Journal of Urban Health

, Volume 94, Issue 6, pp 764–775 | Cite as

Legal Status, Time in the USA, and the Well-Being of Latinos in Los Angeles

  • Maria-Elena De Trinidad YoungEmail author
  • Anne R. Pebley


In the USA, undocumented Latino immigrants may have poorer health because of barriers to health care, stressors, and detrimental effects of immigration enforcement. Previous immigrant health research, however, suggests that recently arrived Latino immigrants have better health than US-born Latinos and their health deteriorates over time. Given the current environments that undocumented immigrants face, legal status is a structural factor that likely influences the patterns of immigrant health. Therefore, the aim of this study was to examine the extent to which physical and mental health differed by legal status and duration in the USA for the Latino population in Los Angeles County, California. We conducted analysis of Latino respondents (n = 1396) to the Los Angeles Family and Neighborhood Survey (L.A.FANS) Wave II. We examined self-reported health, depression measured by the Composite International Diagnostic Interview—Short Form, and blood pressure collected by trained interviewers. Respondents reported their legal status, time in the USA, and other sociodemographic characteristics. Regression models were used to test associations between each outcome and 1) legal status and 2) legal status by duration (≤ 15 and > 15 years) in the USA. Without taking duration into account, we found no significant differences in outcomes between undocumented, documented, or US-born Latinos. Taking duration into account, shorter duration undocumented immigrants had worse self-reported health than the US born. Undocumented immigrants, regardless of duration, had higher blood pressure than documented immigrants who had been in the USA for less time and the same level of blood pressure as the US born. In contrast, shorter duration documented immigrants had lower blood pressure compared to longer duration documented immigrants and US-born counterparts, and marginally lower blood pressure than shorter duration undocumented immigrants. The findings suggest that the “health advantage” generally presumed to exist among immigrants may not affect undocumented immigrants.


Immigrants Latino Undocumented status Health Depression Blood pressure 



This work was supported by a Graduate Summer Research Mentorship from the UCLA Graduate Division and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD051764 and R24HD041022).

Supplementary material

11524_2017_197_MOESM1_ESM.xlsx (11 kb)
Supplemental Table A (XLSX 10 kb)


