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OBJECTIVE: To describe experiences of Latina women who were currently pregnant or recently gave birth around discrimination, anti-immigrant policies, and community violence during the early COVID-19 pandemic. DESIGN: Qualitative secondary analysis. SETTING: Online or phone interviews. PARTICIPANTS: Latina women who were currently pregnant or recently gave birth (N = 26). METHODS: We used reflexive thematic analysis to examine transcribed data from semistructured interviews conducted during the early COVID-19 pandemic with a subgroup of participants enrolled in a larger study related to prenatal care. Participants were English- or Spanish-speaking, Medicaid-eligible, Latina-identifying women who resided in Fresno County, California. We analyzed responses to questions about personal discrimination, the Black Lives Matter movement, and immigration policies using the theoretical frameworks of critical race theory and the political economy of health. RESULTS: We identified four major themes: Avoidance of Community Engagement, Chronic Fear and Vigilance, The Role of Media, and Everyday Discrimination and Injustice. CONCLUSION: Participant experiences reflect the pervasiveness of fear and socioeconomic inequity and call attention to the racialized structures that affect health and health care access for Latina women. These exposures during the perinatal period may have intergenerational effects. These findings underscore the need for responsive and race-conscious perinatal nursing care for Latina women, assessment of the effect of the current sociopolitical environment on well-being, and policies that support equitable access to health and social care.

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Restrictive immigration policies harm the mental health of undocumented immigrants and their U.S. citizen family members. As a sociopolitical stressor, threat to family due to immigration policy can heighten anxiety, yet it is unclear whether political engagement helps immigrant-origin students to cope. We used a cross-sectional survey of college students from immigrant families (N = 2,511) to investigate whether anxiety symptomatology was associated with perceived threat to family and if political engagement moderated this relationship. We stratified analyses by self/parental immigration statuses-undocumented students, U.S. citizens with undocumented parents, and U.S. citizens with lawfully present parents-to examine family members' legal vulnerability. Family threat was significantly associated with anxiety; higher levels of political engagement reduced the strength of this relationship. However, this moderation effect was significant only for U.S. citizens with lawfully present parents. These findings emphasize the importance of the family immigration context in shaping individuals' mental health outcomes.

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Research shows that restrictive immigration policies and practices are associated with poor health, but far less is known about the relationship between inclusive immigration policies and health. Using data from the United States natality files, we estimate associations between state laws granting undocumented immigrants access to driver's licenses and perinatal outcomes among 4,047,067 singleton births to Mexican and Central American immigrant birthing people (2008-2021). Fitting multivariable log binomial and linear models, we find that the implementation of a license law is associated with improvements in low birthweight and mean birthweight. Replicating these analyses among U.S.-born non-Hispanic White birthing people, we find no association between the implementation of a license law and birthweight. These findings support the hypothesis that states' extension of legal rights to immigrants improves the health of the next generation.

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The CDC recommends that persons aged 13-64 receive an HIV test at least once in their lifetime and that some groups test annually or more frequently. Nearly one-half of US Latino immigrants have never been tested for HIV. To the extent that immigration-related laws deter documented and undocumented immigrants from engaging in communicable disease control measures, these laws undermine public health efforts. 1750 noncitizen adult, sexually active, Spanish-speaking Latino immigrants across four cities in the US completed a cross-sectional survey assessing perceptions of immigration-related laws and immigration consequences related to HIV testing and diagnosis. Participants were recruited in-person by staff in community settings, through flyers posted in places frequented by Latino immigrants, and by word-of-mouth through snowball sampling. Outcomes were whether participants had ever received an HIV test and whether they tested in the previous 12 months. Multivariable analyses examined the relative contribution of perceived immigration laws and consequences on HIV testing behaviors when considering established predictors of HIV testing. Perceptions of HIV-related immigration laws and immigration consequences was a significant predictor of never having had an HIV test even when considered relative to common predictors of HIV testing. The influence of perceived immigration laws and consequences on testing in the previous 12 months was not significant in multivariable analysis. Perceived HIV-related immigration laws and consequences appear to be a substantial contributor to reluctance to be tested for HIV among Latino immigrants who have never been tested. Effective interventions should be developed to address these.

