Health Implications of an Immigration Raid: Findings from a Latino Community in the Midwestern United States

Undocumented immigrants experience a pervasive fear of deportation that negatively impacts their psychological, emotional, and physical health [1, 2, 3, 4]. The possibility of immigration status disclosure—which could lead to deportation—decreases health care and social service utilization [2, 4, 5, 6, 7]. Local police collaboration with federal immigration law enforcement exacerbates distrust between local law enforcement and community members, decreasing the likelihood that undocumented immigrants will report crimes, even if they are the victims [8, 9, 10]. Constant surveillance and scrutiny of immigration status transforms public space into an area of heightened risk, and undocumented immigrants become less likely to walk their children to school, visit parks or the grocery store, and participate in a range of sociocultural activities [11, 12, 13, 14]. Taken together, a growing body of research illustrates the direct and indirect effects of immigration law enforcement and policy on the health of undocumented immigrants and the communities in which they live.

Quasi-experimental studies have considered shifts in health-related behaviors after immigration policy change. Findings suggest that policies requiring individuals to provide evidence of immigration status limit access to resources, whether or not individuals are undocumented. For example, after the passage of the Alabama Taxpayer and Citizen Protection Act, which required proof of citizenship to receive public benefits, Latinas were less likely to utilize county health services. This included services exempt from residency requirements, such as treatment for STIs [15, 16]. Similarly, following the passage of Arizona Senate Bill 1070 (SB 1070), which gave police the power to detain individuals who could not verify citizenship, Mexican-origin adolescent mothers were less likely to use public assistance or take their infants to receive medical care [17]. SB 1070 also increased fear of immigration enforcement, restricted neighborhood mobility, and decreased trust in law enforcement, with impacts on health [11].

These quasi-experimental studies present strong evidence of the immediate repercussions of immigration policy on health. However, a focus on state level policies in states with omnibus anti-immigrant legislation omits the daily immigration enforcement events that are ubiquitous in mixed status immigrant communities [18] but are not often covered by mainstream media. Immigration home raids, in which Immigration and Customs Enforcement (ICE) agents enter a residence to detain undocumented immigrants, represent extreme examples of immigration law enforcement with emerging evidence of their influence on health [19, 20, 21]. A typical home raid occurs in the pre-dawn hours when occupants are sleeping. Agents, often with guns drawn and wearing body armor, surround the house, pound on doors, and enter the home after receiving consent, though reports of consent differ [22]. Other individuals suspected of being undocumented may be taken as “collateral” arrests, a process rooted in racial profiling [23]. These arrests frequently include witnesses, often children [10, 14, 19, 20, 22, 24, 25, 26, 27, 28, 29, 30]. Despite the effects of these raids on health however, they have received scant attention in the health literature, often mentioned as one of many aspects of increased immigration enforcement [11].

The current study addresses this gap in the literature by building upon the quasi-experimental designs of previous public health work to investigate the influence of an immigration raid on the health of a Latino/a (henceforth: Latino) community in the Midwestern US. We consider the effects of an immigration raid on a de facto mixed-use property, in which multiple individuals were arrested and deported. Three months before the raid, we began data collection for the Encuesta Buenos Vecinos (EBV; “Good Neighbors Survey”) to investigate the social determinants of health among Latinos in the county. The survey data thus provide a unique opportunity for a natural experiment in which we investigate the effects of a federal/local immigration raid on health in a state that has not passed omnibus anti-immigrant policy (Michigan). Understanding these effects may better prepare health professionals to respond to crises and mitigate the damage to health that occurs following immigration enforcement.

Washtenaw County, MI, has a population of over 12,000 Latinos [31] (about 3.5 % of the population), yet Latinos are frequently underrepresented in county-level data [32]. To gain a more accurate depiction of the health of the Washtenaw County Latino population, collaborators at the University of Michigan, Washtenaw County Public Health Department, and Casa Latina, a community-based organization engaged with the local Latino community, designed and implemented the EBV. Community partners were involved in the creation and review of the EBV instrument, and feedback following the pilot phase was used to shape survey implementation. The University of Michigan’s Institutional Review Board approved the research.

The EBV queried a range of topics, including health-related knowledge, attitudes, beliefs, and behaviors; access to health care; sources of health information; family and child health; and social and neighborhood conditions [32]. Although the study was not designed to capture the effects of immigration raids specifically, it did aim to address issues of concern related to immigration and immigration law enforcement.

The survey was conducted in Spanish or English, online or face-to-face, by trained members of the local Latino community. Inclusion criteria included being 18 years of age or older, identifying as “Hispanic or Latino/a,” and living in Washtenaw County. A total of 487 Latinos participated in the survey from September 2013 to January 2014. An immigration raid occurred about halfway through the data collection period, resulting in 325 participants who completed the survey before and 151 who completed the survey after the raid.

The current natural experiment demonstrates the impact of an immigration raid on the health of a Latino community in the Midwestern US. Results show that participants who completed the EBV survey after the raid reported higher levels of immigration enforcement stress and lower SRH scores, despite a lower percentage of foreign-born participants completing the survey after the raid. Our analyses present strong evidence of the negative influence of immigration raids both directly and indirectly on the lives and health of Latinos in the communities in which raids occur.

Previous studies noted that deportation fear is related to psychological and emotional distress and lower SRH scores [1, 2]. Although we did not explicate the mechanism by which a raid could influence SRH, we found that participants who completed the survey after the raid reported feeling less free to interact with their social networks, less able to use government services, and increasingly fearful of the consequences of deportation (Table 2). Thus, we suggest that participants would be correspondingly less likely to move about and engage with their communities, reflecting a reduction in social capital [36] that may be related to lower SRH scores. Future research is needed to investigate this mechanism.

Immigration raids, acute events that may have immediate effects on communities, occur within populations who experience an inequitable need for support services and may thus exacerbate health inequities. We recommend that health researchers broaden our conversations about immigration enforcement and its health implications. It is critical that researchers continue to investigate the direct effects of immigration enforcement on the individuals who experience it—such as the depression, anxiety, and trauma engendered by one’s arrest, deportation, or witness to a raid. However, we must also consider how enforcement actions tear at the fabric of US society, alienating immigrant and US born Latinos alike by discouraging them from integration and the utilization of services to which they are entitled.

Lastly, our results indicate that having children in the home and being born outside of the US were associated with higher levels of immigration enforcement stress. Maintaining a healthy community requires access to preventative health services, yet fear of accessing these services may increase in the wake of immigration enforcement actions. Members of the community who may already be marginalized and vulnerable—foreign-born women with children in the home—may be less likely to seek out these services following immigration raids. Thus, community health advocates need to work diligently to ensure separation between immigration enforcement and social service provisioning.

This raid was an extreme example of an immigration law enforcement effort that was unpredictable to the community in which it occurred, incorporated overt militarized displays of power, and included an invasion of personal space. Results show that completing the community survey after the raid was associated with higher levels of immigration enforcement stress and lower self-rated health scores. Although novel to the literature, due to the overt violence and trauma of these raids, the results are perhaps not surprising. As immigration policy continues to be a topic of national debate, we must include in these conversations a holistic assessment of the social cost of enforcement policies, including how they may exacerbate existing health inequities among marginalized populations.