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Provider Perceptions of the Effects of Current U.S. Immigration Enforcement Policies on Service Utilization in a Border Community


Abstract and Figures

Restrictive U.S. immigration policies and enforcement have led to concerns among providers about how these changes affect service utilization among Latinx and immigrant communities. This study outlines perceptions from twenty service providers in health care, mental health, legal affairs, and immigrant advocacy in El Paso, Texas. Nearly all respondents stated that their work has been negatively affected by immigration enforcement policies under the current federal administration. Most reported changes in utilization among undocumented immigrants and families of mixed immigration status, as well as legal permanent and temporary residents, refugees or asylum seekers, and U.S. citizens. Negative effects were related to immigration-related fear and uncertainty in the community, a need for public education about policies and individu-als' rights, and changes in immigration policy enforcement. Further research about the impacts of immigration enforcement policies on service utilization is needed. To protect the well-being of immigrant communities, policy makers should be aware of the human rights implications of immigration enforcement policies with regard to service utilization. In a global environment of increasing nationalism and xenophobia, nations must carefully consider the implications of harsh anti-immigrant narratives and strict immigration enforcement on the well-being of minority and immigrant populations.
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© 2019 International Consortium for Social Development
Provider Perceptions of the Effects of Current U.S.
Immigration Enforcement Policies on Service
Utilization in a Border Community
Isabel Latz, Mark Lusk, and Josiah Heyman
Restrictive U.S. immigration policies and enforcement have led to concerns among
providers about how these changes affect service utilization among Latinx and immi-
grant communities. This study outlines perceptions from twenty service providers in
health care, mental health, legal affairs, and immigrant advocacy in El Paso, Texas.
Nearly all respondents stated that their work has been negatively affected by immigra-
tion enforcement policies under the current federal administration. Most reported
changes in utilization among undocumented immigrants and families of mixed immi-
gration status, as well as legal permanent and temporary residents, refugees or asylum
seekers, and U.S. citizens. Negative effects were related to immigration-related fear and
uncertainty in the community, a need for public education about policies and individu-
als’ rights, and changes in immigration policy enforcement. Further research about the
impacts of immigration enforcement policies on service utilization is needed. To protect
the well-being of immigrant communities, policy makers should be aware of the human
rights implications of immigration enforcement policies with regard to service utiliza-
tion. In a global environment of increasing nationalism and xenophobia, nations must
carefully consider the implications of harsh anti-immigrant narratives and strict immi-
gration enforcement on the well-being of minority and immigrant populations.
Keywords: immigration enforcement, immigration policy, service utilization
The intensification of U.S. immigration enforcement policies has raised concerns
among health, social service, and legal assistance providers about unintended
adverse effects on the use of services among Latinx and immigrant communities.
Latinos and Latinas (referred to as Latinx) make up 18 percent of the U.S. popula-
tion and are the country’s largest ethnic minority (Lopez, Passel, & Rohal, 2015).
Isabel Latz, MS, is a doctoral candidate in interdisciplinary health sciences, University of Texas at
El Paso. Also at the University of Texas at El Paso, Mark Lusk, MSW, EdD, is professor, Department
of Social Work, and Josiah Heyman, PhD, is professor of anthropology and director, Center for
Inter-American and Border Studies.
50 Social Development Issues 41 (1) 2019
We will study the effects of current policies on service utilization from the per-
spective of providers in a border community with a high proportion of Latinx and
immigrant residents.
Immigration Policy and Enforcement Changes under the Current
Federal Administration
U.S. immigration policy has prioritized border enforcement and interior deporta-
tion since the 1990s. This policy has hardened in the last two years. The Trump
administration issued a series of executive orders in January 2017 to intensify
immigration enforcement inside the United States, expand enforcement at the
U.S.-Mexico border, and restrict entry to the United States for foreign nationals of
seven Muslim-majority countries. These orders called for the hiring of 10,000
new Immigration and Customs Enforcement (ICE) officers and 5,000 new border
patrol officers, deportation prioritization (fast tracking) of anyone in violation of
immigration law, and expansion of expedited removals (National Immigration
Law Center, 2017; White House Office of the Press Secretary, 2017). A U.S.
Department of Homeland Security memorandum (2017) instructed immigration
enforcement personnel to disregard mitigating factors for immigration enforce-
ment used under previous administrations (prosecutorial discretion).
Immigration and Customs Enforcement has reported a 30-percent increase in
arrests of immigrants without documentation and a more than twofold increase
in arrests of unauthorized immigrants without a criminal background (2017).
Significant policy shifts also occurred at the state level. State legislation related
to immigration increased by 110 percent from 98 laws in 2016 to 206 laws in
2017. The largest category of new laws related to state budget allocations (25%),
followed by law enforcement, including immigration enforcement (21%) (Morse,
Pimienta, & Chan, 2018). For instance, the 2017 Texas Senate Bill 4 (SB 4)
empowers Texas state and local police to inquire about immigration status during
any law enforcement stop, to detain the people involved, and to turn them over to
federal immigration authorities.
Effects of Immigration Enforcement Policies on Health and Service
Scholars have documented that fear of immigration enforcement and deporta-
tion, as well as political rhetoric fueling fear of and antipathy toward immigrants,
heightens anxiety among the Latinx community in general and children in par-
ticular (Gonzalez, 2018; Martinez, Ruelas, & Granger, 2018; Roche, Vaquera,
White, & Rivera, 2018). Fear of deportation increases parental stress among
Latinx families (Berger Cardoso, Scott, Faulkner, & Barrios Lane, 2018). Anti-
immigrant legislation and discourse have adverse effects on youth by weakening
their sense of being American, lowering their self-esteem, reducing their accep-
tance of diversity (intolerance), and adversely impacting their self-efficacy
(Santos, Menjívar, & Godfrey, 2013).
