141st APHA Annual Meeting

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Public health impact of local immigration enforcement policies: Assessing barriers to health services among immigrant latinos in North Carolina

Monday, November 4, 2013 : 8:45 AM - 9:00 AM

Lilli Mann, MPH , Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Florence Simán, MPH , El Pueblo, Inc., Raleigh, NC
Mario Downs , Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Wake Forest School of Medicine, Winston-Salem, NC
Jorge Alonzo, JD , Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Eun-Young Song, PhD , Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Mark Hall, JD , Wake Forest School of Medicine, Winston-Salem, NC
Scott Rhodes, PhD, MPH, CHES, FAAHB , Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Background: Little is known about the public health impact of local immigration enforcement policies such as the 287(g) and Secure Communities programs. We sought to understand how immigration enforcement affects use of public health services and to identify next steps to address barriers to services among immigrant Latinos in North Carolina (NC).

Methods: We conducted six focus groups and 17 interviews with Latino adults across NC to explore the impact of immigration policies on their use of public health services. We also analyzed vital records data to determine whether prenatal care use by Latinas was affected by local implementation of 287(g). Finally, we conducted an empowerment-based forum with public health leaders to discuss findings and develop recommendations to translate knowledge into action.

Results: Participants reported little utilization of services, confusion about eligibility, and a paralyzing fear that jeopardized their physical and mental health overall. We found no statistically significant differences in use of prenatal care before and after implementation of 287(g) but did find that, compared to non-Latinas, Latinas seek prenatal care later, have fewer visits, and are less likely to receive any care. Over 90 public health leaders from 13 counties, including public health personnel, providers, community members, organizational representatives, and academic researchers, participated in the forum.

Conclusions: Clear examples emerged of how immigration enforcement policies negatively impacted the health of Latinos including children, and fear was generalized across counties. The community forum initiated statewide dialogue and collaboration to address the public health impact of local immigration enforcement.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the effect of local immigration enforcement policies on access to public health services among immigrant Latinos.

Keywords: Access Immigration, Latino

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am part of a team that carries out community-based participatory research (CBPR) studies, focusing on the health of immigrant Latino communities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.