State-level immigration and immigrant-focused policies as drivers of Latino health disparities in the United States

Abstract

There has been a great deal of state-level legislative activity focused on immigration and immigrants over the past decade in the United States. Some policies aim to improve access to education, transportation, benefits, and additional services while others constrain such access. From a social determinants of health perspective, social and economic policies are intrinsically health policies, but research on the relationship between state-level immigration-related policies and Latino health remains scarce. This paper summarizes the existing evidence about the range of state-level immigration policies that affect Latino health, indicates conceptually plausible but under-explored relationships between policy domains and Latino health, traces the mechanisms through which immigration policies might shape Latino health, and points to key areas for future research. We examined peer-reviewed publications from 1986 to 2016 and assessed 838 based on inclusion criteria; 40 were included for final review. These 40 articles identified four pathways through which state-level immigration policies may influence Latino health: through stress related to structural racism; by affecting access to beneficial social institutions, particularly education; by affecting access to healthcare and related services; and through constraining access to material conditions such as food, wages, working conditions, and housing. Our review demonstrates that the field of immigration policy and health is currently dominated by a "one-policy, one-level, one-outcome" approach. We argue that pursuing multi-sectoral, multi-level, and multi-outcome research will strengthen and advance the existing evidence base on immigration policy and Latino health.

Documenting best practices for maintaining access to HIV prevention, care and treatment in an era of shifting immigration policy and discourse

“…State level policy can mitigate some of the felt effects of federal level changes in the policy landscape. State action has symbolic significance, communicating whether immigrants are welcome regardless of their status [17]. California has positioned itself in opposition to the Trump administration and its anti-immigrant policies, with the California State Senate passing a "sanctuary state" bill on April 3, 2017, and allocating $12 million the same day to provide legal defense to immigrants on the border fighting deportation proceedings.…”

The Mental Health Implications of Living in the Shadows: The Lived Experience and Coping Strategies of Undocumented African Migrant Women

“…More recently, the challenges associated with being undocumented have been compounded by an increased visibility and normalization of xenophobic, racist and nativist sentiments in the U.S. [10][11][12]. Consequently, undocumented immigrants must cope with a variety of complex stressors resulting from restrictive and punitive policies as well as an increasingly hostile environment [13,14]. Yet, there is a paucity of evidence on how the current sociopolitical environment created by restrictive policies and hostile rhetoric might impact the psychological well-being of African undocumented immigrants.…”

Severe sociopolitical stressors and preterm births in New York City: 1 September 2015 to 31 August 2017

“…Severe stress, induced by social and economic threats, interpersonal violence and hate crimes, can increase risk of preterm birth (PTB; gestation <37 weeks), especially spontaneous PTB, 1–4 as can severe sociopolitical stressors (ie, stressors that arise from political leaders’ threatening rhetoric or from political legislation 3 5 ). Recent changes in such stressors, as tied to the US 2016 presidential election and its aftermath, 5–11 including heightened anti-immigrant, anti-Hispanic and anti-Muslim policies, discrimination and hate crimes, 5–11 could potentially constitute severe sociopolitical stressors with adverse impacts on health, including increased PTB rates. 3–8 Such stressors could result in greater relative increases in risk among immigrant versus native-born populations, even if the former’s absolute rates remain lower (due to the well-known ‘healthy immigrant’ effect 12 ).…”