Latz, Lusk, and Heyman 51
Restrictive immigration policies have been associated with adverse health out-
comes and declines in service utilization among Latinx. For instance, the adoption
of restrictive state immigration enforcement policies is linked to poorer self-rated
health (Anderson & Finch, 2014) and mental health (Hatzenbuehler et al., 2017).
Moreover, studies have found associations between immigration raids and poorer
self-rated health and higher levels of immigration enforcement stress (Lopez et al.,
2017) as well as higher proportions of low birth weight among Latina mothers
(Novak, Geronimus, & Martinez-Cardoso, 2017). Research indicates that parental
detention and deportation have negative material and psychological health effects
on children including posttraumatic stress disorder and depression (Rojas-Flores,
Clements, Hwang Koo, & London, 2017; Zayas, Aguilar-Gaxiola, Yoon, & Rey,
2015). Adverse effects on emotional well-being were found not solely among chil-
dren of detained or deported parents, but also among children of parents who are
at risk of deportation (Brabeck & Xu, 2010; Gulbas et al., 2016).
Research has uncovered associations between restrictive immigration policies
and decreases in visits to county health (White, Blackburn, Manzella, Welty, &
Menachemi, 2014), pediatric emergency (Beniflah, Little, Simon, & Sturm, 2013),
and mental health departments (Fenton, Catalano, & Hargreaves, 1996).
Similarly, Toomey and colleagues (2014) found a relationship between the enact-
ment of Arizona’s SB 1070, a law that enables local police to request proof of
immigration status, and declines in public assistance utilization among Mexican
mothers. Studies revealed links between strengthened enforcement and increased
food insecurity in Mexican noncitizen households (Potochnick, Chen, & Perreira,
2017); lower participation in the Women, Infants, and Children Program in
Mexican mixed-status households in particular (Vargas & Pirog, 2016); and lower
Medicaid and other insurance coverage for children of noncitizen mothers
(Watson, 2014).
Joanna Dreby’s pyramid of immigration enforcement effects (2012) provides a the-
oretical basis for our study. According to this pyramid, the strongest but numeri-
cally smallest impacts are on children in households with individual members
arrested, detained, or deported. In the middle are children in families who live in
fear of deportation (families who mix legal and undocumented members). At the
base of the pyramid are people who are not immediately at risk of arrest but who
struggle with ambivalent identity because of overlaps between stigmatized social
categories of illegal, immigrant, and Latinx, especially those of Mexican origin
(Dreby, 2012). Although the pyramid depicts the effects of deportation policies on
children, the hierarchy of impacts also applies to Latinx communities across age
categories. The most significant but also least frequent effects are family dissolu-
tion and the corresponding material and emotional hardship. The middle catego-
ry includes community members who live in fear of deportation for themselves
and/or family members and friends. Finally, the largest group in the community,
who are farthest removed from direct immigration policy effects, experience diffi-
culties related to their identity based on societal conflations of ethnicity, race,
immigration status, and illegality. The impacts at all levels of the pyramid,
52 Social Development Issues 41 (1) 2019
although to different extents, carry the potential to interfere with health, legal,
and social service utilization among a predominantly Latinx and immigrant com-
munity in the border region.
Implications of Immigration Enforcement in the U.S.-Mexico Border
Questions about enforcement impacts on the well-being of immigrant and Latinx
communities are particularly apt on the U.S.-Mexico border, given the history and
social fabric of the region. On the U.S. side of the border, approximately half of the
population is Hispanic and predominantly Mexican (Stepler & Lopez, 2016; United
States-México Border Health Commission, 2014). In El Paso County (the location
of this study), 82 percent of the population is Hispanic, 25 percent foreign-born,
and approximately 66,000 (of 835,000 total) are undocumented (Migration
Policy Institute, 2014; U.S. Census Bureau, n.d.).
In addition to federal and state policy changes, specific enforcement activities
in El Paso County and its surrounding region have sparked fears and behavioral
changes in the community. For example, an ICE raid at a trailer park in nearby Las
Cruces, New Mexico, in 2017 was followed by a 60-percent increase in absences
from schools (Blitzer, 2017a). In February 2017, an undocumented transgender
woman was detained by ICE at the El Paso courthouse after she participated in a
domestic violence hearing. This incident provoked fear among victims of domestic
violence about engaging with law enforcement and attending court hearings
(Blitzer, 2017b; Lockhart, 2017).
A related concern is that enforcement policies may exacerbate existing health
disparities. Overall, residents in border counties are more likely to be unemployed,
live in poverty, lack health insurance, and have lower access to health care
providers (Coalition for a Healthy Paso del Norte, 2016; Shen, Gai, & Feng, 2016;
United States-México Border Health Commission, 2014). Border residents are dis-
proportionally affected by certain infectious and chronic diseases, including dia-
betes, tuberculosis, and HIV (Moya, Loza, & Lusk, 2012; United States-México
Border Health Commission, 2014). El Paso is categorized as an economically dis-
tressed area and ranks fourth highest in families living at or below the poverty
level. Census data indicate that U.S.-Mexico border areas are consistently at the
bottom of educational and economic development. According to the Annie E.
Casey Foundation, the child poverty rate for Latino children living along the bor-
der (37%) is more than twice the national child poverty rate. In addition, El Paso
County is a critically medically underserved area.
The study aims to assess perspectives of health care, mental health, legal, nutri-
tion, and other social service providers and immigrant advocacy organizations on
Latz, Lusk, and Heyman 53
the effects of immigration enforcement policies on service utilization in the Paso
del Norte border region under the current federal administration. From this initial
pool of service providers, this project seeks to inform a wider investigation of this
topic, both in the United States and internationally where immigration enforce-
ment is also being intensified.
This study used quantitative and qualitative data from telephone survey inter-
views with twenty providers in early 2018. Nineteen providers were in El Paso
County, Texas, and one in Doña Ana County, New Mexico, to the immediate west.