RESUMEN: El CDC recomienda que las personas de 13 a 64 años se hagan una prueba del VIH al menos una vez en la vida y que algunos grupos se hagan la prueba anualmente o con mayor frecuencia. Casi la mitad de los inmigrantes latinos de los Estados Unidos nunca se han hecho la prueba del VIH. En la medida en que las leyes relacionadas con la inmigración disuadan a los inmigrantes documentados e indocumentados de participar en medidas de control de enfermedades transmisibles, estas leyes socavan los esfuerzos de salud pública. 1750 inmigrantes latinos adultos no ciudadanos, sexualmente activos y de habla hispana en cuatro ciudades de EE. UU. completaron una encuesta transversal que evaluó las percepciones de las leyes relacionadas con la inmigración y de las consecuencias de la inmigración relacionadas con las pruebas y el diagnóstico del VIH. Los participantes fueron reclutados en persona en contextos comunitarios, a través de volantes publicados en lugares frecuentados por inmigrantes latinos y de boca en boca a través de muestras de bola de nieve. Las variables dependientes fueron si los participantes se habían hecho una prueba del VIH alguna vez y si se habían hecho la prueba en los últimos 12 meses. Los análisis multivariados examinaron la contribución relativa de la percepción de las leyes de inmigración y de las consecuencias de inmigración sobre los comportamientos relativo a las pruebas del VIH, controlando por predictores conocidos de las pruebas del VIH. Las percepciones de las leyes de inmigración relacionadas con el VIH y las consecuencias de la inmigración fueron un predictor significativo de nunca haberse realizado una prueba del VIH, aun considerando los predictores comunes de la prueba del VIH. La influencia de la percepción de las leyes de inmigración y de las consecuencias de la inmigración sobre la prueba en los últimos 12 meses no fue significativa en el análisis multivariado. Las leyes de inmigración y las consecuencias percibidas relacionadas con el VIH parecen contribuir sustancialmente a la renuencia a hacerse la prueba del VIH entre los inmigrantes latinos que nunca se han hecho la prueba. Deben desarrollarse intervenciones efectivas para abordar esta renuencia.

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BACKGROUND: Using healthcare, whether for routine preventative examinations, chronic condition management, or emergent conditions, is an essential element of achieving and maintaining health. Over 44 million migrants live in the US today and nearly half (44.6 %) are Latino. To the extent that immigration law-related concerns deter US Latino migrants from using healthcare, they jeopardize the health of a substantial though marginalized US subpopulation. METHODS: A multistate sample (N = 1750) of noncitizen adult, Spanish speaking Latino migrants (both undocumented and documented) living in the US completed a cross-sectional survey comprising a scale assessing perceptions of immigration laws and consequences related to healthcare use and whether they had received and/or needed but did not receive healthcare in the previous 12-months. Participants were recruited in community settings and by word-of-mouth. Univariate analyses examined associations among study outcomes and common predictors of healthcare use. Multivariable analyses examined the relative contribution of perceived immigration laws and consequences on healthcare use and unmet need. RESULTS: Perceptions of immigration laws and immigration consequences were a significant predictor of not having received healthcare in the previous 12-months and having needed and not received healthcare in the same period, even when considered relative to common predictors of healthcare use. Immigration documentation status and preferred language predicted healthcare use in univariate analyses but not in the multivariable model. CONCLUSIONS: Perceived immigration laws and consequences related to healthcare use may influence migrants' healthcare use. Effective interventions should be developed to address immigration-related concerns.

