Local enforcement of federal immigration laws affects immigrant Hispanics' healthcare

December 18, 2014

WINSTON-SALEM, N.C. - Dec. 18, 2014 - State and local enforcement of federal immigration laws can have an adverse impact on the use of health care services by immigrant Hispanics, according to a North Carolina-based study by Wake Forest Baptist Medical Center researchers.

The study, published in the Dec. 18 issue of the American Journal of Public Health, analyzed both birth records and information collected in focus groups and individual interviews.

"Our findings suggest that immigration enforcement policies negatively affect the health of immigrant Hispanics, including those with and without documentation," said Scott D. Rhodes, Ph.D., M.P.H., professor of public health sciences at Wake Forest Baptist and lead author of the study.

The statistical focus of the study was the use of prenatal care by Hispanic women shortly before and after implementation of Section 287(g) of the Immigration and Nationality Act, which authorizes U.S. Immigration and Custom Enforcement to enter into agreements with state and local agencies to enforce federal immigration laws during their regular law-enforcement activities. The researchers compared birth records using North Carolina vital records data from the nine months preceding implementation of 287(g) and nine to 18 months after implementation in seven North Carolina counties that signed on to the program and seven counties that did not.

The researchers found that rates of late and inadequate prenatal care among Hispanic mothers increased in the counties that implemented 287(g) while those rates in the non-participating counties declined, but the difference was not statistically significant. In examining all mothers in North Carolina, however, the researchers found that late and inadequate prenatal care increased significantly among Hispanic mothers compared to non-Hispanic mothers across the state after implementation of 287(g).

To complement the statistical analysis, the study team conducted three focus groups and nine individual interviews with Hispanic residents of three counties that implemented 287(g) and three focus groups and eight individual interviews in three counties that did not.

Rhodes said that the participants in those sessions reported knowing that enforcement of immigration laws was increasing but that many of them did not know the details about specific programs such as 287(g) or have a clear understanding of their rights under the law.

"Overall, participants reported fearing immigration enforcement policies and avoiding or delaying utilization of health services, thus endangering their own health and that of their families," Rhodes said.

The researchers said that initiatives to educate immigrant Hispanics about their rights and the availability of services would help to increase their utilization of health care services, and suggested that public officials weigh public health considerations when deciding whether and to what extent federal immigration laws should be enforced on the state and local level.
Support for the study was provided by the Robert Wood Johnson Foundation's Public Health Law Research program.

Co-authors of the study are Lilli Mann, M.P.H., Eunyoung Song, Ph.D., Mary Claire O'Brien, M.D., Beth A. Reboussin, Ph.D., Jorge Alonzo, J.D., Christina J. Sun, Ph.D., and Mario Downs, of Wake Forest Baptist; Mark A. Hall, J.D., of Wake Forest University School of Law; Omar Martinez, J.D., M.P.H., of Columbia University; Florence M. Simán, M.P.H., of El Pueblo Inc.; and Emma Lawlor, B.A., of the University of Arizona.

Wake Forest Baptist Medical Center

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