It was approved by the institutional review board of the University of Texas at El
We recruited twenty experienced professionals from health and mental health ser-
vice (n= 5); immigrant rights, advocacy, and legal assistance (n= 7); and social
service organizations (n= 8). Only organizations providing services to immigrant
and/or low-income populations were considered for this study. Participants were
contacted via mail and telephone calls to provide information about the study, col-
lect their informed consent, and schedule an interview. Information about partic-
ipants’ demographic characteristics is provided in Table 1.
Survey and Interview Procedure
We conducted individual telephone interviews, which varied between fifteen and
twenty-five minutes. One or both of the primary investigators were present and
collected notes during each interview. Interviewers used a script of closed- and
open-ended questions about participants’ demographics and perceptions of effects
of current immigration enforcement policies on their client populations. The
questionnaire was designed by the investigators based on a review of the literature
and discussion of pertinent issues providers may face in the current enforcement
context. For instance, one closed-ended survey question asked whether partici-
pants observed “an increase, a decrease, or no change in service utilization
because of changes to immigration enforcement policies [since the current feder-
al administration took office].” The corresponding response option were increase,
decrease, no change, or don’t know/indeterminate. An open-ended survey question
asked “What do you think is the most important action for addressing or prevent-
ing negative impacts of immigration enforcement policies on your
Data Analysis
All survey data and interview notes were de-identified using randomly gener-
ated numeric codes. Data from closed-ended survey questions were entered into
54 Social Development Issues 41 (1) 2019
quantitative analysis software (SPSS version 15) to produce descriptive statistics.
Notes from open-ended survey questions were entered into qualitative analysis
software (NVIVO version 12) to identify salient themes and subthemes across
responses. Themes were considered salient when they were mentioned repeatedly
by participants from different agencies. For each salient theme, subthemes were
extracted to capture more nuanced information about responses pertaining to an
overall theme.
Effects of Enforcement Policies on Agencies and Clients
Eighteen of the twenty providers in this study reported that their work has been
negatively (n= 13) or both positively and negatively (n= 5) affected by immigra-
tion enforcement policies since the beginning of the current federal administra-
tion. Similarly, a majority of participants (n= 15) reported an increase or decrease
in service utilization by their clients because of changes to immigration enforce-
ment policies. Eight participants reported that this increase/decrease in service
utilization was still occurring at the time of the interview, whereas seven partici-
Table 1 Demographic characteristics of survey participants
Characteristic Category nPercentage
Gender Female 10 50.0
Male 10 50.0
Country of birth Mexico 3 15.0
United States 17 85.0
Age 20–39 7 35.0
40–59 8 40.0
60 5 25.0
Type of organization Health & mental health services 5 25.0
Immigrant rights/legal assistance/
advocacy 7 35.0
Social services (e.g., nutrition,
housing, family services) 8 40.0
Length of time worked in
current role 1–2 years 7 35.0
3–5 years 5 25.0
6–20 years 3 15.0
>20 years 2 10.0
Role at organization Chief operating officer, chief
executive officer, executive
director, director, chief officer,
vice president 15 75.0
Community health worker,
program manager 2 10.0
Attorney, paralegal, immigration
coordinator 3 15.0
Total 20 100.0
Latz, Lusk, and Heyman 55
pants described different patterns, including increases/decreases that were for
only a brief period of time or for a long period of time but are now back to the lev-
els prior to the new federal administration. Reported reasons for decreased service
utilization included fear of driving and being stopped by local law enforcement (n
= 7), fear of sharing personal information (n= 5) or information that could iden-
tify family members or friends (n= 5), fear of experiencing discrimination (n = 4),
and confusion about changes to eligibility requirements (n= 3). In contrast,
reported reasons for increased service utilization included fear of accessing ser-
vices elsewhere and being stopped by local law enforcement (n= 6), loss of
employment/sources of income due to a family member being detained/deported
(n= 4), and loss of employment because of immigration status (n= 3) (see Table
Notably, all participants who reported increases/decreases in service utilization
observed these changes among Hispanics (n= 15) and to a lesser extent among
other racial/ethnic groups (n= 5). Furthermore, service utilization changes were
perceived most often among undocumented immigrants (n= 10) and mixed-sta-
tus families (n= 9), but also extended to legal permanent residents (n= 5), tem-
porary residents (n= 4), refugees/asylum seekers (n= 5), and U.S. citizens (n= 4).
Salient Themes and Subthemes
Based on responses from open-ended survey questions, we identified seven salient
themes and two to eight subthemes for each theme (see Table 3). Nearly all par-
ticipants (n= 17) mentioned fear, uncertainty, and adverse mental health effects
in the community due to current immigration enforcement policies. Participants
talked about a fear of movement and being stopped by local law enforcement
among their client population. Fear also reportedly led to the avoidance of services
and prevented individuals from engaging with law enforcement. As a typical
response regarding effects on clients’ mobility, one participant said “some people
have stopped coming [to use our services]. They are afraid of being stopped on the
way and arrested.” Furthermore, participants referred to adverse mental health
impacts of immigration enforcement (e.g., family separation) and an increased
need for mental health services, especially among children. The following quote
reflects the fear among clients that some providers perceived: “The threat of deten-
tion becomes this constant fear . . . people are afraid of doing daily activities, like
taking their kids to school.”
More than half of participants (n= 12) reported the need for public education
and information sharing about current immigration enforcement policies.
Respondents mentioned a need to correct and prevent the spread of misinforma-
tion, which fueled fears and harmful behaviors (e.g., service avoidance) among
community members. In addition, providers perceived a need to inform the com-
munity about their civil rights and enable individuals to distinguish appropriate
from inappropriate behavior by immigration enforcement officials. Providers
shared that “people need to know which policies affect them—what the policies
are, what their rights are, and that they know how to apply these rights.”
