There is growing evidence that Asian and Latinx immigrants' health and health care access is shaped by immigrant policies that determine their rights, protections, and access to resources and the extent to which they are targeted by policing or deportation based on citizenship/legal status and other immigration-related social categories. However, there is limited population-based evidence of how immigrants experience the direct consequences of policies, nor of the impact of such consequences on their health. Between 2018 and 2020, we conducted the Research on Immigrant Health and State Policy (RIGHTS) Study, developing a population-based survey of Asian and Latinx immigrants in California (n = 2010) that measured 23 exclusionary experiences under health care and social services, education, labor/employment, and immigration enforcement policies.
View Article and Find Full Text PDFRestrictive federal and state immigration policies create conditions of employment exclusion that may negatively influence the health of immigrants. In particular, these policy effects are reflected in labor market and workplace experiences that determine the types of work and employment opportunities that immigrants are able to access and pursue. This study examines the relationship between both cumulative and individual measures of employment exclusion and self-rated health and psychological distress among Asian and Latino immigrants in California, and whether this relationship is modified by legal status.
View Article and Find Full Text PDFFarmworkers in the U.S. experienced high rates of COVID-19 infection and mortality during the COVID-19 pandemic.
View Article and Find Full Text PDFUnlabelled: Policy Points Inclusive state immigrant policies that expand rights and resources for immigrants may improve population health, but little is known about their local-level implementation. Local actors that have anti-immigrant attitudes can hinder the implementation of state policies, whereas the persistent influence of anti-immigrant federal policies reinforces barriers to accessing health and other resources granted by state policies. Local actors that serve immigrants and support state policy implementation lack the resources to counter anti-immigrant climates and federal policy threats.
View Article and Find Full Text PDFObjectives: Immigration enforcement policies are associated with immigrants' barriers to health care. Current evidence suggests that enforcement creates a "chilling effect" in which immigrants avoid care due to fear of encountering enforcement. Yet, there has been little examination of the impact of immigrants' direct encounters with enforcement on health care access.
View Article and Find Full Text PDFIntroduction: Despite having worse healthcare access and other social disadvantages, immigrants have, on average, better health outcomes than U.S.-born individuals.
View Article and Find Full Text PDFAlthough exclusionary immigration policies are associated with fear of deportation and avoidance of public benefits, relationships between immigration enforcement policy and public charge policies are largely unknown. Using a California population-based survey of 1103 Asian and Latinx immigrants in 2018, we tested the relationship between immigrants' experiences with law enforcement and their concern about public charge. Direct encounters with various forms of law enforcement, including being asked to show proof of citizenship by law enforcement, staying inside to avoid police or immigration officials, and having known someone who had been deported, were associated with immigrants' avoidance of public benefits due to public charge concerns.
View Article and Find Full Text PDFObjective: To evaluate implementation of a community-engaged approach to scale up COVID-19 mass testing in low-income, majority-Latino communities.
Methods: In January 2021, we formed a community-academic "Latino COVID-19 Collaborative" with residents, leaders, and community-based organizations (CBOs) from majority-Latinx, low-income communities in three California counties (Marin/Merced/San Francisco). The collaborative met monthly to discuss barriers/facilitators for COVID-19 testing, and plan mass testing events informed by San Francisco's Unidos en Salud "test and respond" model, offering community-based COVID-19 testing and post-test support in two US-census tracts: Canal (Marin) and Planada (Merced).
Front Public Health
October 2022
As evidence of the negative health impact of immigration enforcement policy continues to mount, public health research has focused primarily on the psychosocial health mechanisms, such as fear and stress, by which immigration enforcement may harm health. We build on this research using structural vulnerability theory to investigate the structural processes by which enforcement policy may shape Latino immigrants' health. We conducted qualitative analysis of from a purposive sample of Latino immigrants (n=14) living in Southern California in 2015, a period of significant federal, state, and local enforcement policy change.
View Article and Find Full Text PDFRural Latinx immigrants experienced disproportionately negative health and economic impacts during the COVID-19 pandemic. They contended with the pandemic at the intersection of legal status exclusions from the safety net and long-standing barriers to health care in rural regions. Yet, little is known about how rural Latinx immigrants navigated such exclusions.
View Article and Find Full Text PDFEvidence shows that state-level restrictive immigrant policies are associated with health disparities between noncitizens and citizens. Most research has focused on Latinos and there is limited knowledge of the relationship between restrictive policies and citizenship status among other groups, particularly Asian and Pacific Islanders (API). We examined whether state-level criminalization policy contexts (e.
View Article and Find Full Text PDFU.S. food insecurity rates rapidly increased during the COVID-19 pandemic, with disproportionate impacts on Latino immigrant households.
View Article and Find Full Text PDFLack of trust in biomedical research, government, and health care systems, especially among racial/ethnic minorities and under-resourced communities, is a longstanding issue rooted in social injustice. The COVID-19 pandemic has further highlighted existing health and socioeconomic inequities and increased the urgency for solutions to provide access to timely, culturally, and linguistically appropriate evidence-based information about COVID-19; and ultimately to promote vaccine uptake. California's statewide alliance STOP COVID-19 CA (comprising eleven sites), leverages long standing community partnerships to better understand concerns, misinformation, and address racial/ethnic inequities in vaccine hesitancy and uptake.
