Unpacking Immigrant Health: Policy, Stress, and Demographics
Currently, immigration and the status of immigrants are prevalent issues in the national and academic rhetoric as immigration policy is at a standstill in the U.S. At a federal level, passing any humane immigration policy is an uphill battle as the current administration fuels hatred towards this population which often includes referring to immigrants as criminals, animals, and in general dehumanizing the population. The intersection of such rhetoric and aggressive enforcement practices serves to create oppressive living environments where immigrants work, engage socially, and raise their children. Concomitantly, the status of immigrants’ health and well-being is a critical issue among a segment of immigration scholars because as the restrictive immigration policy context and anti-immigrant rhetoric increases so does the risk for poor health outcomes among immigrants and their families. Emerging evidence suggests that documentation status is a social determinant of health and subsequently has been linked to poor health outcomes (Vargas Bustamante et al. 2012) through increased stress. Additionally, a growing body of literature reveals the far-reaching effects of anti-immigrant sentiment and policies beyond undocumented individuals to family members and entire communities (Vargas and Ybarra 2017; Viruell Fuentes et al. 2012). Immigrants represent 13.3% (42.4 million individuals) of the total U.S. population (Camarota and Zeigler 2016), it is estimated that 11 million immigrants are undocumented (Krogstad et al. 2017), and nearly 26% of children in the U.S. have an immigrant parent (Migration Policy Institute 2016a). Thus, the health consequences associated with the current immigration climate may impact a large segment of the U.S. population, making it a public health concern.
This special issue is the first part of a 2-part series on Race and Immigration. In part one, we present a compilation of articles on immigrant health. Collectively, these papers “unpack” various factors that play a role on immigrant’s health and overall well-being. The studies span issues of policy enforcement, how the effects of policy are manifested in the lives of immigrants, and differences by socio-demographics across various groups of immigrants.
The first three papers emphasize policy issues. LeBrón et al. (2018) shed light on the racialized processes used to enforce immigration policies; specifically, the authors’ focus on how institutions exact immigration policies and engage in bureaucratic surveillance. Findings illustrate how racialized practices blur the lines between Latinas/os, immigrants, and undocumented immigrants; that is, racialized practices “spillover” impacting Latinos regardless of the their documentation status. The authors argue that racialized processes affect health through experiences of stigma, hypervigilance, and restricted access to health-promoting resources. In response to an evolving immigration policy context for undocumented youth, Enriquez, Morales Hernandez, and Ro used a mixed methods design to examine the dimensions of “illegality” and their effects on the health of undocumented college students. Enriquez et al. (2018) construct a model to disentangle how “illegality” is manifested in the lives of undocumented youth and in turn how “illegality” impacts their health. Rich quotes further demonstrate how dimension of “illegality” impacts undocumented youths’ day-to-day lives. Readers are encouraged to continue to deconstruct how policies impact the lives of immigrants beyond threat of deportation. Gurrola and Ayón (2018) use the social determinants of health framework to understand how immigration policy, its enforcement, and anti-immigrant sentiment impacts immigrant health. Findings illuminate how the immigration policy context and anti-immigrant sentiment alter immigrants’ social interactions in multiple social environments and in their interaction with institutions. Participants relate barriers in accessing health care for themselves and their children. In addition, these findings highlight another dimension of the “spillover” effects of immigration policies as the study was completed in the state of California which has passed several pro-integration immigration policies, yet participants often referenced the restrictive policies passed in the neighboring state of Arizona (e.g., ∣SB1070).
The next two papers examine health outcomes and stress, and speak to the impact on immigrant families. García used the stress process model to understand stressors associated with the threat of deportation. This paper expands the stress process literature by bridging this model to the immigrant community. Findings reveal how the threat of deportation is experienced as an anticipatory stressor and overtime as a chronic stressor. Stress levels associated with the threat of deportation are exacerbated by fear of family fragmentation, economic insecurity, and increased social isolation as a means of avoiding authorities. Such factors have been linked to poor health outcomes. DeCarlo Santiago et al. (2018) offer a family perspective on immigrant health by longitudinally examining cumulative socio-demographic risk and immigrant-related stress in a sample of immigrant parents and their children. Their findings highlight the intergenerational toll that immigrant-related stress takes on the whole family including children who are US citizens.