56 Social Development Issues 41 (1) 2019
Ten participants pointed out impacts related to adverse effects of specific laws,
policies, or enforcement activities on their clients. Specifically, participants
observed behavioral changes among community members following passage of
Table 2 Provider perspectives on effects of U.S. immigration enforcement policies on
service utilization (N= 20)
Survey item Response options n%
Q5: Since the beginning of the new federal Positively 0 0.0
administration, would you say immigration Negatively 13 65.0
enforcement policies have influenced your Both 5 25.0
work positively, negatively, both, or have No effects 2 10.0
not affected your work?
Q7: Would you say there has been an increase, Increase 8 40.0
a decrease, or no change in service utilization Decrease 6 30.0
because of changes to immigration enforcement Both 1 5.0
policies? No change 4 20.0
Don’t know 1 5.0
Q8: Would you say this increase/decrease in Brief period of time 1 5.0
service utilization was for a brief period of Long period but now
time only, for a long period but now things are back to normal 1 5.0
back to normal, or is it still occurring? Still occurring 8 40.0
Other, specify 5 25.0
Don’t know 1 5.0
Not applicable 4 20.0
Q9: Would you say this increase/decrease in Hispanics 15 75.0
service utilization was among particular racial/ Whites 0 0.0
ethnic groups of your patients/clients/members African Americans 1 5.0
(select all that apply)? Asians 2 10.0
Other, specify 2 10.0
Q10: Would you say this increase/decrease in Undocumented 10 50.0
service utilization was among groups of your Mixed-status families 9 45.0
patients/clients/members with a particular Legal permanent residents 5 25.0
immigration/legal status (select all that apply)? Legal temporary residents 4 20.0
Refugees/asylum seekers 5 25.0
U.S. citizens 4 20.0
Other, specify 1 5.0
Q11: Have your patients/clients/members shared Fear of sharing personal
some of the reasons why they discontinued/ information 5 25.0
postponed your services related to immigration Fear of sharing information
enforcement policies (select all that apply)? that could help identify
family members/friends 5 25.0
Fear of driving and being
stopped by police 7 35.0
Fear of experiencing
discrimination 4 20.0
Confusion about changes
to eligibility requirements 3 15.0
Other, specify 1 5.0
SB 4, such as avoidance of the outdoors, and perceived a need to provide informa-
tion about the implications of the legislation. Immigration raids by ICE reportedly
provoked fear, confusion, and retreats from services and daily activities in the com-
munity. For instance, one participant observed that “the ICE arrest at the El Paso
courthouse had an impact—many people don’t understand the policy details, but
this was an example of ‘it’s real, it’s happening.’”
Effects on organizations included perceived needs or concerns regarding fund-
ing and staffing. Some respondents reported increased difficulty in providing ser-
vices because of immigration enforcement under the current administration. The
statement of one participant reflects a common observation among providers:
“Reaching the population we are trying to serve has become more challenging—
this political climate has made it more difficult to reach people.” Others reported
effects on employees themselves, such as a sense of hopelessness and a struggle to
find a balance between work and spare time due to a perceived need to be working
Almost half of participants (n= 9) described spillover effects of immigration
enforcement policies on the larger community (i.e., beyond undocumented immi-
grants). These effects included perceived threats to families and communities, as
well as fear about how the administration’s policies might affect the status of legal
residents. In the words of one participant, “Fear and needs apply to the whole fam-
ily—[immigration] policies are not only targeting undocumented, they are target-
ing entire families based on their race. Families feel that their family unity has
been threatened.” Another participant said, “people suddenly think their residen-
cy is being threatened. Green card holders are now feeling at risk of being deport-
Participants (n= 7) also highlighted their experiences with changes to enforce-
ment of immigration policies from the previous federal administration. These
Latz, Lusk, and Heyman 57
Table 2 Provider perspectives on effects of U.S. immigration enforcement policies on
service utilization (N= 20)—(continued)
Survey item Response options n%
Q13: Have your patients/clients/members shared Loss of employment/sources
some of the reasons why they utilized/needed of income due to a family
your services more frequently related to member being detained/
immigration enforcement policies (select all deported 4 20.0
that apply)? Loss of employment/
sources of income due
to a family member losing
employment because of
immigration status 2 10.0
Fear of accessing services
elsewhere and potentially
being stopped by police 6 30.0
Other, specify 3 15.0
58 Social Development Issues 41 (1) 2019
Table 3 Overview of salient themes and subthemes from open-ended survey ques-
Theme Subtheme n
Fear, uncertainty, and Fear of movement/being stopped by law enforcement 5
adverse mental Fear of contacting/engaging with law enforcement 4
health effects General fear 4
(17 participants Adverse mental health effects 3
referred to theme) Fear of detention/deportation 3
Service avoidance due to fear 3
Confusion/concerns about policy effects on service eligibility 2
Fear of engaging in daily activities 2
Need for public Need to correct misinformation 6
education and Need for information sharing about appropriate immigration
information sharing enforcement and civil rights 6
(12 participants General need for information about policy implications 6
referred to theme) Need for information sharing to prepare clients & families
for possible detention/deportation 3
Adverse effects of SB 4 6
specific laws, Arrest at El Paso courthouse 5
policies, or enforce- ICE raids 5
ment activities Termination of Deferred Action for Childhood Arrivals 3
(10 participants Executive orders 1
referred to theme)
Effects on organiza- Funding and staffing needs and/or concerns 5
tions Greater difficulty providing services 4
(10 participants Effects on employees 4
referred to theme) Confusion/uncertainty regarding effects 3
Expansion of organizations’ work 3
Spillover effects on Stress among and perceived threats to families and communities 6
larger community Fear, confusion, or concerns about how current legal status
(9 participants might be affected 5
referred to theme)
Changes to immigra- Increases in immigrant detention/deportation/ICE detainer
tion policy requests 5
enforcement Family separation 4
(7 participants Lack of transparency and accountability in immigration
referred to theme) enforcement 4
Poor conditions in detention & lack of access to health and
legal services 4
Fewer releases on bond 3
Denials of asylum/other legal status applications 3
Community responses Increased community organizing 4
and advocacy Greater cooperation among organizations 2
efforts Increased interests in immigration issues and volunteering 2
(6 participants
referred to theme)
included an increased use of detention and deportation, family separation in
detention, lack of accountability in immigration enforcement, poor conditions
and lack of access to health and legal services in detention, and increased denials
of asylum. Participant responses included “We see denials across the board—of
work permits, of prosecutorial discretion, even for persons with compelling
humanitarian reasons. Everything is hard-fought.”