  1. 1.
    Chavez LR. The Latino threat: constructing immigrants, citizens, and the nation. Stanford, Calif.: Stanford University Press; 2008.Google Scholar
  2. 2.
    Golash-Boza T, Hondagneu-Sotelo P. Latino immigrant men and the deportation crisis: a gendered racial removal program. Latino Stud. 2013;11(3):271–92.CrossRefGoogle Scholar
  3. 3.
    Valdez CR, Lewis Valentine J, Padilla B. “Why we stay”: immigrants’ motivations for remaining in communities impacted by anti-immigration policy. Cult Divers Ethn Minor Psychol. 2013;19(3):279–87.CrossRefGoogle Scholar
  4. 4.
    Motomura H. Immigration outside the law. New York: Oxford University Press; 2014.Google Scholar
  5. 5.
    Anderson KF, Finch JK. Racially charged legislation and Latino health disparities: the case of Arizona’s S.B. 1070. Sociol Spectr. 2014;34(6):526–48.CrossRefGoogle Scholar
  6. 6.
    Martinez O, Wu E, Sandfort T, Dodge B, Carballo-Dieguez A, Pinto R, et al. Evaluating the impact of immigration policies on health status among undocumented immigrants: a systematic review. J Immigr Minor Health. 2015;17(3):947-70.Google Scholar
  7. 7.
    Castaneda H, Holmes SM, Madrigal DS, Young ME, Beyeler N, Quesada J. Immigration as a Social Determinant of Health. Annu Rev Public Health. 2015;36:375-92.Google Scholar
  8. 8.
    Rodriguez H, Saenz R, Menjivar C (Eds.). Latinas/os in the United States. Changing the face of América. New York, USA: Springer; 2008.Google Scholar
  9. 9.
    Creighton MJ, Goldman N, Pebley AR, Chung CY. Durational and generational differences in Mexican immigrant obesity: is acculturation the explanation? Soc Sci Med. 2012;75(2):300–10.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DE. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367–97.Google Scholar
  11. 11.
    Abraido-Lanza AF, Dohrenwend BP, Ng-Mak DS, Turner JB. The Latino mortality paradox: a test of the “salmon bias” and healthy migrant hypotheses. Am J Public Health. 1999;89(10):1543–8.Google Scholar
  12. 12.
    Viruell-Fuentes EA, Miranda PY, Abdulrahim S. More than culture: structural racism, intersectionality theory, and immigrant health. Soc Sci Med. 2012;75(12):2099–106.CrossRefPubMedGoogle Scholar
  13. 13.
    Zambrana RE, Carter-Pokras O. Role of acculturation research in advancing science and practice in reducing health care disparities among Latinos. Am J Public Health. 2010;100(1):18–23.Google Scholar
  14. 14.
    Acevedo-Garcia D, Sanchez-Vaznaugh EV, Viruell-Fuentes EA, Almeida J. Integrating social epidemiology into immigrant health research: a cross-national framework. Soc Sci Med. 2012;75(12):2060–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Carter-Pokras O, Zambrana RE. Collection of legal status information: caution! Am J Public Health. 2006;96(3):399; author reply 399-400.Google Scholar
  16. 16.
    Prentice JC, Pebley AR, Sastry N. PRENTICE ET AL. RESPOND. Am J Public Health. 2006;96(3):399–400.Google Scholar
  17. 17.
    Arbona C, Olvera N, Rodriguez N, Hagan J, Linares A, Wiesner M. Acculturative stress among documented and undocumented Latino immigrants in the United States. Hisp J Behav Sci. 2010;32(3):362–84.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Cavazos-Rehg PA, Zayas LH, Spitznagel EL. Legal status, emotional well-being and subjective health status of Latino immigrants. J Natl Med Assoc. 2007;99(10):1126–31.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Tamashiro KLK, Hegeman MA, Sakai RR. Chronic social stress in a changing dietary environment. Physiol Behav. 2006;89(4):536–42.CrossRefPubMedGoogle Scholar
  20. 20.
    Spruill T. Chronic psychosocial stress and hypertension. Curr Hypertens Rep. 2010;12(1):10–6.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Moore CJ, Cunningham SA. Social position, psychological stress, and obesity: a systematic review. J Acad Nutr Diet. 2012;112(4):518–26.CrossRefPubMedGoogle Scholar
  22. 22.
    Fowler-Brown AG, Bennett GG, Goodman MS, Wee CC, Corbie-Smith GM, James SA. Psychosocial stress and 13-year BMI change among blacks: the Pitt County Study. Obesity. 2009;17(11):2106–9.Google Scholar
  23. 23.
