Immigration Policy and Women’s Health

In honor of Women’s History Month, we will highlight the impact of state and national policies on immigrant women’s health. Immigrant women are often left out of conversations on a path to citizenship, deportation, and labor. When immigrant women are considered, it is often through negative stereotypes – from the portrayal of immigrant women a threat to national security because of “anchor babies” to raising the fear of immigrant women as taking advantage of social safety net programs. These harmful portrayals justify harmful laws, with real impacts on women’s health and safety.

Policies and laws shape the safety, rights and resources of all people. Immigrant women are no exception: fear of deportation and family separation causes stress and anxiety; unauthorized status diminishes women’s rights and may lead to a range of forms of exploitation, from labor to sexual exploitation; or poor wages and lack of access to care can create barriers to health-promoting resources. The safety of immigrant women is threatened when immigration enforcement policies such as Secure Communities prevent women from accessing services or calling police.

Other social policies also shape health. Health reform initiatives actively bar immigrant women from receiving safety net benefits. While the Affordable Care Act (ACA) opened many doors for women to receive reproductive health care, expanding coverage for preventive health care including family planning, STI screening, and screening for domestic violence, undocumented immigrants are excluded from the ACA. In addition, in the US we are currently experiencing broad attacks on women’s reproductive health; 43 new policies were passed in 2012 restricting access to abortion services (Guttmacher Institute). Low-income and undocumented women are disproportionately impacted by these laws as they rely more heavily on community clinics to receive reproductive health services. These policies, whether part of our immigration, social welfare, or health care systems, determine what services and supports immigrant women have a “right” to and shape access to health-promoting resources – from U-Visas for domestic abuse survivors to health insurance.

Women’s Health
One of the main narratives in research on immigrant health is the “Healthy Immigrant Paradox” (or the “Latino Paradox”) – in which immigrants have equal or better health outcomes despite lower wealth and education than US-born populations. This “paradox” hides many important issues and, despite some findings to support the theory, does not justify complacency about the health of immigrant women. Both gender and immigration status are important predictors of health. These multiple forms of discrimination overlap, or ”intersect,” to put immigrant women and particularly undocumented immigrants, at risk of a number of health challenges. Here is a brief overview of some of the many issues public health and immigrant rights activists might consider in their work. For more information, check out the research bibliography at the end of the post or feel free to contact The Curious Ostrich with any questions.

Health Care
• Due to public health insurance program policies and limited access to employer-based health insurance, immigrant women are less likely to have health insurance, and less likely to have a regular source of health care, than non-immigrants (CDC 2005).
• After the 1996 Welfare Reform that barred many immigrants from receiving public benefits, immigrant women were less likely to access pre-natal care and other services (Fuentes-Afflick et al 2006)
• When Massachusetts implemented their health care reform policy, immigrants were left out. And the increased fear of deportation created new barriers to care among women who had previously accessed services at community clinics (Dennis et al 2009).

Occupational Health
• Immigrant women often work in informal jobs such as domestic work and in jobs with high risks for injury (e.g. garment work). Undocumented workers face discrimination in the workplace, lack adequate protections due to insufficient regulation of informal labor markets, work in high-risk industries, and have higher rates of occupational injuries.
• Immigrant women are additionally affected by gender inequities, such as wage disparities (Browne and Misra 2003), and gender and sexual discrimination in the workplace.

Reproductive and Maternal Health
• Immigrant women have higher rates of mortality from cervical cancer
• Undocumented women have lower use of prenatal care services and higher rates of low birth weight, than documented immigrants (Korinek and Smith 2011).
• In border states with few abortion providers, such as Texas, Internal Border Patrol Checkpoints limit mobility, making it difficult for immigrant women to travel to abortion clinics.

Violence Against Women
• Intimate partner violence (IPV) is a risk factor for poor mental and physical health (Yick 2003, Barkho 2007). Although women of all national and ethnic backgrounds are victims of violence (Han 2010, Grzywacz 2009, Brabeck 2009, Bhuyan 2008, Barkho 2007), the immigration experience can exacerbate violence in relationships, putting immigrant women at particular risk (Han 2010, Grywacz 2009).
• Some women report that their partners use their vulnerable legal status as a way to control and threaten them – in a study of South Asian immigrant women in Boston, there was a strong association between having a partner who refused to help change their immigrant status and experiencing IPV (Raj et al 2005).
• A study of mother’s in New York City cited the fear of being “bad” mothers if they reported abusive family members (who would then face deportation) (Earner et al 2010).

Mental Health
• Immigrant women are at increased risk for poor mental health. Fear of deportation and family separation, as well as the challenges such as language and cultural barriers, are significant stressors for immigrant women (Arbona 2010, Norris 2011).