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BACKGROUND: Recent U.S. immigration policy has increasingly focused on asylum deterrence and has been used extensively to rapidly deport and deter asylum-seekers, leaving thousands of would-be asylum-seekers waiting indefinitely in Mexican border cities, a large and growing proportion of whom are pregnant and parenting women. In the border city of Tijuana, Mexico, these women are spending unprecedented durations waiting under unsafe humanitarian conditions to seek safety in the U.S, with rising concerns regarding increases in gender-based violence (GBV) among this population during the COVID-19 pandemic. Given existing gaps in evidence, we aimed to describe the lived experiences of GBV in the context of asylum deterrence policies among pregnant and parenting asylum-seeking women at the Mexico-U.S. border. METHODS: Within the community-based Maternal and Infant Health for Refugee & Asylum-Seeking Women (MIHRA) study, we conducted semi-structured qualitative interviews with 30 asylum-seeking women in Tijuana, Mexico between June and December 2022. Eligible women had been pregnant or postpartum since March 2020, were 18-49 years old, and migrated for the purposes of seeking asylum in the U.S. Drawing on conceptualizations of structural and legal violence, we conducted a thematic analysis of participants' experiences of GBV in the context of asylum deterrence policies and COVID-19. RESULTS: Pregnant and parenting asylum-seeking women routinely faced multiple forms of GBV perpetuated by asylum deterrence policies at all stages of migration (pre-migration, in transit, and in Tijuana). Indefinite wait times to cross the border and inadequate/unsafe shelter exacerbated further vulnerability to GBV. Repeated exposure to GBV contributed to poor mental health among women who reported feelings of fear, isolation, despair, shame, and anxiety. The lack of supports and legal recourse related to GBV in Tijuana highlighted the impact of asylum deterrence policies on this ongoing humanitarian crisis. CONCLUSION: Asylum deterrence policies undermine the health and safety of pregnant and parenting asylum-seeking women at the Mexico-U.S. border. There is an urgent need to end U.S. asylum deterrence policies and to provide respectful, appropriate, and adequately resourced humanitarian supports to pregnant and parenting asylum-seeking women in border cities, to reduce women's risk of GBV and trauma.

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Legislative action on issues of immigration emerged prominently across and within US states throughout the 2000s. The emerging literature on this topic demonstrates the political motivations driving anti-immigrant laws that negatively impact the mobility of Hispanic/Latino and Foreign-born populations across US states. Considerable research identifies the political mechanisms driving restrictive state-level immigration policies. Despite the growth of this scholarly work, the impact of these laws within states requires further study. This paper broadens the approach to the study of restrictive state-level omnibus immigration laws (OILs) using a rich dataset to uncover the effects of these laws on compositional change for undocumented, foreign-born, and Hispanic/Latino populations from 2005 to 2017. Using a quasi-experimental design, I show that by passing omnibus immigration laws, states shape demographic patterns of Foreign-born populations. Specifically, I find that states that pass omnibus immigration laws experience a decrease in undocumented and Foreign-born populations relative to states that did not pass similar laws. Effects are estimated each year after the passage of OILs, providing additional insight into the temporal impact of omnibus immigration laws on the settlement patterns of these groups. I conclude by discussing the theoretical implications of the multiple interior immigration law and policies, specifically at the state level, and their salience in shaping population dynamics across the United States.

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In this paper, we explore the material and symbolic effects of "deservingness projects" (Kline, 2019) for Latinx immigrants as they have played out over the COVID-19 pandemic. On a material level, exclusionary policies have exacerbated Latinx immigrants' disenfranchisement and contributed to disproportionate sickness and economic strife during the pandemic. On a symbolic level, they have contributed to subjective experiences of fear, distress, and desperation, and have eroded many immigrants' trust in institutions and support systems. Crucially, though, the pandemic's injustices have also crystallized a sense of outrage and indignation among some Latinx immigrants, provoking assertions of self-worth and sociopolitical projects of belonging and mutual care. Our findings thus challenge the notion that subjective self-understandings as 'undeserving' are fundamental to the undocumented experience and show that the pandemic's fallout has strengthened some immigrants' ability and willingness to "make claims for inclusion" (Abrego, 2011) and sociopolitical change.