View Article and Find Full Text PDFUnlabelled: Policy Points Although immigration policy is recognized as a social determinant of health, less is known about how mechanisms, such as news coverage of policy, influence intermediary and proximal health processes like seeking health care. The extent of news coverage of federal, state, and local exclusionary or integration immigration policies can influence public agendas regarding immigrant inclusion and exclusion. Exclusionary federal immigrant policies have dominated the news across the United States over the past ten years, despite active immigrant integration policymaking at national, state, and local levels.
View Article and Find Full Text PDFImportance: Criminalizing immigrant policies, a form of structural racism, are associated with preterm birth; however, to date, few population studies have examined this association by race and nativity status or examined the association of inclusive immigrant policies with preterm birth.
Objective: To assess the extent to which variation in preterm birth by race/ethnicity and nativity status is associated with state-level criminalizing vs inclusive immigrant policies.
Design, Setting, And Participants: This retrospective, cross-sectional study analyzed birth record data from all 50 states and the District of Columbia in 2018, as well as state-level indicators of inclusive and criminalizing immigrant policies.
Little is known about promotoras' professional experiences engaging in Latinx health promotion. In this promotora-led community-based participatory study, we purposively recruited and interviewed 30 Spanish-speaking promotoras who worked in Los Angeles County and who had at least 5 years of experience as promotoras. Using a constructivist grounded theory approach, findings revealed promotoras self-identified as health professionals who offered unique, insider perspectives.
View Article and Find Full Text PDFImportance: The association of state-level immigrant policies with uninsurance among Latino youths remains unknown.
Objective: To assess the association of state-level immigrant integration and criminalization policies with health insurance coverage among US-born Latino youths by maternal citizenship.
Design, Setting, And Participants: This cross-sectional study analyzed secondary data from the American Community Survey, January 1, 2016, to December 31, 2018, for US-born Latino youths (age, ≤17 years) and their mothers (age, 18-64 years) as well as state-level indicators of immigrant integration and criminalization policies (in all 50 states and the District of Columbia).
Background: In the last thirty years, major shifts in immigrant policy at national and state levels has heightened boundaries among citizens, permanent residents, and those with other statuses. While there is mounting evidence that citizenship influences immigrant health care inequities, there has been less focus on how policies that reinforce citizenship stratification may shape the extent of these inequities. We examine the extent to which the relationship between citizenship and health care inequities is moderated by state-level criminalization policies.
View Article and Find Full Text PDFBackground: Studies have observed that recent Latino immigrants tend to have a physical health advantage compared to immigrants who have been in the US for many years or Latinos who are born in the United States. An explanation of this phenomenon is that recent immigrants have positive health behaviors that protect them from chronic disease risk. This study aims to determine if trends in positive cardiovascular disease (CVD) risk behaviors extend to Latino immigrants in California according to citizenship and documentation status.
View Article and Find Full Text PDFBackground: Many conceptual frameworks that touch on immigration and health have been published over the past several years. Most discuss broad social trends or specific immigrant policies, but few address how the policy environment affects the context of settlement and incorporation. Research on the social determinants of health shows how policies across multiple sectors have an impact on health status and health services, but has not yet identified the policies most important for immigrants.
View Article and Find Full Text PDFWe examined the impact of Medicaid expansion on rates of the remaining uninsured at the federally qualified health center level by race/ethnicity, limited English proficiency, and poverty status of their patients. Results indicated a systematic disadvantage in nonexpansion states for federally qualified health centers with high concentrations of these populations and an advantage in expansion states for federally qualified health centers with fewer limited English proficiency patients. Our findings highlight the importance of maintaining the Affordable Care Act in reducing disparities in coverage and the importance of federal funding to continue services for the remaining uninsured and vulnerable populations in both expansion and nonexpansion states.
View Article and Find Full Text PDFBackground: Undocumented status is rarely measured in health research, yet it influences the lives and well-being of immigrants. The growing body of research on undocumented status and health shows the need to assess the measurement of this legal status. We discuss the definition of undocumented status, conduct a systematic review of the methodological approaches currently taken to measure undocumented status of immigrants in the USA, and discuss recommendations for advancement of measurement methods.
View Article and Find Full Text PDFPolicy-making related to immigrant populations is increasingly conducted at the state-level. State policy contexts may influence health insurance coverage by determining noncitizens' access to social and economic resources and shaping social environments. Using nationally representative data, we investigate the relationship between level of inclusion of state immigrant policies and health insurance coverage and its variation by citizenship and race/ethnicity.
View Article and Find Full Text PDFJ Urban Health
December 2017
In the USA, undocumented Latino immigrants may have poorer health because of barriers to health care, stressors, and detrimental effects of immigration enforcement. Previous immigrant health research, however, suggests that recently arrived Latino immigrants have better health than US-born Latinos and their health deteriorates over time. Given the current environments that undocumented immigrants face, legal status is a structural factor that likely influences the patterns of immigrant health.
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