    Passel JS, Cohn DV, Rohal M. Unauthorized immigrant totals rise in 7 states, fall in 14: decline in those from mexico fuels most state decreases. Washington, D.C.: Pew Research Center; 2014.Google Scholar
  24. 24.
    Passel JS, Cohn DV. A portrait of unauthorized immigrants in the United States. Washington, D.C.: Pew Hispanic Center; 2009.Google Scholar
  25. 25.
    Ortiz V, Telles E. Racial Identity and Racial Treatment of Mexican Americans. Race Soc Probl. 2012;4(1): 10.1007/s12552-012-9064-8.
  26. 26.
    Lopez IFH. Race and erasure: the salience of race to Latinos/as. In: Delgado R, Stefancic J, editors. Critical race theory: the cutting edge. Philadelphia, USA: Temple University Press; 2000. p. 369–78.Google Scholar
  27. 27.
    Massey DS, Sánchez M. Brokered boundaries: creating immigrant identity in anti-immigrant times. New York: Russell Sage Foundation; 2010.Google Scholar
  28. 28.
    Gleeson S, Gonzales RG. When do papers matter? An institutional analysis of undocumented life in the United States. Int Migr. 2012;50(4):1–19.CrossRefGoogle Scholar
  29. 29.
    Gleeson S. Labor rights for all? The role of undocumented immigrant status for worker claims making. Lawn Soc Inq. 2010;35(3):561–602.Google Scholar
  30. 30.
    Menjívar C, Abrego LJ. Immigrant families. Cambridge, UK: Polity; 2016.Google Scholar
  31. 31.
    Bean FD, Brown SK, Bachmeier JD. Parents without papers : the progress and pitfalls of Mexican-American integration. New York: Russell Sage Foundation; 2015.Google Scholar
  32. 32.
    Gee GC, Ford CL. Structural racism and health inequities: old issues, New Directions. Du Bois review: social science research on race. 2011;8(1):115–132.Google Scholar
  33. 33.
    Phelan JC, Link BG, Tehranifar P. Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010;51(Suppl):S28–40.CrossRefPubMedGoogle Scholar
  34. 34.
    Marmot M, Allen JJ. Social determinants of health equity. Am J Public Health 2014;104(Suppl 4):S517–9.Google Scholar
  35. 35.
    Torres JM, Young MED. A life-course perspective on legal status stratification and health. SSM - Population Health. 2016;2:141–8.Google Scholar
  36. 36.
    Flores G, Abreu M, Tomany-Korman SC. Why are Latinos the most uninsured racial/ethnic group of US children? A community-based study of risk factors for and consequences of being an uninsured Latino child. Pediatrics. 2006;118(3):e730–40.Google Scholar
  37. 37.
    Guendelman S, Angulo V, Wier M, Oman D. Overcoming the odds: access to care for immigrant children in working poor families in California. J Matern Child Health. 2005;9(4):351–62.Google Scholar
  38. 38.
    Stevens GD, West-Wright CN, Tsai KY. Health insurance and access to care for families with young children in California, 2001-2005: differences by immigration status. J Immigr Minor Health. 2010;12(3):273–81.CrossRefPubMedGoogle Scholar
  39. 39.
    Vargas Bustamante A, Chen J, Fang H, Rizzo JA, Ortega AN. Identifying health insurance predictors and the main reported reasons for being uninsured among US immigrants by legal authorization status. Int J Health Plann Manage. 2014;29(1):e83-e96.Google Scholar
  40. 40.
    Vargas Bustamante A, Fang H, Garza J, Carter-Pokras O, Wallace SP, Rizzo JA, et al. Variations in healthcare access and utilization among Mexican immigrants: the role of documentation status. J Immigr Minor Health. 2012;14(1):146–55.CrossRefPubMedGoogle Scholar
  41. 41.
    Broder T, Moussavian A, Blazer J. Overview of Immigrant Eligibility for Federal Programs. Los Angeles, USA: National Immigrant Law Center; 2015.Google Scholar
  42. 42.
    Hagan J, Rodriguez N, Capps R, Kabiri N. The effects of recent welfare and immigration reforms on immigrants’ access to health care1. Int Migr Rev. 2003;37(2):444–63.CrossRefGoogle Scholar
  43. 43.
    Kaushal N, Kaestner R. Welfare reform and health insurance of immigrants. Health Serv Res. 2005;40(3):697–722.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Rodriguez M, Young ME, Wallace SP. Creating conditions to support healthy people: state policies that affect the health of undocumented immigrants and their families. Los Angeles, USA: UCLA Center for Health Policy Research; 2014.Google Scholar
