Federal Policy Research Articles

Driving Climate Action via Government Public Relations: The Role of Government-Citizen Relationships and Situational Perceptions

ABSTRACT The purpose of this study is to predict the active communication behaviors and their Behavioral Intentions to Support Federal Climate Policies from the view of government public relations. Using data from an online survey of 548 adults living in the United States, this study investigated the roles of Government-Citizen Relationships (GCR) and situational perceptions (i.e. Problem Recognition, Constraint Recognition, and Involvement Recognition) in predicting active communication behaviors (i.e. information seeking, forefending, and forwarding) and federal climate policies in the framework of situational theory of problem solving (STOPS). The results of this study indicate that GCR is critical in predicting active communication behaviors and public support. While Involvement Recognition among situational perceptions is significant to predict active communication behaviors and public support, program recognition and Constraint Recognition are partially significant. The results highlight the pivotal mediating roles of situational perceptions – Problem Recognition, Constraint Recognition, and Involvement Recognition – in the link between GCR and public support for federal climate policies.

An observational study protocol to capture, validate and characterise lucid episodes in people living with advanced dementia receiving hospice care.

Lucid episodes (LEs) in advanced neurodegenerative disease, characterised by a transient recovery of abilities, have been reported across neurological conditions, including Alzheimer's disease and related dementias. Evidence on LEs in dementia is extremely limited and draws predominantly from retrospective case reports. Lucidity in dementia has received growing attention given the clinical, caregiving and potential epidemiological implications of even a temporary return of abilities in advanced disease. Following a funding initiative by the National Institute on Aging, several new investigations are focused on establishing foundational evidence on lucidity in dementia. The objectives of this study are to capture, characterise and validate potential LEs via audiovisual observation, computational linguistic and timed-event coding of audiovisual data, and informant case review for face validation of LEs. This prospective multifaceted observational study will investigate LEs in advanced dementia through longitudinal audiovisual observation within an inpatient hospice unit. Audiovisual data will be coded to generate variables of participant verbal output, verbal expressions, non-verbal communicative actions and functional behaviours to enable measurement of features that can be used to characterise LEs. Multiple methods will be used to identify potential LEs including field interviews with caregivers/clinicians who witness significant events during data collection, reports from research staff who witness significant events during data collection and detection by researchers during video data processing procedures. Potential LEs will undergo a structured case review with informants familiar with the participant to facilitate validation and enable triangulation across measures generated through coding. This study will be conducted in accordance with all Federal Policies for the Protection of Human Subjects and the protocol (ID 2021-1243) has been approved by the University of Wisconsin-Madison Institutional Review Board. Findings will be disseminated via scientific conferences, journal publications and newsletters shared with participants and through dementia-focused and caregiver-focused networks.

Disproportionality monitoring for Special Education and Stakeholder Practices in a Post-Affirmative Action Landscape

ABSTRACT In this article, we examine and explore how the recent US Supreme Court case on affirmative action within higher education will shape and contextualize disproportionate minority representation and its monitoring within a K-12 public school context for students with disabilities. That is, as the litigation and ultimate judicial decision shape how institutions of higher education advance affirmative action policies for the admission of racialized and ethnic minority college students, another unanswered question remains. Namely, how will K-12 public school districts both adhere to federal policy that mandates proportionate racial representation of students with disabilities within special education categories and support teachers and school systems with compliance to federal policy? Using a legal compliance focal point theoretical perspective, this article contextualizes the affirmative action conversation as one that must include guidance to education systems and teachers working to ensure federal compliance and racial equity within special education.

Australian schooling policy: A risky proposition

AbstractThis article utilises recent Australian schooling policies and associated international educational policies as a stimulus to reflect on the extent to which schooling provides genuinely ‘educational’ opportunities for students. To do so, the article draws upon Gert Biesta’s notion of the ‘risk’ of education to analyse the extent to which recent and current key federal government policies in Australia, and significant OECD and UNESCO policies, seem to enable more educationally-oriented schooling. The article reveals that while there are multiple discourses at play in relation to federal government policies, the way in which these policies have become more ‘national’ in orientation, and the attendant prescriptive attention to ‘capturing’ students’ learning in more and more ‘precise’ ways, mitigate against the possibilities for more risk-responsive schooling opportunities for students. While educational policies are always open to contestation in their enactment, more economistic and managerial foci within these texts militate against more productive, ‘risky’, learning. As a consequence, Australian schooling policy is a ‘risky proposition’—not because it places students ‘at risk’ of harm but because it does not draw sufficiently upon notions of risk as a resource to inform educational provision in preparation for living in an uncertain world.

An assessment of federal alcohol policies in Canada and priority recommendations: Results from the 3rd Canadian Alcohol Policy Evaluation Project.