In contrast, other participants (n = 6) reported that challenges posed by immi-
gration policy changes and increased enforcement to their agencies and clients
activated attempts to respond positively and empower communities. These com-
munity responses and advocacy efforts included greater cooperation across orga-
nizations and increased community organizing, interest in immigration issues,
and volunteering for immigrant advocacy organizations. One participant
observed that “unintended effects of these policies are that we have seen groups
come together to coordinate a response and mobilization of advocacy groups due
to outrage over policies.”
Providers in a U.S.-Mexico border community have noticed changes in service uti-
lization due to new immigration enforcement policies. Immigrants and clients of
mixed status, especially those of Hispanic origin, are fearful of immigration
enforcement and are changing their utilization of services, most commonly by
decreasing service utilization. For the most part, this is because of fear of appre-
hension and possible deportation. There has been an increase in clients’ service
needs, specifically to obtain information about how changes to immigration poli-
cies might affect them and their current legal status, to receive legal assistance,
and to obtain mental health care. Paradoxically, intensification of immigration
enforcement leads to a complex mix of decreased and increased service utilization.
Consistent with Dreby’s pyramid, providers report effects across a range of citi-
zenship and immigration statuses, including Latinx citizens and legal residents as
well as the most vulnerable undocumented and their close relatives.
Previous research into effects of current immigration enforcement policies on
service utilization from provider and user perspectives revealed similar findings.
Hardy and colleagues (2012) examined community impacts of Arizona’s SB 1070
in a Latino neighborhood and found an increase in levels of fear following imple-
mentation of the legislation. This fear was reflected in residents’ declines in health
care and social service utilization, mobility restrictions, and diminished trust in
local law enforcement (Hardy et al., 2012). Rhodes and colleagues (2015)
assessed effects of local immigration enforcement policies on health care service
utilization among Hispanic residents in North Carolina. Qualitative data from the
perspective of service users (N= 83) revealed a limited understanding of immi-
gration policy details and residents’ rights, among other emerging themes, in line
with a key finding from our study (Rhodes et al., 2015).
Latz, Lusk, and Heyman 59
60 Social Development Issues 41 (1) 2019
The study has several practical implications. First, there is a need to share infor-
mation about immigration enforcement policies and the human and civil rights of
immigrants with the community to promote informed decision making in service
utilization. Furthermore, community health and social workers can facilitate
providers’ outreach to hidden communities that may be particularly vulnerable to
exclusion from service provision due to their immigration and/or socioeconomic
status. Given the reality of stricter enforcement policies, emphasis should be
placed on providing immigrants with the tools to know which services they have
a right to receive and what risks their choices involve. Information about immi-
gration enforcement policies and their effects on service utilization needs to be
promulgated to decision makers to facilitate evidence-based policy formulation.
Stricter immigration enforcement is on the rise globally and has important
adverse effects on the human rights of migrants. Provider and service user stud-
ies are needed across a variety of world settings, including traditional receiving
countries and new transit and settlement zones. In an international environment
of increasing nationalism and xenophobia, nations must carefully consider the
implications of harsh anti-immigrant narratives and strict immigration enforce-
ment on the well-being of minority and immigrant populations.
Anderson, K. F., & Finch, J. K. (2014). Racially charged legislation and Latino
health disparities: The case of Arizona’s SB 1070. Sociological
Spectrum, 34, 526–548.
Beniflah, J. D., Little, W. K., Simon, H. K., & Sturm, J. (2013). Effects of immigra-
tion enforcement legislation on Hispanic pediatric patient visits to the
pediatric emergency department. Clinical Pediatrics, 52, 1122–1126.
Berger Cardoso, J., Scott, J. L., Faulkner, M., & Barrios Lane, L. (2018). Parenting
in the context of deportation risk. Journal of Marriage and Family, 80,
Blitzer, J. (2017a, March 23). After an immigration raid, a city’s students vanish.
New Yorker. Retrieved from
Blitzer, J. (2017b, February 23). The woman arrested by ICE in a courthouse
speaks out. New Yorker. Retrieved from
Brabeck, K., & Xu, Q. (2010). The impact of detention and deportation on Latino
immigrant children and families: A quantitative exploration. Hispanic
Journal of Behavioral Sciences, 32, 341–361.
Coalition for a Healthy Paso Del Norte. (2016). A healthy Paso del Norte: 2016
report. Retrieved from
Dreby, J. (2012). The burden of deportation on children in Mexican immigrant
families. Journal of Marriage and Family, 74, 829–845.
Fenton, J. J., Catalano, R., & Hargreaves, W. A. (1996). Effect of proposition 187
on mental health service use in California: A case study. Health
Affairs, 15, 182–190.
Gonzalez, R. G. (2018). Lives in limbo: Undocumented and coming of age in America.
Berkeley, CA: University of California Press.
Gulbas, L. E., Zayas, L. H., Yoon, H., Szlyk, H., Aguilar Gaxiola, S., & Natera, G.
(2016). Deportation experiences and depression among US citizen chil-
dren with undocumented Mexican parents. Child: Care, Health and
Development, 42, 220–230.
