVID-19 and to strengthen health systems more broadly.

(Il)legality and psychosocial well-being: Central Asian migrant women in Russia

Legal status has shown far-reaching consequences for international migrants' incorporation trajectories and outcomes in Western contexts. In dialogue with the extant research, we examine the implications of legal status for subjective well-being of Central Asian migrant women in the Russian Federation. Using survey data collected through respondent-driven sampling in two large cities, we compare migrants with regularized and irregular legal statuses on several interrelated yet distinct dimensions of subjective well-being. We find that, regardless of other factors, regularized status has a strong positive association with migrants' perception of their rights and freedoms but not with their feeling of being respected in society. Regularized status is positively associated with self-efficacy and negatively with depression. Yet, no net legal status difference is found in migrants' views on their relations with other migrants or on treatment of migrants by native-borns. The findings are situated within the cross-national scholarship on the ramifications of racialized immigrant (il)legality and its implications for membership and belonging.

The adverse health effects of punitive immigrant policies in the United States: A systematic review

BACKGROUND

Immigrants in the United States (US) today are facing a dynamic policy landscape. The Trump administration has threatened or curtailed access to basic services for 10.5 million undocumented immigrants currently in the US. We sought to examine the historical effects that punitive laws have had on health outcomes in US immigrant communities.

METHODS

In this systematic review, we searched the following databases from inception-May 2020 for original research articles with no language restrictions: Ovid MEDLINE, Ovid EMBASE, Cochrane Library (Wiley), Web of Science Core Collection (Clarivate), CINAHL (EBSCO), and Social Work Abstracts (Ovid). This study is registered with PROSPERO, CRD42019138817. Articles with cohort sizes >10 that directly evaluated the health-related effects of a punitive immigrant law or policy within the US were included.

FINDINGS

6,357 studies were screened for eligibility. Of these, 32 studies were selected for inclusion and qualitatively synthesized based upon four themes that appeared throughout our analysis: (1) impact on healthcare utilization, (2) impact on women's and children's health, (3) impact on mental health services, and (4) impact on public health. The impact of each law, policy, mandate, and directive since 1990 is briefly discussed, as are the limitations and risk of bias of each study.

INTERPRETATION

Many punitive immigrant policies have decreased immigrant access to and utilization of basic healthcare services, while instilling fear, confusion, and anxiety in these communities. The federal government should preserve and expand access for undocumented individuals without threat of deportation to improve health outcomes for US citizens and noncitizens.

Legal Violence, Health, and Access to Care: Latina Immigrants in Rural and Urban Kansas

Using interviews and ethnography started in 2016 in rural and urban Kansas, we examine the consequences of an amplified immigration enforcement combined with a local limited health care infrastructure that reproduce legal violence manifesting on Latina immigrants' health, access to care, and community participation. We highlight the conditions rooted in place that generate short- and long-term negative impacts for Latina immigrants' health. Fear and anxiety about the deportation of themselves and their family members make them ill and also generate apprehension about contacting medical institutions, driving, and spending time in public spaces. These circumstances coalesce in women's lives to block access to medical care and undermine women's roles in their communities. Following gendered expectations, women turn to their informal networks to seek health care for their families. In the context that the enforcement regime has created, these ties can turn exploitative.

Emotional and physical reactions to perceived discrimination, language preference, and health-related quality of life among Latinos and Whites

PURPOSE

To investigate whether emotional and physical reactions to perceived discrimination are associated with health-related quality of life (HRQOL) among whites and Latinos (by language preference) in Arizona.

METHODS

A cross-sectional analysis using the Arizona Behavioral Risk Factor Surveillance System (2012-2014) was restricted to non-Hispanic white and Latino (grouped by English- or Spanish-language preference) participants who completed the Reactions to Race optional module (N = 14,623). Four core items from the Centers for Disease Control and Prevention's Healthy Days Measures were included: self-rated health; physically unhealthy, mentally unhealthy; and functionally limited days. Poisson regression models estimated prevalence ratios and 95% confidence intervals (CIs) for poor self-rated health. Multinomial logistic models estimated odds ratios and 95% CI for poor mental, physical, and functionally limited days (defined as 14 + more days). Models were adjusted for sociodemographics, health behaviors, and multimorbidity.

RESULTS

Reports of emotional and physical reactions to perceived discrimination were highest among Spanish-language preference Latinos. Both Spanish- and English-language preference Latinos were more likely to report poor self-rated health in comparison to whites. In separate fully adjusted models, physical reactions were positively associated with each HRQOL measure. Emotional reactions were only associated with reporting 14 + mental unhealthy (aOR 3.16; 95% CI 1.82; 5.48) and functionally limited days (aOR 1.93; 95% CI 1.04, 3.58).

CONCLUSIONS

Findings from this study suggest that physical and emotional reactions to perceived discrimination can manifest as diminished HRQOL. Consistent collection of population-based measures of perceived discrimination is warranted to track and monitor differential health vulnerability that affect Latinos.

Policies of Exclusion: Implications for the Health of Immigrants and Their Children

Public policies play a crucial role in shaping how immigrants adapt to life in the United States. Federal, state, and local laws and administrative practices impact immigrants' access to education, health insurance and medical care, cash assistance, food assistance, and other vital services. Additionally, immigration enforcement activities have substantial effects on immigrants' health and participation in public programs, as well as effects on immigrants' families. This review summarizes the growing literature on the consequences of public policies for immigrants' health. Some policies are inclusive and promote immigrants' adaptation to the United States, whereas other policies are exclusionary and restrict immigrants' access to public programs as well as educational and economic opportunities. We explore the strategies that researchers have employed to tease out these effects, the methodological challenges of undertaking such studies, their varying impacts on immigrant health, and steps that can be undertaken to improve the health of immigrants and their families.

Caught in the Middle: Spanish-Speaking Bilingual Mental Health Counselors as Language Brokers

Literature regarding language brokering has primarily focused on family and community members serving as language brokers. However, bilingual mental health counselors often find themselves serving as language brokers as well. In this article we focus on bilingual mental health counselors who work with the growing Spanish-speaking immigrant population in the United States. We examine bilingual counselors without formal training in Spanish who serve as language brokers, and examine the ethical and professional challenges they face. Such challenges highlight the complexities of living in two worlds and providing psychological services in two languages. In examining their roles as language brokers, we discuss implications for future mental health counseling practice, training, and research. We present the ¡BIEN! Bilingual and Bicultural Counseling Services model for training counselors to deliver services to Spanish-speaking clients, along with recommendations for training programs.

Latina young adults' use of health care during initial months in the United States

We examined social ecological predictors of health care utilization among Latina young adults during their initial year after immigration to the United States. Participants were 530 Latinas (ages 18-23) who immigrated to Miami-Dade County, Florida, 11.5 months before assessment. We used multiple logistic regression to test predictors of health care usage. Approximately 36% utilized care. Dimensions of marianismo differentially associated with usage. Usage also was more likely for participants who reported more social network attachment, better health, greater neighborhood cohesion, and possessed a job and health insurance. Findings inform interventions to increase health care usage globally among women after immigration.