Immigration policies and mental health morbidity among Latinos: A state-level analysis

Abstract

Rationale Despite abundant state-level policy activity in the U.S. related to immigration, no research has examined the mental health impact of the overall policy climate for Latinos, taking into account both inclusionary and exclusionary legislation. Objective To examine associations between the state-level policy climate related to immigration and mental health outcomes among Latinos. Methods We created a multi-sectoral policy climate index that included 14 policies in four domains (immigration, race/ethnicity, language, and agricultural worker protections). We then examined the relation of this policy climate index to two mental health outcomes (days of poor mental health and psychological distress) among Latinos from 31 states in the 2012 Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey of non-institutionalized individuals aged 18 years or older. Results Individuals in states with more exclusionary immigration policies had higher rates of poor mental health days than participants in states with less exclusionary policies (RR: 1.05, 95% CI: 1.00, 1.10). The association between state policies and the rate of poor mental health days was significantly higher among Latinos versus non-Latinos (RR for interaction term: 1.03, 95% CI: 1.01, 1.06). Furthermore, Latinos in states with more exclusionary policies had 1.14 (95% CI: 1.04, 1.25) times the rate of poor mental health days than Latinos in states with less exclusionary policies. Results were robust to individual- and state-level confounders. Sensitivity analyses indicated that results were specific to immigration policies, and not indicators of state political climate or of residential segregation. No relationship was observed between the immigration policy index and psychological distress. Conclusion These results suggest that restrictive immigration policies may be detrimental to the mental health of Latinos in the United States.

Health consequences of the US Deferred Action for Childhood Arrivals (DACA) immigration programme: a quasi-experimental study

“…The findings of large effects on mental health are consistent with results from observational studies showing rising symptoms of anxiety and depression with policies that raise the risk of deportation. [7][8][9][10][11][12][13][14][15] These findings could be of considerable importance in the current policy environ ment, with the USA broadening the legal infrastructure and human resources base needed to deport undocumented immigrants and restrict the entry of new migrants. 24,41 Additionally-as of the time of writing-the future of the DACA programme itself seems to be in doubt.…”

“…[3][4][5][6] In particular, the results of studies from both the USA and European settings suggest that immigration policies that raise the risk of deportation or place limits on legal rights and access to social services might raise the risk of poor mental health outcomes, such as depression and anxiety, and curtail access to health care more generally. [7][8][9][10][11][12][13][14][15] In recent years, the USA has witnessed substantial changes in policies towards undocumented immigrants. In June, 2012, the US Government initiated the Deferred Action for Childhood Arrivals (DACA) programme, which provided temporary work permits and freedom from deportation to individuals who met specific eligibility criteria (panel).…”

“…More generally, studies linking policies targeting undocumented migrants to health outcomes are generally descriptive, with the underlying causality less clear. [7][8][9][10][11][12][13][14][15] This broader question has gained significance in recent months, as fundamental changes in US immigration policy are being debated. 24,25 In this study we aimed to examine the consequences of the US DACA programme on self-reported overall and mental health among undocumented immigrants of Hispanic origin (who represent the majority of DACAeligible individuals).…”

Enhanced immigration enforcement in the USA and the transnational continuity of HIV care for Latin American immigrants in deportation proceedings

“…Once in the US, stressors related to their documentation status and the fear of family separation are prevalent, but can be especially harmful in states with more restrictive immigration legislation. 6 Isolation and the loss of established social or family networks can lead to substance use and unprotected sex with casual partners 7 . Among gender and sexual minorities, changing behavioral norms and the opportunity to live more openly in the US can lead to high risk behaviors and entrance into high transmission risk networks 8 .…”

“…Exclusionary policies have been associated with poor mental health outcomes, enhanced risk of HIV infection, and delays in HIV diagnosis and treatment 6,20–22 . Heterogeneity in immigration policy enforcement in different areas of the country (for example, rural vs urban, or liberal versus conservative jurisdictions) can have a profound effect on the risk of detention/deportation, access to social benefits, including basic health care and identification cards, and the stress associated with undocumented status 6,21 .…”