Background Given the anti-immigrant rhetoric and policy proposals by President Donald Trump during the 2016 presidential campaign and afterwards, his election to president in November 2016 and subsequent policy changes has affected immigrant families. In this study, we aim to better understand how post-election policy change may have impacted the health and well-being, including health and social service utilization, of Latino immigrants in Southeastern Michigan. Methods We conducted 28 in-depth interviews with frontline staff at two Federally Qualified Health Centers and a non-profit agency. These staff had intimate knowledge of and insights into the lived experiences of the mixed-status immigrant families they serve. The interviews were audio recorded, transcribed, and analyzed thematically. Results Our findings show three major themes: (1) An increased and pervasive fear of deportation and family separation among mixed-status immigrant clients, (2) The fear of deportation and family separation has resulted in fractures in community cohesion, and (3) Fear of deportation and family separation has had an impact on the healthcare utilization and health-related behaviors of mixed-status families. Staff members report that these three factors have had an impact on physical and mental health of these immigrant clients. Conclusions These results add to previous literature on the effect of immigration policies on the health and provide key insights for interventions to improve the health of immigrants within this socio-political environment.

Immigration-and enforcement-related policies and laws have significantly and negatively impacted the health and well-being of undocumented immigrants. We examine barriers and facilitators to healthcare and social services among undocumented Latino(a)/Latinx immigrants specifically in the post 2016 US presidential election socio-political climate. By grounding our study on the perspectives of frontline providers, we explore their challenges in meeting the needs of their undocumented clients. These include client access to healthcare and social services, the barriers providers face in providing timely and effective services, and avenues to reduce or overcome factors that impede service provision to improve quality of care for this population. Data are from 28 in-depth interviews with frontline healthcare and social service providers. Based on data analysis, we found that the domains of the Three Delays Model used in obstetric care provided a good framework for organizing and framing the responses. Our findings suggest that these undocumented clients encounter three phases of delay: delay in the decision to seek care, delay in identifying and traveling to healthcare facilities, and delay in receiving adequate and appropriate care at healthcare facilities. Given the current socio-political climate for immigrants, healthcare and social services organizations that serve undocumented clients should adapt existing services or introduce new services, including those that are not site-based.

Rising hostility towards immigrants characterised the 2016 Presidential election in the United States (US) and subsequent policy priorities by the new presidential administration. The political shift towards aggressive policies targeting undocumented immigrants is far-reaching and extends into other communities that convive con-or coexist with-immigrant communities. Our study aims to examine the rippling effects of these anti-immigrant policies and rhetoric on health and social service providers in Southeast Michigan who predominantly serve Latino immigrants. Between April and August 2018, we conducted in-depth individual interviews in two Federally Qualified Health Centers and a non-profit social service agency at a county health department. We interviewed 28 frontline health and social service providers. After coding and thematic analyses, we found that staff members' experiences in supporting immigrant clients was congruent with definitions of secondary trauma stress and compassion fatigue, whereby exposure to clients' trauma combined with job burden subsequently impacted the mental health of providers. Major themes included: (a) frontline staff experienced a mental and emotional burden in providing services to immigrant clients given the restrictive anti-immigrant context; and (b) this burden was exacerbated by the increased difficulties in providing these services to their clients. Staff described psychological and emotional distress stemming from exposure to clients' immigration-related trauma and increased mental health needs. This distress was exacerbated by an increased demand to meet clients' needs, which involved explaining or translating documents into English, assisting with legal paperwork, referring clients to mental health resources, addressing increased transportation barriers, and reestablishing trust with the community. Our findings add qualitative data on the mental health implications for frontline providers who support Latino immigrant clients impacted by immigration and highlights the need for further research and resources that address the workplace-related stress generated by heightened immigration enforcement.

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