  45. 45.
    Rodriguez MA, Bustamante AV, Ang A. Perceived quality of care, receipt of preventive care, and usual source of health care among undocumented and other Latinos. J Gen Intern Med. 2009;24(Suppl 3):508–13.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Ortega AN, Fang H, Perez VH, Rizzo JA, Carter-Pokras O, Wallace SP, et al. Health care access, use of services, and experiences among undocumented Mexicans and other Latinos. Arch Intern Med. 2007;167(21):2354–60.CrossRefPubMedGoogle Scholar
  47. 47.
    Korinek K, Smith KR. Prenatal care among immigrant and racial-ethnic minority women in a new immigrant destination: exploring the impact of immigrant legal status. Soc Sci Med. 2011;72(10):1695–703.CrossRefPubMedGoogle Scholar
  48. 48.
    Poon KK, Dang BN, Davila JA, Hartman C, Giordano TP. Treatment outcomes in undocumented Hispanic immigrants with HIV infection. PLoS One. 2013;8(3):e60022.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Pivnick A, Jacobson A, Blank AE, Villegas M. Accessing primary care: HIV+ Caribbean immigrants in the Bronx. J Immigr Minor Health. 2010;12(4):496–505.CrossRefPubMedGoogle Scholar
  50. 50.
    Chin JJ, Kang E, Kim JH, Martinez J, Eckholdt H. Serving Asians and Pacific Islanders with HIV/AIDS: challenges and lessons learned. J Health Care Poor Underserved. 2006;17(4):910–27.CrossRefPubMedGoogle Scholar
  51. 51.
    Castro-Echeverry E, Kao LS, Robinson EK, Silberfein EJ, Ko TC, Wray CJ. Relationship between documentation status and survival for medically underserved Hispanic breast cancer patients. J Surg Res. 2013;180(2):284–9.CrossRefPubMedGoogle Scholar
  52. 52.
    Campesino M, Ruiz E, Glover JU, Koithan M. Counternarratives of Mexican-origin women with breast cancer. ANS Adv Nurs Sci. 2009;32(2):E57–67.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Berk ML, Schur CL. The effect of fear on access to care among undocumented Latino immigrants. J Immigr Minor Health. 2001;3(3):151–6.Google Scholar
  54. 54.
    Hacker K, Chu J, Leung C, Marra R, Pirie A, Brahimi M, et al. The impact of immigration and customs enforcement on immigrant health: perceptions of immigrants in Everett, Massachusetts, USA. Soc Sci Med. 2011;73(4):586–94.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Maldonado CZ, Rodriguez RM, Torres JR, Flores YS, Lovato LM. Fear of discovery among Latino immigrants presenting to the emergency department. Acad Emerg Med. 2013;20(2):155–61.CrossRefPubMedGoogle Scholar
  56. 56.
    Rhodes SD, Mann L, Siman FM, Song E, Alonzo J, Downs M, et al. The impact of local immigration enforcement policies on the health of immigrant hispanics/latinos in the United States. Am J Public Health. 2015;105(2):329–37.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Menjivar C, Kanstroom D. Introduction—immigrant “illegality”: constructions and critiques. In: Cecilia Menjivar DK, editor. Constructing immigrant “illegality”: critiques, experiences, and responses. New York: Cambridge University Press; 2014.Google Scholar
  58. 58.
    Potochnick SR, Perreira KM. Depression and anxiety among first-generation immigrant Latino youth: key correlates and implications for future research. J Nerv Ment Dis. 2010;198(7):470–7.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Ojeda L, Pina-Watson B. Day laborers’ life satisfaction: the role of familismo, spirituality, work, health, and discrimination. Cultur Divers Ethnic Minor Psychol. 2013;19(3):270–8.CrossRefPubMedGoogle Scholar
  60. 60.
    Negi NJ. Battling discrimination and social isolation: psychological distress among Latino day laborers. Am J Community Psychol. 2013;51(1–2):164–74.CrossRefPubMedGoogle Scholar
  61. 61.
    Fenton JJ, Catalano R, Hargreaves WA. Effect of proposition 187 on mental health service use in California: a case study. Health Aff (Millwood). 1996;15(1):182–90.CrossRefGoogle Scholar
  62. 62.
    Amuedo-Dorantes C, Puttitanun T, Martinez-Donate AP. How do tougher immigration measures affect unauthorized immigrants? Demography. 2013;50(3):1067–91.CrossRefPubMedGoogle Scholar
  63. 63.