Hardy, L. J., Getrich, C. M., Quezada, J. C., Guay, A., Michalowski, R. J., & Henley,
E. (2012). A call for further research on the impact of state-level immi-
gration policies on public health. American Journal of Public Health, 102,
Hatzenbuehler, M. L., Prins, S. J., Flake, M., Philbin, M., Frazer, M. S., Hagen, D.,
& Hirsch, J. (2017). Immigration policies and mental health morbidity
among Latinos: A state-level analysis. Social Science and Medicine, 174,
Lockhart, P. R. (2017, March 20). Immigrants fear a choice between domestic
violence and deportation. Mother Jones. Retrieved from http://www
Lopez, M. H., Passel, J., & Rohal, M. (2015, September 28). Modern immigration
wave brings 59 million to U.S., driving population growth and change through
2065. Washington, DC: Pew Research Center. Retrieved from
Lopez, W. D., Kruger, D. J., Delva, J., Llanes, M., Ledón, C., Waller, A., . . . Israel, B.
(2017). Health implications of an immigration raid: Findings from a
Latino community in the Midwestern United States. Journal of Immigrant
and Minority Health, 19, 702–708.
Martinez, A. D., Ruelas, L., & Granger, D. A. (2018). Household fear of deporta-
tion in relation to chronic stressors and salivary pro-inflammatory
cytokines in Mexican-origin families post-SB 1070. Population Health, 5,
Migration Policy Institute. (2014). Profile of the unauthorized population: El Paso
County, TX. Retrieved from
Morse, A., Pimienta, M., & Chan, I. (2018). Report on State Immigration Laws
2017. Immigrant Policy Project, National Conference of State
Legislatures. Retrieved from
Latz, Lusk, and Heyman 61
62 Social Development Issues 41 (1) 2019
Moya, E. M., Loza, O., & Lusk, M. (2012). Border health: Inequities, social deter-
minants, and the cases of tuberculosis and HIV. In M. Lusk, K. Staudt, &
E. Moya (Eds.), Social justice in the US-Mexico border region (pp. 161–178).
New York, NY: Springer.
National Immigration Law Center. (2017). Understanding Trump’s executive order
affecting deportations and “sanctuary cities.” Retrieved from https://www
Novak, N. L., Geronimus, A. T., & Martinez-Cardoso, A. M. (2017). Change in
birth outcomes among infants born to Latina mothers after a major
immigration raid. International Journal of Epidemiology,46, 839–849.
Potochnick, S., Chen, J., & Perreira, K. (2017). Local-level immigration enforce-
ment and food insecurity risk among Hispanic immigrant families with
children: National-level evidence. Journal of Immigrant and Minority
Health, 19, 1042–1049.
Rhodes, S. D., Mann, L., Simán, F. M., Song, E., Alonzo, J., Downs, M., . . . Hall, M.
A. (2015). The impact of local immigration enforcement policies on the
health of immigrant Hispanics/Latinos in the United States. American
Journal of Public Health, 105, 329–337.
Roche, K. M., Vaquera, E., White, R. M. B., & Rivera, I. (2018). Impacts of immi-
gration actions and news and the psychological distress of US Latino par-
ents raising adolescents. Journal of Adolescent Health, 62, 525–531.
Rojas-Flores, L., Clements, M. L., Hwang Koo, J., & London, J. (2017). Trauma
and psychological distress in Latino citizen children following parental
detention and deportation. Psychological Trauma: Theory, Research,
Practice, and Policy,9, 352.
Santos, C., Menjívar, C., & Godfrey, E. (2013). Effects of SB 1070 on children. In
L. Magaña & E. Lee (Eds.), Latino politics and Arizona’s immigration law SB
1070 (pp. 79–92). New York, NY: Springer.
Shen, M., Gai, Y., & Feng, L. (2016). Limited access to healthcare among
Hispanics in the US-Mexico border region. American Journal of Health
Behavior, 40, 624–633.
Stepler, R., & Lopez, M. H. (2016, September 8). Ranking the Latino population in
metropolitan areas. Washington, DC: Pew Research Center. Retrieved from
Toomey, R. B., Umaña-Taylor, A. J., Williams, D. R., Harvey-Mendoza, E.,
Jahromi, L. B., & Updegraff, K. A. (2014). Impact of Arizona’s SB 1070
immigration law on utilization of health care and public assistance
among Mexican-origin adolescent mothers and their mother
figures. American Journal of Public Health, 104(S1), S28–S34.
United States-México Border Health Commission (2014). Access to health care in
the U.S.-México border region: Challenges and opportunities. Retrieved from
U.S. Census Bureau. (n.d.). Quick facts: El Paso County, Texas. Retrieved from
U.S. Department of Homeland Security. (2017, February 20). Enforcement of the
immigration law to serve the national interest (Memorandum). Retrieved
U.S. Immigration and Customs Enforcement. (2017). Fiscal year 2017 ICE
enforcement and removal operations report. Retrieved from
Vargas, E. D., & Pirog, M. A. (2016). Mixed status families and WIC uptake: The
effects of risk of deportation on program use. Social Science Quarterly, 97,
Watson, T. (2014). Inside the refrigerator: Immigration enforcement and chilling
effects in Medicaid participation. American Economic Journal: Economic
Policy, 6, 313–338.
White House Office of the Press Secretary. (2017, January 25). Executive Order:
Enhancing public safety in the interior of the United States. Retrieved from
White, K., Blackburn, J., Manzella, B., Welty, E., & Menachemi, N. (2014).
Changes in use of county public health services following implementa-
tion of Alabama’s immigration law. Journal of Health Care for the Poor and
Underserved, 25, 1844–1852.
Zayas, L. H., Aguilar-Gaxiola, S., Yoon, H., & Rey, G. N. (2015). The distress of
citizen-children with detained and deported parents. Journal of Child and
Family Studies, 24, 3213–3223.
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... Further, social networks and support systems may be disrupted when families must relocate to other locations for legal or employment reasons or return to their origin country through deportation or under threat (see Roberts, Menjívar, and Rodriguez 2017). Amplified interior enforcement elevates Latina immigrants' fear of spending time in public spaces or outside the home , undermining the deployment of social ties (Ayón 2017), creating mistrust in social institutions ) that can lead to "institutional apathy" (Estrada, Ebert, and Halla Lore 2016), and decreasing service utilization among Latina/o immigrants (Latz, Lusk, and Heyman 2019). A recent survey of educators (Ee and Gandara 2020) points to the negative effects of enforcement on immigrant parents' involvement in their children's schools. ...
