The Curious Ostrich Immigration Policy-to-Health Framework

At the Curious Ostrich we provide updates and analysis on immigration news – providing health professionals and immigrant rights activists a “heads up” on immigration, xenophobia, and health. Looking at current events and national policy through a health perspective, we see that our immigration laws are powerful determinants of health for immigrants in the United States.  In the past, few public health researchers have focused on the ways immigration policies affect the rights, opportunities, and health of immigrants. But the public health field is increasingly taking notice that immigration policy is health policy. We believe that we will be more likely to achieve justice for immigrants and healthier communities when public health professionals understand (and address) the social and policy contexts that impact immigrant communities.

Last year, the American Public Health Association issued a policy statement supporting an end to the Secure Communities enforcement program.  The American Journal of Public Health published a recent study calling for more research on how state-level immigration policies, specifically, SB 1070, affect public health.  A growing number of researchers are trying to document and understand how policies and the experience of being undocumented affects health, such as immigrants’ access to health care (Stevens et al., 2010; Vargas Bustamante et al., 2011) and the impact of family separation, legal vulnerability, and stress in undocumented families (Arbona et al., 2010; Brabeck and Xu, 2010).

This is an important starting point!  Yet, the immediate experiences of immigrants and their families are the result of the full context of their lives in the United States, as well as our nation’s often anti-immigrant history, culture, politics, and laws.  Public health research and action must reflect this full picture.  

We have created a framework to illustrate the web of factors related to laws and policies that have an impact on the health of immigrants.

1) Our laws and policies are rooted in historical, political and cultural contexts.  The US has implemented immigration policies since it founding, including deportation and exclusionary policies such as the Chinese Exclusion Act in 1882. Each wave of anti-immigrant policy has been driven by racist and xenophobic narratives – immigrants viewed as a threat or as undeserving. The legacies of these cultural narratives and harmful policies continue to impact how immigrants are treated both in our political and popular debates and narratives.

2) These laws and policies influence the circumstances of immigrant’s lives, specifically their rights, resources, and safety.  Can immigrants access appropriate and affordable health care services? Do immigrant workers receive fair wages and are they safe in their workplaces? Are immigrant children able to attend schools and universities?  Do immigrants feel respected and safe in their communities? All of these questions are decided by specific federal, state, and local policies that expand or limit the rights and resources that determine the opportunities for immigrants and their families, as well as their overall safety in this nation as they pursue those opportunities.  These three factors are interconnected, as rights can create safety and access to resources or safety and resources can support individuals to exercise their rights.

3) These three factors are also inseparable, because the positive presence of all three are needed to promote positive physical, mental and community health outcomes.
When protective factors – such as access to health and educational services – align, immigrants will experience greater health and well-being. The lack of any or all three of these, such as limited access to employment and educational opportunities, stress and fear due to discrimination and anti-immigrant legislation, or vulnerability to violence, result in significant health risks.

Public health professionals and immigrants rights activists will have to make critical assessments of how existing and proposed policies may protect or harm the health of our nation’s immigrants. Our hope is that this diagram provides a framework for considering how various immigration policies may actually impact immigrant communities.  For example, the debate on “comprehensive immigration reform” is just heating up. It is heartening that there is growing support for a path to citizenship, but the proposals currently being developed would make the process lengthy and burdensome and continue existing bans on receiving public benefits. The proposals would also further codify border militarization and enforcement programs. Public health has an important role to play in these debates – ensuring that the true community costs are considered as immigration policy decisions move forward.

When we look at this diagram, we also see many opportunities for action! People working in all areas of public health can incorporate an immigrants rights perspective into their work. In the coming months, we will provide information and discussion on some of the main health issue areas in this diagram. And we will share ideas and opportunities for health and immigration activists alike to participate in this work.

Stay tuned to the Curious Ostrich for up-to-date health research and analysis.