    Holmes LM, Marcelli EA. Neighborhoods and systemic inflammation: high CRP among legal and unauthorized Brazilian migrants. Health Place. 2012;18(3):683–93.CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    Wen M, Maloney TN. Neighborhood socioeconomic status and BMI differences by immigrant and legal status: evidence from Utah. Econ Hum Biol. 2014;12:120–31.CrossRefPubMedGoogle Scholar
  65. 65.
    Abraído-Lanza AF, Dohrenwend BP, Ng-Mak DS, Turner JB. The Latino mortality paradox: a test of the “salmon bias” and healthy migrant hypotheses. Am J Public Health. 1999;89(10):1543–8.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Goldman N, Pebley A, Creighton M, Teruel G, Rubalcava L, Chung C. The consequences of migration to the United States for short-term changes in the health of Mexican immigrants. Demography. 2014;51(4):1159–73.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Peterson C, Pebley AR, Sastry N, Yuhas K, Ghosh-Dastidar B, Haas A, et al. The Los Angeles family and neighborhood survey, wave 2 user’s guide and codebook: labor and population program. Los Angeles, CA: RAND Corporation; 2011.Google Scholar
  68. 68.
    Franklin SS, Larson MG, Khan SA, Wong ND, Leip EP, Kannel WB, et al. Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation. 2001;103(9):1245–9.CrossRefPubMedGoogle Scholar
  69. 69.
    MacMahon S, Peto R, Collins R, Godwin J, MacMahon S, Cutler J, et al. Blood pressure, stroke, and coronary heart disease: Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990;335(8692):765–74.CrossRefPubMedGoogle Scholar
  70. 70.
    Zile MR, Brutsaert DL. New concepts in diastolic dysfunction and diastolic heart failure: Part I diagnosis, prognosis, and measurements of diastolic function. Circulation. 2002;105(11):1387–93.CrossRefPubMedGoogle Scholar
  71. 71.
    StataCorp. Stata: Release 13. In: Statistical Software. College Station, TX: StataCorp LP.; 2013.Google Scholar
  72. 72.
    Abrego LJ. Sacrificing families: navigating laws, labor, and love across borders. Stanford, CA: Stanford University Press; 2014.Google Scholar
  73. 73.
    Holmes SM. “Is it worth risking your life?”: ethnography, risk and death on the U.S.–Mexico border. Soc Sci Med. 2013;99:153–61.CrossRefPubMedGoogle Scholar
  74. 74.
    Gee GC, Ryan A, Laflamme DJ, Holt J. Self-reported discrimination and mental health status among African descendants, Mexican Americans, and other Latinos in the New Hampshire REACH 2010 initiative: the added dimension of immigration. Am J Public Health. 2006;96(10):1821–8.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Gubernskaya Z, Bean FD, Van Hook J. (Un)Healthy immigrant citizens: naturalization and activity limitations in older age. J Health Soc Behav. 2013;54(4):427–43.CrossRefPubMedPubMedCentralGoogle Scholar
  76. 76.
    Pong SL, Landale NS. Academic achievement of legal immigrants’ children: the roles of parents’ pre- and postmigration characteristics in origin-group differences. Child Dev. 2012;83(5):1543–59.CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    Landale NS, Hardie JH, Oropesa RS, Hillemeier MM. Behavioral functioning among Mexican-origin children: does parental legal status matter? J Health Soc Behav. 2015;56(1):2–18.CrossRefPubMedPubMedCentralGoogle Scholar
  78. 78.
    Arenas E, Goldman N, Pebley AR, Teruel G. Return migration to Mexico: does health matter? Demography. 2015;52(6):1853-68.Google Scholar
  79. 79.
    Miranda PY, Schulz AJ, Israel BA, Gonzalez HM. Context of entry and number of depressive symptoms in an older Mexican-origin immigrant population. J Immigr Minor Health. 2011;13(4):706–12.CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Zúñiga V, Hernández-León R. New destinations: Mexican immigration in the United States. New York: Russell Sage Foundation; 2005.Google Scholar
  81. 81.
    Council NR. Hispanics and the future of America. Washington, DC: The National Academies Press; 2006.Google Scholar

Copyright information

© The New York Academy of Medicine 2017

Authors and Affiliations

  • Maria-Elena De Trinidad Young
    • 1
    Email author
  • Anne R. Pebley
    • 1
  1. 1.University of California, Los AngelesLos AngelesUSA

Personalised recommendations