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The 2017 revitalization of the controversial Security Communities program, which requires local law enforcement to cooperate with federal immigration officials in the United States, has made it urgent to better understand such enforcement programs’ effects on the well-being of Latinas/os, especially the foreign-born. Social isolation from increased immigration enforcement can have significant impacts on economic, social, and health outcomes among Latina/o immigrants and non-immigrants. This article analyzes the gendered impacts of different levels of increased local involvement in immigration enforcement on social isolation, using a survey of over 2000 Latinas/os in four large US cities, all considered to be traditional destinations. Unsurprisingly, respondents reported increased social isolation resulting from local law enforcement’s involvement in immigration enforcement. In contrast to results from previous research, our analysis found that women and men were equally likely to feel socially isolated and that having children led to more social isolation for both women and men. Personal and vicarious experiences with immigration enforcement, as well as living in Phoenix and Houston — two urban areas with the strictest enforcement regimes — were strongly related to social isolation. Our results indicate that local authorities’ increased involvement in immigration enforcement can lead to more social isolation for Latina immigrants, particularly those who have children, aligning their experiences with men’s and, thus, undermining Latinas’ previously recognized role as bridges between their families and social institutions and as community builders.
Individuals migrate to improve their wellbeing and quality of life, and often experience adverse situations, both during the process of migration and once within the host country. The purpose of this paper is to unpack the barriers to and facilitators of community participation, among Latinx immigrants with disabilities in the United States and Latinx migrant workers in Canada, following the Social Ecological Model. The authors draw from an appraisal of existing literature and their own participatory research with Latinx immigrants. Based on this integrative literature review, Latinx experience individual issues such as language barriers and lack of knowledge of the services available to them. At the community level they experience discrimination, limited opportunities for community participation, and lack of opportunities for meaningful employment. At the systemic and policy level in the United States, the antimigrant political environment keeps Latinx immigrants with disabilities from participating in their communities due to fear of deportation. In Canada, Latinx workers experience the paradox of migration and discrimination. The discussion of barriers and facilitators is followed by recommendations for community research and action.
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Sociologists recognize that immigration enforcement policies are forms of institutionalized racism that can produce adverse health effects in both undocumented and documented Latinos and Mexican-origin persons in the United States. Despite this important advancement, little research examines the relationship between fear of immigration enforcement and biobehavioral health in mixed-status Mexican-origin families. This study applies an embodiment of racism approach to examine how household fear of deportation (FOD) is related to differences in salivary proinflammatory cytokines (IL-1 β , IL-6, IL-8, and TNF α ) in healthy Mexican-origin families with at least one immigrant, living in Phoenix, AZ. Participants were 111 individuals (n=46 adults, 72% female; n=65 children, 49% female) from 30 low-income, mixed-status families. During a home visit, anthropometric measures and saliva were collected from each family member and a household survey was administered. Saliva was assayed for salivary IL-1 β , IL-6, IL-8, and TNF α . Random effects multilevel structural equation models estimated the relationship between household FOD and a salivary proinflammatory cytokine latent variable between families, while controlling for other chronic stressors (economic/occupational, immigration, parental, and family conflict). Household FOD ( β =0.68, p=0.04) and family conflict chronic stress ( β =1.96, p=0.03) were strongly related to elevated levels of proinflammatory cytokines between families. These results were consistent in non-mixed and mixed-status families. Future research is needed to characterize what aspects of living with an undocumented family member shape the physical health outcomes of persons with authorized status or US-citizenship.
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Background: Growing evidence indicates that immigration policy and enforcement adversely affect the well-being of Latino immigrants, but fewer studies examine 'spillover effects' on USA-born Latinos. Immigration enforcement is often diffuse, covert and difficult to measure. By contrast, the federal immigration raid in Postville, Iowa, in 2008 was, at the time, the largest single-site federal immigration raid in US history. Methods: We employed a quasi-experimental design, examining ethnicity-specific patterns in birth outcomes before and after the Postville raid. We analysed Iowa birth-certificate data to compare risk of term and preterm low birthweight (LBW), by ethnicity and nativity, in the 37 weeks following the raid to the same 37-week period the previous year (n = 52 344). We model risk of adverse birth outcomes using modified Poisson regression and model distribution of birthweight using quantile regression. Results: Infants born to Latina mothers had a 24% greater risk of LBW after the raid when compared with the same period 1 year earlier [risk ratio (95% confidence interval) = 1.24 (0.98, 1.57)]. No such change was observed among infants born to non-Latina White mothers. Increased risk of LBW was observed for USA-born and immigrant Latina mothers. The association between raid timing and LBW was stronger among term than preterm births. Changes in birthweight after the raid primarily reflected decreased birthweight below the 5th percentile of the distribution, not a shift in mean birthweight. Conclusions: Our findings highlight the implications of racialized stressors not only for the health of Latino immigrants, but also for USA-born co-ethnics.
