Declared impact of the US President’s statements and campaign statements on Latino populations’ perceptions of safety and emergency care access

Abstract

Statements about building walls, deportation and denying services to undocumented immigrants made during President Trump’s presidential campaign and presidency may induce fear in Latino populations and create barriers to their health care access. To assess how these statements relate to undocumented Latino immigrants’ (UDLI) and Latino legal residents/citizens’ (LLRC) perceptions of safety and their presentations for emergency care, we conducted surveys of adult patients at three county emergency departments (EDs) in California from June 2017 to December 2018. Of 1,684 patients approached, 1,337 (79.4%) agreed to participate: 34.3% UDLI, 36.9% LLRC, and 29.8% non-Latino legal residents/citizens (NLRC). The vast majority of UDLI (95%), LLRC (94%) and NLRC (85%) had heard statements about immigrants. Most UDLI (89%), LLRC (88%) and NLRC (87%) either thought that these measures were being enacted now or will be enacted in the future. Most UDLI and half of LLRC reported that these statements made them feel unsafe living in the US, 75% (95% CI 70–80%) and 51% (95% CI 47–56%), respectively. More UDLI reported that these statements made them afraid to come to the ED (24%, 95% CI 20–28%) vs LLRC (4.4%, 95% CI 3–7%) and NLRC (3.5%, 95% CI 2–6%); 55% of UDLI with this fear stated it caused them to delay coming to the ED (median delay 2–3 days). The vast majority of patients in our California EDs have heard statements during the 2016 presidential campaign or from President Trump about measures against undocumented immigrants, which have induced worry and safety concerns in both UDLI and LLRC patients. Exposure to these statements was also associated with fear of accessing emergency care in some UDLIs. Given California’s sanctuary state status, these safety concerns and ED access fears may be greater in a nationwide population of Latinos.

Racial and/or Ethnic and Socioeconomic Disparities of SARS-CoV-2 Infection Among Children

“…Hispanic individuals also reported the highest rates of difficulty in avoiding public transportation, the lowest rates in ability to telework, and the highest rates of difficulty obtaining child care that was not with a group of children. 17 Along with the aforementioned reasons for these disparities, Hispanic children may have experienced the most pronounced burden of infection because of compounding additional factors, such as immigration status and language barriers. Furthermore, symptomatic adults may avoid testing because of fears of deportation.…”

“…Furthermore, symptomatic adults may avoid testing because of fears of deportation. 17,18 Future work to ensure equitable allocation of testing and culturally appropriate prevention education may help improve early identification, quarantine, and distribution of resources to reduce community spread of disease.…”

Challenges for Adult Undocumented Immigrants in Accessing Primary Care: A Qualitative Study of Health Care Workers in Los Angeles County

“…29 Preliminary findings from studies in these communities demonstrate that in spite of efforts to extend public health services, the ramifications of federal policy may limit utilization of these services among undocumented immigrants. 29,33 Los Angeles County (LA County) is home to > 1 million undocumented immigrants-the largest of any county in the United States. 34 LA County provides a safety-net system of care through the Department of Health Services (LAC-DHS), which serves all patients irrespective of ability to pay or immigration status.…”

“… 29 Preliminary findings from studies in these communities demonstrate that in spite of efforts to extend public health services, the ramifications of federal policy may limit utilization of these services among undocumented immigrants. 29 , 33 …”

Children in Immigrant Families: Advocacy Within and Beyond the Pediatric Emergency Department

“… 38 When states have enacted laws threatening immigrant families, such as with Arizona's SB1070 or Georgia's HB87, healthcare utilization among immigrant families decreased. 51 , 52 Likewise, restrictive policies, statements, and attitudes towards immigrant families coming from the Trump administration also undoubtedly affect families' comfort level with seeking medical care 53 and willingness to trust the health care system with their personal information. 46 Most recently, the amended Public Charge rule caused confusion and fear among immigrant families, leading to decreased utilization of healthcare, even by those not directly affected by the rule change.…”