Promising Developments
Yet, there are also policies and social movements that are promising to create better protections and facilitating increased social and economic opportunities for immigrant women.

Protecting Women’s Rights: The Violence Against Women Act, renewed this year, continues to provide protections for immigrant women in abusive situations. The act includes the U-Visa, which allows women who have been abused who are here with temporary or unauthorized status to gain legal residence (Moynihan 2008, Conyers 2007).

Supporting Integration: Policies that offer pathways to citizenship, or increase access to the rights that of citizenship, improve the health of immigrant women. In Western Europe, researchers found that in countries with more progressive immigration – or “integration” – policies including pathways to citizenship, anti-discrimination and affirmative action legislation, and policies protecting against economic and social exclusion, the health inequalities between immigrant and non-immigrant women were reduced and in some cases eliminated (Bollini et al 2009). In the US, state laws supporting immigrants rights also reduce health inequity. In 1999, Utah passed a law allowing undocumented immigrants to get driver licenses. While in general, undocumented women had poorer health outcomes than documented immigrants, those women who participated in the driver license program had higher rates of pre-natal care, demonstrating that policies supporting access to rights and resources among undocumented immigrants can significantly improve the health outcomes of women and children (Korinek and Smith 2011).

Organizing: Immigrant women around the nation are actively involved in promoting policies and opportunities for themselves and their communities. There are many immigrant women’s groups working to empower immigrant women. Mujeres Unidas y Activas in Oakland, California provides immigrant women with support, from crisis intervention services to job training, as well as leads statewide advocacy campaigns. The National Domestic Workers Bill of Rights is a nationwide campaign to protect domestic workers, who are predominantly immigrants, in their workplaces. This movement is quickly spreading throughout the nation. There are also many immigrant women entrepreneurs – 13% of all woman-owned businesses – working to create job opportunities for themselves and others.

There is a growing movement to protect the health of immigrants by expanding access to care and by pushing for a more humane immigration system. Women have distinct health needs (e.g. reproductive health services), and face distinct health challenges (e.g. the overlapping discrimination of gender and immigration status); and policies can unwittingly create new health risks for women when these specific issues aren’t taken into consideration. As these policy efforts move forward, we hope to see the rights of women explicitly considered and included in policy conversations.

10/25 – 11/1: Updates on Elections, Bay Area Immigration Policies, and Deportation

What to Watch in the Election:
Tuesday is election day! In addition to the presidential race, several states will decide on significant immigration policies. Some to watch out for: In Maryland, voters will face an initiative similar to the DREAM Act – offering undocumented youth in-state tuition at state universities. A Montana initiative would require immigrants to provide proof of citizenship in order to access state benefits programs. This legislation, like other state laws adding barriers to accessing services, will place unreasonable hardship on immigrants and their families in accessing basic social services. Given the lack of comprehensive immigration policy reform at a national level, states and local governments will continue to pass immigration policies – though some states are working to protect immigrants rights, the trend is overwhelmingly towards punitive immigration policies.

Local Policy Updates:
In the Bay Area, this week brought two positive changes to our local immigration policies. Alameda County joined a small number of counties nationwide that will now explicitly consider deportation in criminal prosecution proceedings. Under this new policy, announced by the County’s District Attorney, prosecutors will consider the threat of deportation when handling low-level non-violent crimes. In addition, the DA modified the guidelines for plea bargains to enable a number of alternative sentences, such as longer jail sentences, rather than mandatory deportation. In the past two years, 1,700 people arrested by Alameda County local police have been deported, only 73% of whom had been convicted of a crime; this is a step in the right direction, but it remains unclear if these modified policies will significantly minimize the risk of deportation for non-violent offenders.

In Berkeley, the City Council passed a policy in which the City will no longer comply with Secure Communities – Berkeley Police “will not honor requests by ICE” to detain individuals that are thought to be undocumented immigrants, in the case that they are no longer being held for criminal proceedings. Berkeley’s new policy is thought to be one of the strongest disavowals of S-Comm nationally, and advocates hope this will facilitate additional jurisdictions passing similar policies in the future.

Supreme Court Case on Deportation:
In 2010, in the Padilla v. Kentucky case, the Supreme Court ruled that immigrants must be told about the possible consequences of pleading guilty – including the risk of deportation. This week, the Court heard a new case – Chaidez v. United States – to determine if the Padilla decision should apply to deportation cases heard prior to 2010. Roselva Chaidez is a lawful permanent resident, she lives with her two children and three grandchildren – all US citizens. In 2007, as part of her application process to become a citizen, she disclosed a prior conviction – her attorney did not advise her at the time about the potential deportation consequences of this disclosure. This case highlights the precarious status of immigrants and their families, and the complicated legal hurdles immigrants must navigate. As we are seeing with the deferred deportation policy, many immigrant youth are afraid to apply out of concerns about the potential future consequences of declaring their undocumented status. The process for gaining rights to residency or citizenship should not put immigrants at risk of deportation.