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Objective: This study examines posttraumatic stress disorder (PTSD) symptoms and psychological distress among 91 Latino U.S.-born children (ages 6 to 12), living in mixed-status families with a least 1 undocumented parent at risk for detention or deportation. Method: Multiagent (child, parent, teacher, clinician) and standardized assessments were conducted at baseline to assess for child trauma and psychological distress. Results: Analyses indicate that PTSD symptoms as reported by parent were significantly higher for children of detained and deported parents compared to citizen children whose parents were either legal permanent residents or undocumented without prior contact with immigration enforcement. Similarly, findings revealed differences in child internalizing problems associated with parental detention and deportation as reported by parent as well as differences in overall child functioning as reported by clinician. In addition, teachers reported higher externalizing for children with more exposure to PTEs. Conclusions: These findings lend support to a reconsideration and revision of immigration enforcement practices to take into consideration the best interest of Latino citizen children. Trauma-informed assessments and interventions are recommended for this special population. (PsycINFO Database Record
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Local-level immigration enforcement generates fear and reduces social service use among Hispanic immigrant families but the health impacts are largely unknown. We examine the consequence of 287(g), the foundational enforcement program, for one critical risk factor of child health-food insecurity. We analyze nationally representative data on households with children from pooled cross-sections of the Current Population Survey Food Supplemental Survey. We identify the influence of 287(g) on food insecurity pre-post-policy accounting for metro-area and year fixed-effects. We find that 287(g) is associated with a 10 percentage point increase in the food insecurity risk of Mexican non-citizen households with children, the group most vulnerable to 287(g). We find no evidence of spillover effects on the broader Hispanic community. Our results suggest that local immigration enforcement policies have unintended consequences. Although 287(g) has ended, other federal-local immigration enforcement partnerships persist, which makes these findings highly policy relevant.
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Immigration raids exemplify the reach of immigration law enforcement into the lives of Latino community members, yet little research characterizes the health effects of these raids. We examined the health implications of an immigration raid that resulted in multiple arrests and deportations and occurred midway through a community survey of a Latino population. We used linear regression following principal axis factoring to examine the influence of raid timing on immigration enforcement stress and self-rated health. We controlled for age, sex, relationship status, years in the county in which the raid occurred, children in the home, and nativity. 325 participants completed the survey before the raid and 151 after. Completing the survey after the raid was associated with higher levels of immigration enforcement stress and lower self-rated health scores. Findings indicate the negative impact of immigration raids on Latino communities. Immigration discussions should include holistic assessments of health.
Purpose: U.S. Latino parents of adolescents face unprecedented threats to family stability and well-being due to rapid and far-reaching transformations in U.S. immigration policy. Methods: Two hundred thirteen Latino parents of adolescents were recruited from community settings in a suburb of a large mid-Atlantic city to complete surveys assessing parents' psychological distress and responses to immigration actions and news. Univariate and bivariate analyses were conducted to describe the prevalence of parents' responses to immigration news and actions across diverse residency statuses. Multiple logistic regression models examined associations between immigration-related impacts and the odds of a parent's high psychological distress. Results: Permanent residents, temporary protected status, and undocumented parents reported significantly more negative immigration impacts on psychological states than U.S. citizens. Parents reporting frequent negative immigration-related impacts had a significantly higher likelihood of high psychological distress than did other parents, and these associations were maintained even when accounting for parents' residency status, gender, education, and experience with deportation or detention. The odds of a parent reporting high psychological distress due to negative immigration impacts ranged from 2.2 (p < .05) to 10.4 (p < .001). Conclusions: This is one of the first empirical accounts of how recent immigration policy changes and news have impacted the lives of Latino families raising adolescent children. Harmful impacts were manifest across a range of parent concerns and behaviors and are strong correlates of psychological distress. Findings suggest a need to consider pathways to citizenship for Latina/o parents so that these parents, many of whom are legal residents, may effectively care for their children.
Nearly 5.1 million children younger than age 18 live with at least one undocumented parent, about 7% of the U.S. child population. Between 2010 and 2013, an estimated 300,000 parents of U.S. citizen children were deported. Raising children in the context of deportation risk increases overall parenting stress for undocumented Latino parents. To investigate this and understand the experience of undocumented parenting, the authors interviewed 70 undocumented parents in two Southwest cities from 2012 to 2013. The authors frame their analysis using the lens of the problem of “illegality.” There are three domains of stressors associated with parenting in the context of deportation risk: trapped parenting, threat of family separation, and altered family processes. The authors discuss these findings in the context of the literature on undocumented families and parenting stress and connect these findings to the current sociopolitical context experienced by Latino families in the United States .
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 a more exclusionary immigration policy climate had higher rates of poor mental health days than participants in states with a less exclusionary policy climate (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 a more exclusionary policy climate had 1.14 (95% CI: 1.04, 1.25) times the rate of poor mental health days than Latinos in states with a less exclusionary policy climate. 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.
Objective: Using large national databases, we investigated how living in the US-Mexico border region further limited access to healthcare among the non-elderly Hispanic adult population after controlling individual and county-level characteristics. Methods: The 2008-2012 individual-level data of non-elderly Hispanic adults from the Behavioral Risk Factor Surveillance System (BRFSS) were merged with county-level data from Area Health Resources File (AHRF). Multivariate logistic analyses were performed to predict insurance status and access to doctors using residency in the US-Mexico border region as the key predictor, adjusting individual and county-level factors. Results: Controlling only individual characteristic, Hispanics living in the US-Mexico border region had significantly lower odds of having health insurance (adjusted odds ratio [AOR] = 0.51; 95% confidence interval [CI], 0.49-0.54) and access to doctors (AOR = 0.69; 95% CI, 0.66-0.72). After including county-level measurements of healthcare system capacity and other local characteristics, the border region continued to be associated with lower likelihood of healthcare access. Conclusion: Hispanic residents in the U.S.-Mexico border had less access to healthcare than their inland counterparts. The findings highlight unique features in this region and support policies and initiatives to improve minority healthcare access, particularly among disadvantaged populations in this region.
Objective: Develop and test measures of risk of deportation and mixed-status families on WIC uptake. Mixed-status is a situation in which some family members are U.S. citizens and other family members are in the U.S. without proper authorization. Methods: Estimate a series of logistic regressions to estimate WIC uptake by merging data from Fragile Families and Child Well-being Survey with deportation data from U.S.-Immigration Customs and Enforcement. Results: The findings of this study suggest that risk of deportation is negatively associated with WIC uptake and among mixed-status families; Mexican origin families are the most sensitive when it comes to deportations and program use. Conclusion: Our analysis provides a typology and framework to study mixed-status families and evaluate their usage of social services by including an innovative measure of risk of deportation.