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We present a framework for studying the spillover effect of negative foreign COVID-19 news on attitudes towards immigration. Our framework proposes that exposure to negative COVID-19 news from foreign countries can activate negative associations with foreigners, reduce positive attitudes towards them, and increase perceived threat, ultimately leading to decreased support for immigration. We conducted three studies to test this framework. Study 1 found that exposure to negative COVID-19 news about a foreign country increased negative valence associations with that country. Study 2 showed that exposure to more negative COVID-19 news about foreign countries was associated with lower acceptance of immigration policies in real life. Study 3 replicated the spillover effect of negative news exposure using a scenario manipulation. The effects of negative news exposure on immigration policy acceptance in both Studies 2 and 3 were mediated by changes in foreigner attitudes and intergroup threat. Our results demonstrate the important spillover effect of negative foreign COVID-19 news exposure on immigration attitudes and highlight the association perspective as a foundation for understanding attitude changes during the COVID-19 pandemic.

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Little is known about how exclusionary immigration laws affect ethnic identity and self-esteem among Latinx middle school students. Arizona's SB 1070, which required local officers to verify the legal status of detained individuals, garnered national attention for its impact on immigrant and Latinx communities. This study tested a longitudinal parallel multiple mediation model where perceptions of the effects of an exclusionary immigration law (Arizona's SB 1070) on self-esteem were mediated by dimensions of ethnic identity (ethnic centrality, ethnic private regard, ethnic public regard). Data were collected from a two-wave survey of 891 early adolescents ranging in age from 10 to 14 years (M = 12.09 years; SD = 0.99), a majority (71%) of whom were of Mexican descent. Analyses revealed an indirect effect of T1 perceptions of this law on T2 self-esteem (7 months later), holding T1 measures constant, with T2 ethnic centrality, private regard, and public regard acting as mediators. Perceived effects of this exclusionary law led to increased self-esteem through increased dimensions of ethnic identity. Results reveal how ethnic identity functions as a multidimensional construct in the process through which exclusionary immigration policy may impact the self-esteem of Latinx early adolescents.

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Introduction: To understand how mixed-immigration status families-families with a mixture of people with and without documentation-in the United States (U.S.) fared during the COVID-19 pandemic. Specifically, this study highlights how health inequities were exacerbated during the height of the pandemic due to the implementation of anti-immigration policies such as Public Charge Rule, which stipulates that receiving public benefits is grounds for inadmissibility for immigrants seeking naturalization. Methods: In-depth semistructured interviews were conducted over Zoom with 14 members of mixed-status families between February and April 2021. The interviews were audio recorded, transcribed, and analyzed using Atlas.ti. Using grounded theory, we assessed the level of awareness about Public Charge Rule and the health challenges these families faced during the COVID-19 pandemic. Results: Themes that emerged included financial problems, job insecurity, housing insecurity, food insecurity, mental health problems, distrust of government and health officials, and a fear of Public Charge Rule. We present a framework for understanding health inequities for mixed-status families during the COVID-19 pandemic. Discussion: Public Charge Rule caused fear and confusion for mixed-status families during the COVID-19 pandemic, resulting in individuals not receiving public benefits they urgently needed. This created heightened mental health problems due to job, housing, and food insecurity. Health Equity Implications: We discuss how trust between mixed-status families and the government needs foundational rebuilding. In addition to streamlining the process for these families to apply for legal status, it is important to protect and support mixed-status families through programs and policies during public health emergencies.

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Policy Points There is growing attention to the role of immigration and immigrant policies in shaping the health and well-being of immigrants of color. The early 21st century in the United States has seen several important achievements in inclusionary policies, practices, and ideologies toward immigrants, largely at subnational levels (e.g., states, counties, cities/towns). National policies or practices that are inclusionary toward immigrants are often at the discretion of the political parties in power. Early in the 21st century, the United States has implemented several exclusionary immigration and immigrant policies, contributing to record deportations and detentions and worsening inequities in the social drivers of health.

