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FSPH researchers investigating how public policies affect whether immigrants access healthcare

Researchers at the UCLA Center for Health Policy and Research are seeking to understand how policies in California may affect Asian and Latino immigrants.

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Date: 
Wednesday, November 21, 2018
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The debate about how to address immigration in the United States may be at full throttle, but researchers at the Fielding School’s UCLA Center for Health Policy Research (CHPR) want to ensure the conversation is informed by data.

The researchers are seeking to understand how policies in California may affect how Asian and Latino immigrants—the largest immigrant groups in the state—access healthcare. Last September, a team led by Steven Wallace, professor of community health sciences at the UCLA Fielding School of Public Health and associate director of the CHPR, initiated the study with a five-year, $2.5 million grant from the National Institute on Minority Health and Health Disparities.

Wallace, along with Maria-Elena De Trinidad Young (PhD ’18), a research scientist at the center, recently shared insight gained from their work.

FSPH: Why were you interested in conducting this study?

Wallace: This research builds on work we’ve been doing together and collaborating with others on for several years. I’ve done work on immigrant health since 1978. When Maria-Elena joined our doctoral program, we put together a report that looked at state and national policies that could affect immigrant health. Maria-Elena had done a series of independent projects that were looking at outcomes of state policies on different health outcomes, and she also looked at data from the California Health Interview Survey [a statewide survey administered by FSPH’s UCLA Center for Health Policy Research]. That work sparked a conversation about what is the actual connection between immigration policies and health? There’s a moderate amount of literature around how, say, a law in Arizona terrifies the community and results in a drop in healthcare access,(1) or how a year after a large raid at a meatpacking plant in Iowa by the U.S. Immigration and Customs Enforcement (ICE) there is a spike in premature births for Latinos.(2) There’s lots of correlational data but not a lot of information about actual experiences of immigrants and health outcomes.  

FSPH: How are you are conducting the study?

Young: We are conducting a survey with 1,000 Asian and 1,000 Latino California Health Interview Survey respondents over the course of two years. We developed a 15-minute survey, available in five languages, that asks immigrants about their experiences in the areas of healthcare, social services, labor and employment, law enforcement and education. We also ask the respondents their general perceptions of immigration in California: Do they feel discriminated against? Do they feel safe in their neighborhoods?

Additionally, we are in the process of conducting approximately 60 one-on-one interviews with Mexican and Chinese immigrants living in Los Angeles and Orange Counties. The idea is to get a sense of the diversity of experiences of people living in the more inclusive counties in California and in the more exclusive counties. Los Angeles County, for example, provides health coverage to anyone regardless of citizenship status. Orange County has contracts with ICE and helps with the deportation of immigrants. Our hope is to hear the stories about how, on a day-to-day basis, immigrants interact with their workplaces, schools and communities, and how these experiences affect whether they seek healthcare when needed.  

FSPH: How do California laws regarding immigration compare with those in other states?

Young: Based on our research, California has the most inclusive policy environment for immigrants in the country. But, there’s wide variation at the county levels and even California has room to improve further at the state level.

FSPH: Why is it important to study immigrant health?

Wallace: A quarter of the population in California is born abroad.

Young: Immigrants are a part of our families, communities, institutions, nation. It’s an important group to study at this particular time because of societal shifts in terms of who is being stigmatized and excluded in different ways. Studying immigrant health is about knowing who is potentially at risk of being left out of things like the Affordable Care Act or other policies that are meant to make society healthier. We have a responsibility as public health researchers to keep an eye on what’s happening to vulnerable populations.

Wallace: There’s a long history of saying, ‘I’m healthy because I make the right decisions. I eat right and I exercise and it’s all on me.’ But people don’t make those decisions in a vacuum. Studies such as this one help identify where public policy can improve the conditions under which people can be healthy. These conditions include access to education, a good job, the ability to circulate in your community. Everyone benefits when everyone in the state has the best chances for a healthy life.

References

1.     Toomey RB, Umana-Taylor AJ, Williams DR, et al. 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. AJPH 2014;104 Suppl 1:S28-34

2. Novak NL, Geronimus AT, Martinz-Cardoso AM. Change in birth outcomes among Latina mothers after a major immigration raid. Int J Epi. 2017;46(3):839-849