A relationship between discrimination and poor mental health outcomes among immigrants is well established (Ornelas and Perreira 2011; Yoo et al. 2009). Nguyen et al. (2018) expand this finding by examining the relationship between discrimination and an indicator of physical health among an understudied immigrant group, the Caribbean black population. The authors present an analysis on the impact of discrimination on chronic kidney disease and how it may vary by socio-demographic characteristics. Chronic kidney disease is a public health concern as if left untreated can lead to kidney failure requiring dialysis or kidney transplant.
Older adults (65 years and more) constitute 15% of the immigrant population in the U.S. (Migration Policy Institute 2016b). Approximately 16% of older adults who are immigrants live below the poverty line, 40% are member of low-income families, and they tend to have less than a high school education and limited English proficiency (Farrell 2016). The final article sheds light on the health needs of older immigrants. Torr and Walsh (2018) elucidate the varied experiences among older immigrants in the U.S. For instance, the authors stress that Vietnamese refugees differ considerably from other immigrants due their forced immigration experience and context of reception in the U.S. This study’s findings are critical in light of the growing immigrant older adult population. As this segment of the immigrant population continues to grow, it is critical to understand their needs in order to better serve them and support their families.
This collection of empirical articles on immigrants’ health, brings together an interdisciplinary perspective on the current status, challenges, and socio-demographic and policy factors that influence immigrant health. Findings from these studies support the growing body of research that examines the nexus between immigration policy and health policy. Immigrant policies and enforcement practices both heighten immigrant health needs and limit access to health care. We hope that this special issue will encourage scholars, practitioners, and community activist to continue to fight for immigrant rights and find solutions to their health needs.
- Camarota, S. A., & Zeigler, K. (2016). Immigrants in the United States. A profile of the foreign-born using 2014 and 2015 Census Bureau data. Center for Immigrant Studies. Retrieved from https://cis.org/sites/cis.org/files/immigrant-profile_0.pdf.
- DeCarlo Santiago, C., Distel, L. M. L., Ros, A. M., Brewer, S. K., Torres, S. A., Papdakis, J. L., et al. (2018). Mental health among Mexican-origin immigrant families: The roles of cumulative sociodemographic risk and immigrant-related stress. Race and Social Problems. https://doi.org/10.1007/s12552-018-9236-2.Google Scholar
- Farrell, C. (2016). The painful struggles of America’s older immigrants. Retrieved from https://www.forbes.com/sites/nextavenue/2016/12/12/the-painful-struggles-of-americas-older-immigrants/#75dc177439d9.
- García, S. J. (in press). Living a deportation threat: Stressors confronted by undocumented Mexican immigrant women. Race and Social Problems.Google Scholar
- Krogstad, J. M., Passel, J. S., & Coh, D. (2017). 5 facts about illegal immigration in the U.S. Retrieved from http://www.pewresearch.org/fact-tank/2017/04/27/5-facts-about-illegal-immigration-in-the-u-s/.
- LeBrón, A. M. W., Schultz, A. J., Gamboa, C., Reyes, A. G., Viruell-Fuentes, E., & Israel, B. (2018). “They are clipping our wings”: Health implications of restrictive immigrant policies for Mexican-origin women in a northern border community. Race and Social Problems. https://doi.org/10.1007/s12552-018-9238-0.Google Scholar
- Migration Policy Institute. (2016a). Children in U.S. immigrant families. Retrieved from https://www.migrationpolicy.org/programs/data-hub/charts/children-immigrant-families.
- Migration Policy Institute (2016b). Age-sex pyramids of U.S. immigrant and native-born, populations, 1970-present. Retrieved from https://www.migrationpolicy.org/programs/data-hub/charts/age-sex-pyramids-immigrant-and-native-born-population-over-time?width=1000&height=850&iframe=true.
- Vargas Bustamante, A., Fang, H., Garza, J., Carter-Pokras, O., Wallace, S. P., Rizzo, J. A., & Ortega, A. N. (2012). Variations in healthcare access and utilization among Mexican immigrants: The role of documentation status. Journal of Immigrant and Minority Health, 14(1), 146–155.CrossRefGoogle Scholar
- Yoo, H. C., Gee, G. C., & Takeuchi, D. (2009). Discrimination and health among Asian American immigrants: Disentangling racial from language discrimination.Google Scholar