President Obama Wins a Second Term, 11/5 – 11/11

President Obama will have a second chance to enact comprehensive immigration reform that he campaigned for on in his first bid of the presidency in 2008. There is more hope than ever now that the Republican party has begun to realize their need to bolster support from the Latino community. In the analysis of the race, many pundits lay blame for Romney’s loss on the hard line he took on immigration. Romney advocated for “self-deportation” which would make life so miserable for immigrants, that they would return to their home country on their own volition. Romney also counted Kris Kobach, architect of AZ SB1070, among his advisors during his campaign. As a result of these stances, Latinos came out in favor of four more years with Obama by a wide margin. Notable conservatives are arguing for a new strategy that welcomes Latinos to the GOP. With the growing Latino population, GOP would be wise to listen to Sean Hannity. Otherwise, the Democratic victories on Nov. 6th might be the first of many.  Even the notorious sherriff from Maricopa County is striking a conciliatory tone, saying that he wants to meet with Latinos to explain his policies. Although, unless he dramatically changes course he is unlikely to receive a receptive audience. In addition to getting pushback from moderates, there is a growing movement that seeks to push back against his abuse of power.
In other election related news, USC’s Center for Study of Immigrant Integration has released a report on the vote of Naturalized citizens, a group that represents 3.6% of voting aged citizens in the US.

Giants Closer Sergio Romo Makes Statement with t-shirt
On October 31st, the San Francisco Giants led a parade through San Francisco celebrating their World Series victory. Sergio Romo, one of the team stars, and child of Mexican farmworkers, wore a t-shirt that read “I just look illegal.” The shirt brought attention to the debate on immigration and the stigmatizing use of the word “illegal” by many in the anti-immigrant movement. The t-shirt was a bold statement in sport that often prefers to avoid political controversy.

Support health insurance access for deferred action youth! 10/20-10/25

Submit comments to HHS to allow DACA-approved individuals to participate in the Affordable Care Act – [Deadline October 29th]
The California Pan-Ethnic Health Network has released a call for advocates to submit comments to the Department of Health and Human Services to speak out against the recent decision to exclude DACA-eligible individuals from the Affordable Care Act.  Anyone can submit comments and, to make the job easier, a sample letter is available.  Simply follow these instructions to submit comments electronically:

• Step 1: Go to www.regulations.gov
• Step 2: Search for document ID ” CMS–9995–IFC2″ to find the regulation on DACA and health care. Make sure you are commenting on the “Pre-Existing Condition Insurance Plan” Interim Final Rule (Thanks to Natalie for the clarification)
• Step 3: Click on “Comment Now” button to submit comments

CPHEN’s call reminds us that this policy:

• Runs counter to the primary goal of the ACA – to expand access to affordable health coverage.
• Will lead to higher health insurance premiums for everyone by excluding young, healthy individuals from enrolling in coverage in the Health Benefit Exchange.
• Will likely lead to poorer health outcomes and increase health disparities by denying young immigrants the care they need.

Despite this effort to reverse the recent HHS decision, other undocumented immigrants and legal permanent residents who have lived in the U.S. for less than five years are excluded from new coverage opportunities under the Affordable Care Act.  States such as California that have large immigrant populations will continue to have many uninsured individuals.  For more information, visit The Kaiser Family Foundation, which provides an excellent overview of immigrants’ eligibility to participate in health coverage expansion from the Affordable Care Act.

“Adios Arpaio” in full force
A vibrant “Adios Arpaio” campaign has been actively registering voters and mobilizing to ouster Joe Arpaio from his position as Sherriff of Maricopa County, Arizona.  Just this week, a lawsuit was filed against the sheriff for the death of Ernest “Marty” Atencio while in county custody.  The Adios Arpaio campaign is made up of a coalition of Latino and immigrant rights advocates and local unions, such as UNITE HERE, and has registered 34,000 voters.  Particularly active are students from the local high schools who have become politically mobilized because, in the words of one, “they have the same issue inside, that they can’t stand discrimination against Latinos.”  Organizers say this is a long-term strategy to mobilize the Latino vote in Arizona: “The next one will be Jan Brewer.”

President Obama says he’s confident he can achieve Comprehensive Immigration Reform during a second term
In an previously off-the-record interview with an Iowa newspaper, President Obama expressed confidence that he could achieve an comprehensive immigration reform bill during a second term, specifically, because “the Republican Party have so alienated the fastest-growing demographic group in the country, the Latino community…George Bush and Karl Rove were smart enough to understand the changing nature of America.”