Pilot Deportation Program:
The Federal government is starting a two-month pilot program it hopes will protect the safety of immigrants deported to Mexico. Under the new program, immigrants will be sent to Mexico City, rather than returned to border towns; the Mexican government will then provide bus fare to return to their hometowns. The pilot is designed in part to protect immigrants who face significant safety concerns when dropped off on the border; however critics feel that this will make it more difficult for immigrants to return to their families. The program does not fully address the significant human rights issues at the center of our current deportation policies – and it will be critical for immigrants rights advocates to monitor this pilot. Having a ‘humanitarian’ deportation program does not justify US deportation policies. However, as deportations will continue it is essential that the US government address the challenges and dangers involved.

9/25 – 10/2: Governor Brown vetoes Trust Act and Domestic Workers Bill of Rights; Janet Napolitano formalizes consideration of same-sex partnerships in deportation cases

This week brought mixed news on immigration policy. While there were some bright spots at the federal level – particularly with the explicit acknowledgement and consideration of same-sex partnerships in stopping deportation hearings – California missed two critical opportunities to protect the State’s undocumented immigrants. By vetoing the Trust Act and the Domestic Workers’ Bill of Rights, California Governor Jerry Brown endorsed the secondary rights given to undocumented immigrants and domestic workers. Slow implementation of the deferred action program for young immigrants also highlights the long ways ahead to protecting immigrants’ rights, even in the case of supportive legislation.

Same Sex Partnerships Considered in Deportation Cases
In June of last year, the Department of Homeland Security passed new deportation guidelines that enabled law enforcement officers to consider “ties and contributions to the community, including family relationships” when determining deportation cases for undocumented immigrants with no criminal record. This week, Secretary of Homeland Security Janet Napolitano published written guidelines that same sex partnerships be considered in the law’s provisions about family relationships. Although this written guidance only reiterates the Department’s existing stance on same-sex partnerships in regards to deportation hearings, LGBTQ advocacy groups considered the formalization of this policy as a step in the right direction. However, there remains substantial discrimination within immigration law for the LGBTQ community – same-sex partnerships do not allow undocumented immigrants to apply for green cards.

Governor Brown Vetoes the Trust Act and the Domestic Workers Bill of Rights
This week, Governor Brown had the opportunity to sign the Trust Act into law – this piece of legislation would have enabled the State’s local law enforcement officials to use greater discretion in complying with Secure Communities by only reporting undocumented immigrants to ICE in the case that they have a serious or violent felony on their record. The Trust Act would have been an important step towards protecting the many immigrants who are deported each year for minor arrests (such as traffic violations) – as well as their communities who face a range of consequences from family separation to fear and stress as a result of Secure Communities’ strict deportation policies. Only a small number of local governments have passed legislation similar to the Trust Act; California’s acknowledgement of the harms associated with Secure Communities would have sent a strong statement about the health and community impacts of increasing deportation.

Governor Brown also vetoed AB 889 – the California Domestic Workers Bill of Rights – a law that would have ensured basic labor protections for the State’s many domestic workers, including overtime pay and meal breaks. Gov. Brown cited concerns about the implications for costs to the disabled and elderly communities who require in-home care – despite the fact that domestic workers and disabled activists have been organizing together to support labor laws that protect both in-home workers and those communities who need care-takers. Good health is supported with laws that protect basic rights such as access to shelter, sustenance, and fair labor.

Deferred Deportation Faces Implementation Challenges
Since the passage of the deferred deportation program in August, tens of thousands of young immigrants have applied for the two-year permits to live and work in the US. However, challenges have emerged that are creating barriers to applicants and slowing the implementation of the law. Employers in particular are concerned with the risks they may face in participating in the law. In order to qualify, a person must show that they have been in the US for at least 5 years and were in the country on June 15 – employers can provide verification of applicants qualification; however, in providing this, they also open themselves up to prosecution for having employed undocumented immigrants. Although the Department of Homeland Security says they will not use this process to go after employers except in cases of severe labor law violations, small businesses and farm employer organizations are hesitant to provide employment verification; particularly in light of the uncertain election season and the potential that in the near future immigration policies could shift substantially. Applicants also face challenges such as finding all the required forms of verification, raising money for the filing fee, and the administrative roadblocks to processing applications. Although over 1 million people are eligible for deferred action, only 100,000 have applied, and to date 29 have been approved.