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Restrictive immigration policies may adversely affect the health of Latina mothers and their infants. We hypothesized that undocumented Latina mothers and their US born children would have worse birth outcomes and healthcare utilization following the November 2016 election. We used a controlled interrupted time series to estimate the impact of the 2016 presidential election on low birth weight (LBW), preterm birth, maternal depression, well child visit attendance, cancelled visits, and emergency department (ED) visits among infants born to Latina mothers on emergency Medicaid, a proxy for undocumented immigration status. There was a 5.8% (95% CI: -0.99%, 12.5%) increase in LBW and 4.6% (95% CI: -1.8%, 10.9%) increase in preterm births immediately after the 2016 election compared to controls. While these findings were not statistically significant at p < 0.05, the majority of our data suggest worsened birth outcomes among undocumented Latina mothers after the election, consistent with larger prior studies. There was no difference in well child or ED visits. While restrictive policies may have contributed to worse birth outcomes among undocumented Latina mothers, our findings suggest that Latino families still attend infants' scheduled visits.

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This article focuses on Mexican individuals who grew up in the U.S. (1.5 generation) without documents and were not able to benefit from Deferred Action for Childhood Arrivals (DACA) or who were unable to renew their DACA. A 2012 Executive Action by former president Obama, DACA gave some undocumented youth relief from deportation and a 2-year renewable work permit provided they met certain criteria. Undocumented individuals DACA failed to reach have generally been overlooked in immigration research in favor of examining how DACA recipients' lives have been transformed by DACA. This project helps fill this gap by examining life outside of DACA, and how the program acted as an internal U.S. border of exclusion for many. This research also aids in understanding the impacts of changing government policies on vulnerable populations, especially those who are in some respects made even more vulnerable by their faith in the government, fear of the government, or are actively excluded from government programs. This investigation is part of a study that compares 20 DACA beneficiaries to 20 individuals without DACA. Through ethnographic methodologies and one-on-one interviews, this article examines the 20 research participants who fall outside DACA. It investigates why people who qualified for DACA did not apply, barriers to applying/renewing, and how members of the 1.5 generation were excluded from the program by restrictions such as date of arrival requirements. The article discusses what it means for research participants to live outside of DACA, and how they see their lives because they do not have DACA while others do. For example, what does it mean to age out of qualifying for DACA? What actions did individuals then take regarding their lack of legal status?

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Objective: This study explored the predictive relationship among international student trauma responses, visa status anxiety, and perceived institutional support. Researchers also sought to understand the relationship between help seeking behaviors and trauma exposure responses. Participants: International students (n = 172) from U.S. colleges and universities enrolled since March 2020. Methods: Data were collected via an electronic survey administered during the fall 2020 academic term. Results: The model was found to be significant, explaining 67% of the variance of student trauma responses. Anxiety surrounding students' ability to stay in the U.S. was found to be the greatest contributor to the model. Additionally, particular clusters of trauma symptomatology were significantly correlated with help seeking from specific individuals within student networks. Finally, students reported moderate levels of mental health help seeking behaviors, with friends and family being the most likely sources sought out for help. Conclusions: Despite focus on students' health and wellness concerns related to the COVID-19 pandemic, visa policy uncertainty was a primary driver of self-reported trauma symptomatology at the onset of the pandemic.

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Objectives: Neighborhood disadvantage may increase the risk of adverse health outcomes among older refugees. Yet few studies rigorously estimate the effects of place-based factors on later-life health, particularly dementia and mortality. Evidence about refugees is especially sparse. Methods: This study leveraged a natural experiment in the form of a Danish policy (1986-1998) that dispersed refugees quasi-randomly across neighborhoods upon arrival. We used longitudinal registers allowing 30 years of follow-up among refugees aged 40+ years upon arrival in Denmark (N = 9,854). Cox models assessed the association between neighborhood disadvantage and risk of dementia and mortality. We examined heterogeneous effects by sex, age, and family size. We also examined associations among non-refugee immigrants and native-born Danes. Results: Neighborhood disadvantage was not associated with dementia in any group. One unit increase in neighborhood disadvantage index (ranges -8 to 5.7) was associated with greater mortality risk among non-refugee immigrants (HR 1.06, 95%CI: 1.02, 1.10) and native-born Danes (HR 1.11, 95%CI: 1.06, 1.17). In contrast, neighborhood disadvantage was associated with lower mortality risk among refugees (HR 0.96, 95%CI: 0.93, 0.99). Neighborhood disadvantage remained negatively associated with mortality risk in subgroups: refugees who are female (on moderate-disadvantage compared to low-disadvantage), aged 60+, and who arrived with families. Discussion: While neighborhood disadvantage was associated with lower mortality risk among refugees, it was associated with greater mortality risk among non-refugee immigrants and native-born Danes, perhaps due to confounding in the latter groups or different place-based experiences by immigration status. Future research is warranted to explain the reasons for contrasting findings.

