Key Points Question Did preterm births increase among Latina women who were pregnant during the 2016 US presidential election? Findings This population-based study used an interrupted time series design to assess 32.9 million live births and found that the number of preterm births among Latina women increased above expected levels after the election. Meaning The 2016 presidential election may have been associated with adverse health outcomes of Latina women and their newborns.

Scholars have expressed growing interest in the relationship between legal status stratification and health. Nevertheless, the extant research often lacks theoretical underpinnings. We propose the life-course perspective as a theoretical lens with which to understand relationships between legal status stratification and health outcomes. In particular, the life-course perspective guides researchers׳ attention to historical contexts that have produced differential social, political, and economic outcomes for immigrants based on legal status, and to the potentially long-term and intergenerational relationships between legal status stratification and health. We review four key dimensions of the life-course perspective and make recommendations for future directions in public health research on legal status and health.

PURPOSE Based on the recognition that food insecurity (FI) is associated with poor health across the life course, many US health systems are actively exploring ways to help patients access food resources. This review synthesizes findings from studies examining the effects of health care-based interventions designed to reduce FI. METHODS We conducted a systematic review of peer-reviewed literature published from January 2000 through September 2018 that described health carebased FI interventions. Standardized mean differences (SMD) were calculated and pooled when appropriate. Study quality was rated using Grading Recommendations Assessment Development and Evaluation criteria. RESULTS Twenty-three studies met the inclusion criteria and examined a range of FI interventions and outcomes. Based on study design and sample size, 74% were rated low or very low quality. Studies of referral-based interventions reported moderate increases in patient food program referrals (SMD = 0.67, 95% CI, 0.36-0.98; SMD = 1.42, 95% CI, 0.76-2.08) and resource use (pooled SMD = 0.54, 95% CI, 0.31-0.78). Studies describing interventions providing food or vouchers reported mixed results for the actual change in fruit/vegetable intake, averaging to no impact when pooled (-0.03, 95% CI,-0.66 to 0.61). Few studies evaluated health or utilization outcomes; these generally reported small but positive effects. CONCLUSIONS Although a growing base of literature explores health care-based FI interventions, the low number and low quality of studies limit inferences about their effectiveness. More rigorous evaluation of FI interventions that includes health and utilization outcomes is needed to better understand roles for the health care sector in addressing FI.

Objectives We determined the impact of premigration circumstances on postmigration psychological distress and self-rated physical health among Latino immigrants. Methods We estimated ordinary least squares and logistic regression models for Latino immigrants in the 2002/2003 National Latino and Asian American Study (n|=|1603). Results Mean psychological distress scores (range|=|10–50) were 14.8 for women and 12.7 for men; 35% of women and 27% of men reported fair or poor physical health. A third of the sample reported having to migrate; up to 46% reported unplanned migration. In multivariate analyses, immigration-related stress was significantly associated with psychological distress, but not with self-rated health, for both Latino men and women. Having to migrate was associated with increased psychological distress for Puerto Rican and Cuban women respondents and with poorer physical health for Puerto Rican migrant men. Unplanned migration was significantly associated with poorer physical health for all Latina women respondents. Conclusions The context of both pre- and postmigration has an impact on immigrant health. Those involved in public health research, policy, and practice should consider variation in immigrant health by migration circumstances, including the context of exit and other immigration-related stressors.

