Abstract
BackgroundImmigrants in the United States (US) today are facing a dynamic policy landscape. The Trump administration has threatened or curtailed access to basic services for 10.5 million undocumented immigrants currently in the US. We sought to examine the historical effects that punitive laws have had on health outcomes in US immigrant communities.MethodsIn this systematic review, we searched the following databases from inception–May 2020 for original research articles with no language restrictions: Ovid MEDLINE, Ovid EMBASE, Cochrane Library (Wiley), Web of Science Core Collection (Clarivate), CINAHL (EBSCO), and Social Work s (Ovid). This study is registered with PROSPERO, CRD42019138817. Articles with cohort sizes >10 that directly evaluated the health-related effects of a punitive immigrant law or policy within the US were included.Findings6,357 studies were screened for eligibility. Of these, 32 studies were selected for inclusion and qualitatively synthesized based upon four themes that appeared throughout our analysis: (1) impact on healthcare utilization, (2) impact on women’s and children’s health, (3) impact on mental health services, and (4) impact on public health. The impact of each law, policy, mandate, and directive since 1990 is briefly discussed, as are the limitations and risk of bias of each study.InterpretationMany punitive immigrant policies have decreased immigrant access to and utilization of basic healthcare services, while instilling fear, confusion, and anxiety in these communities. The federal government should preserve and expand access for undocumented individuals without threat of deportation to improve health outcomes for US citizens and noncitizens.
Highlights
Immigration is an irrefutable and foundational tenet of the American nation
In 20 of 45 United States (US) states reporting ethnic data of COVID-19 cases, the proportion of cases among Latinx individuals is at least twice as high as what would be expected on the basis of population; in 11 of the 45 states with available data, the proportion of Latinx individuals infected is more than three times as high [4,5]
A 2017 study investigating undocumented immigrants’ and healthcare providers’ perceptions of Georgia’s HB87, Section 287(g) of the Immigration and Nationality Act (INA), and the Secure Communities Program found that strict anti-immigrant policies increased fear and trauma among immigrants, which resulted in their refraining from or delaying care, restricting mobility, including for therapy or exercise, and seeking alternate care at small, private, fee-forservice clinics [15]
Summary
Immigrants in the United States (US) today are facing a dynamic policy landscape. The Trump administration has threatened or curtailed access to basic services for 10.5 million undocumented immigrants currently in the US. We sought to examine the historical effects that punitive laws have had on health outcomes in US immigrant communities
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