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This quasi-experimental study examined whether "sanctuary city" policies are an effective mechanism for reducing mental health inequalities by immigrant origin status in Latinx populations in California. Ample evidence indicates that people experience mental health problems when restrictive immigration policies are imposed. It remains unclear whether sanctuary city policies can improve population mental health in the groups targeted by restrictive immigration policies: undocumented immigrant Latinxs, documented immigrant Latinxs, and native-born Latinxs. We combined data on California's 482 cities concerning whether and when they implemented a sanctuary policy with health data on approximately 142,000 adults, 6400 adolescents and 13,000 children from the multi-year California Health Interview Survey. After using propensity score matching to identify non-sanctuary cities comparable to sanctuary cities, we estimated respondent-level difference-in-differences models to determine whether sanctuary city policies had beneficial mental health effects on three age groups: adults, adolescents, and children during the period 2007-2018. There was a trend toward improved mental health in sanctuary cities after policy enactment, but the patterns of mental health in the three Latinx immigration sub-groups of each age group did not conform to our hypotheses. Buffering the adverse effects of harsh federal immigration policies may need to involve other approaches, such as expanded local mental health care access. We discuss these results in terms of alternative treatment interference, residents' policy awareness, the policy's capacity to address past health impacts, methodological issues, and potential policy momentum.

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During 2021, nearly 150,000 unaccompanied children (UCs) were apprehended at the US-Mexican border. Most are leaving Guatemala, Honduras, and El Salvador, motivated by poverty, climate change, and violence. UCs are most often apprehended by the Border Patrol and then transferred to the Office of Refugee Resettlement (ORR), the Department of Health and Human Services. ORR is responsible for ensuring that the child is released to a parent or sponsor in the United States capable of providing an adequate home. Advocacy must not only address a complex system of legal and custodial care but also confront a troubled political environment.

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This study examines the impact of Omnibus Immigration Laws on the mental health of the Hispanic populations in the U.S. We use a Difference-in-Differences framework and data from the Behavioral Risk Factor Surveillance System Survey of Centers for Disease Control and Prevention for the 2000-2016 period that contains information on more than 400 thousand Hispanics residing in the U.S. We find that the most stringent provision, namely, "show me your papers" laws, adversely affects the mental health of Hispanics and contributes to an increase of 12%-16% in the number of unhealthy mental days and an increase of 13%-18% in the probability of having frequent mental distress in the states with "show me your papers" laws. OIL provisions that enforced the use of E-Verify or limited the use of public benefits to unauthorized immigrants did not have any effect on mental health. The study also examines (1) police stops, (2) physical health, insurance, and employment status, (3) co-ethnic density, and (4) immigration enforcement awareness as potential mechanisms that could lead to a deterioration in the mental health of Hispanics. The evidence indicates their vulnerability to strict immigration enforcement. The social and public health cost should be carefully evaluated when formulating and implementing immigration policies.

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Anti-immigrant rhetoric and immigration policy enforcement in the United States over the last 2 decades has increased attention to fear of deportation as a determinant of poor health. We describe its association with mental health outcomes among Middle East and North African (MENA) residents of Michigan. Using a convenience sample of MENA residents in Michigan (n = 397), we conducted bivariate and multiple variable regression to describe the prevalence of deportation worry and examine the relationship between deportation worry and depressive symptoms (PHQ-4 scores). We found that 33% of our sample worried a loved one will be deported. Deportation worry was associated with worse mental health (p < 0.01). Immigration policies are health policies and deportation worry impacts mental and behavioral health.

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