IMPORTANCE Current US immigration policy targets immigrants from Mexico and other Latin American countries; anti-immigration rhetoric has possible implications for the US-born children of immigrant parents. OBJECTIVE To assess whether concerns about immigration policy are associated with worse mental and physical health among US citizen children of Latino immigrants. DESIGN, SETTING, AND PARTICIPANTS This study of cohort data from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a long-term study of Mexican farmworker families in the Salinas Valley region of California, included a sample of US-born adolescents (n = 397) with at least 1 immigrant parent. These adolescents underwent a health assessment before the 2016 presidential election (at age 14 years) and in the first year after the election (at age 16 years). Data were analyzed from March 23, 2018, to February 14, 2019. EXPOSURES Adolescents aged 16 years self-reported their concern about immigration policy using 2 subscales (Threat to Family and Children's Vulnerability) of the Perceived Immigration Policy Effects Scale (PIPES) instrument. MAIN OUTCOMES AND MEASURES Resting systolic blood pressure, diastolic blood pressure, and mean arterial pressure; body mass index; maternal-and self-reported depression and anxiety problems (using Behavioral Assessment System for Children, 2nd edition); self-reported sleep quality (using Pittsburgh Sleep Quality Index [PSQI]); and maternal rating of child's overall health. All measures except sleep quality were assessed at both the aged-14-years and aged-16-years visits. Health outcomes at age 16 years and the change in outcomes between ages 14 and 16 years were examined among youth participants who reported low or moderate PIPES scores vs high PIPES scores. RESULTS In the sample of 397 US-born Latino adolescents (207 [52.1%] female) and primarily Mexican American individuals, nearly half of the youth participants worried at least sometimes about the personal consequences of the US immigration policy (n = 178 [44.8%]), family separation because of deportation (177 [44.6%]), and being reported to the immigration office (164 [41.3%]). Those with high compared with low or moderate PIPES scores had higher self-reported mean anxiety T scores (5.43; 95% CI, 2.64-8.23), higher maternally reported anxiety T scores (2.98; 95% CI, 0.53-5.44), and worse PSQI scores (0.98; 95% CI, 0.36-1.59). Youth participants with high PIPES scores reported statistically significantly increased levels of anxiety over the 2 visits (adjusted mean difference-indifferences, 2.91; 95% CI, 0.20-5.61) and not significantly increased levels of depression (adjusted mean difference-indifferences , 2.63; 95% CI,-0.28 to 5.54). CONCLUSIONS AND RELEVANCE Fear and worry about the personal consequences of current US immigration policy and rhetoric appear to be associated with higher anxiety levels, sleep problems, and blood pressure changes among US-born Latino adolescents; anxiety significantly increased after the 2016 presiden...

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Latino people in the US are experiencing higher excess deaths during the COVID-19 pandemic than any other racial/ethnic group, but it is unclear which sociodemographic subgroups within this diverse population are most affected. Such information is necessary to target policies that prevent further excess mortality and reduce inequities. Using death certificate data for January 1, 2016 through February 29, 2020 and time-series models, we estimated the expected weekly deaths among Latino people in California from March 1 through October 3, 2020. We quantified excess mortality as observed minus expected deaths and risk ratios (RR) as the ratio of observed to expected deaths. We considered subgroups categorized by age, sex, nativity, country of birth, educational attainment, occupation, and combinations of these factors. Our results indicate that during the first seven months of the pandemic, Latino deaths in California exceeded expected deaths by 10,316, a 31% increase. Excess death rates were greatest for individuals born in Mexico (RR 1.44; 95% PI, 1.41, 1.48) or a Central American country (RR 1.49; 95% PI, 1.37, 1.64), with less than a high school degree (RR 1.41; 95% PI, 1.35, 1.46), or in food-and-agriculture (RR 1.60; 95% PI, 1.48, 1.74) or manufacturing occupations (RR 1.59; 95% PI, 1.50, 1.69). Immigrant disadvantages in excess death were magnified among working-age Latinos in essential occupations. In sum, the COVID-19 pandemic has disproportionately impacted mortality among Latino immigrants, especially those in unprotected essential jobs. Interventions to reduce these inequities should include targeted vaccination, workplace safety enforcement, and expanded access to medical care and economic support.

SDH V codes are infrequently utilized in inpatient settings for discharges other than those related to mental health and alcohol/substance use. Utilization incentives will likely need to be developed to realize the potential benefits of cataloging SDH information.