To systematically assess the Canadian federal government's current alcohol policies in relation to public health best practices. The 2022 Canadian Alcohol Policy Evaluation (CAPE) Project assessed federal alcohol policies across 10 domains. Policy domains were weighted according to evidence for their relative impact, including effectiveness and scope. A detailed scoring rubric of best practices was developed and externally reviewed by international experts. Policy data were collected between June and December 2022, using official legislation, government websites, and data sources identified from previous iterations of CAPE as sources. Contacts within relevant government departments provided any additional data sources, reviewed the accuracy and completeness of the data, and provided amendments as needed. Data were scored independently by members of the research team. Final policy scores were tabulated and presented as a weighted overall average score and as unweighted domain-specific scores. Compared to public health best practices, the federal government of Canada scored 37% overall. The three most impactful domains-(1) pricing and taxation, (2) marketing and advertising controls, and (3) impaired driving countermeasures-received some of the lowest scores (39%, 10%, and 40%, respectively). Domain-specific scores varied considerably from 0% for minimum legal age policies to 100% for controls on physical availability of alcohol. Many evidence-informed alcohol policies have not been adopted, or beenadopted only partially, by the Canadian federal government. Urgent adoption of the recommended policies is needed to prevent and reduce the enormous health, social, and economic costs of alcohol use in Canada.

Wildfire Management Strategy and Its Relation to Operational Risk

Abstract Changes to US wildfire policy in 2009 blurred the distinction between fires managed for resource benefits and fires with primarily suppression objectives, making management strategies difficult to track. Here, qualitative text is coded from a sample of 282 Wildland Fire Decision Support System Relative Risk Assessments completed on wildfires between 2010 and 2017 to examine the prevalence of different strategies and their associations with risk. Suppression is used most, associated with high risk. Managers discuss intent to suppress even when it is untenable. Monitoring, confine, or point protection are used much less commonly and when risk is low. The Southwest region discusses a diversity of strategies, leveraging landscape barriers from past management to support them; the Northwest discusses suppression or monitoring and rarely links strategy selection to barriers. Based on associations between physical barriers to fire spread, risk, and strategy, creating more barriers may provide a path forward to better implement fire policy. Study Implications: Systematic analysis of text data in wildfire decision documents provides insights into how fires are managed. Most wildfires are still aggressively suppressed despite federal fire policy promoting the use of fire to enhance resources. When managers discuss risk during wildfires, it is evident that physical barriers to fire spread (e.g., rivers, roads, trails, rocky scree), including mechanical fuel treatments, prescribed fires, and previous wildfires, are important factors in operational fire planning. However, management strategies promoting the use of wildfire to enhance ecological resiliency or reduce transmission of future fires to values are used sparingly. Southwest fire managers are relying on past wildfires, fuel treatments, and prescribed fires more so than the Northwest to engage in a full spectrum of fire management strategies. This finding suggests that, at least in some geographies, ongoing investments in fuels management will pay dividends in reducing risk and broadening opportunities to meet federal policy goals.

Discussion of federal policies affecting broadband expansion and telehealth in Appalachia

Background There have been 188 rural hospital closures in the United States since 2010 with approximately 20% of these in Appalachia. Telehealth has become a way that nurses can reach rural patients who might not otherwise receive health care. Objectives The purpose of this paper is to (1) outline the federal policies enacted during COVID-19 for broadband expansion; and (2) suggest how advanced practice nursing care might be affected by broadband expansion and telehealth in the region. Methods A search of PubMed was conducted in January 2023, using the search words, “policy”, “telehealth”, “broadband”, and “Appalachia”. Findings New laws appropriated funds to expand broadband infrastructure that made it possible for telehealth to be used by nurses to deliver health care to rural patients. Conclusion This discussion paper found that broadband legislation was instrumental in expanding telecommunications and telehealth by NPs. There is a great need for broadband to continue to expand and for trained nurses to provide care via telehealth.

Understanding the expansion of social control and helping professionals as unwilling agents of the state: The passing of the Child Abuse Prevention and Treatment Act in the United States

Abstract It is widely known that those in the helping professions are mandated to report suspected incidences of child maltreatment. However, few are aware of the historical resistance to mandated reporting that helping professionals demonstrated before the passing of the Child Abuse Prevention and Treatment Act (CAPTA) of 1974 and the associated federal mandates that compelled helping professionals to engage in mandated reporting, oftentimes against their will. By analysing historical policy documents through a grounded theory approach, the authors identified three themes that describe the rationale for the passage of CAPTA: (1) identifying national evidence of child abuse; (2) resistance to intrusion of the helping professional-client relationship; and (3) the necessity of immunity waivers for those who reported instances of child abuse and misdemeanor punishment for those who failed to report such instances. In light of conversations around abolishing or reforming child protective services, it is important to understand how the first federal child protective services policy in the United States originated and how these regulations embedded social control into the foundation of the helping professional-client relationship, thus turning helping professionals into unwilling agents of the state. Implications of mandated reporting, including introducing a penal aspect to the helping professional-client relationship, are also explored.

Pediatric Cancer Communication on Twitter: Natural Language Processing and Qualitative Content Analysis.

During the COVID-19 pandemic, Twitter (recently rebranded as "X") was the most widely used social media platform with over 2 million cancer-related tweets. The increasing use of social media among patients and family members, providers, and organizations has allowed for novel methods of studying cancer communication. This study aimed to examine pediatric cancer-related tweets to capture the experiences of patients and survivors of cancer, their caregivers, medical providers, and other stakeholders. We assessed the public sentiment and content of tweets related to pediatric cancer over a time period representative of the COVID-19 pandemic. All English-language tweets related to pediatric cancer posted from December 11, 2019, to May 7, 2022, globally, were obtained using the Twitter application programming interface. Sentiment analyses were computed based on Bing, AFINN, and NRC lexicons. We conducted a supplemental nonlexicon-based sentiment analysis with ChatGPT (version 3.0) to validate our findings with a random subset of 150 tweets. We conducted a qualitative content analysis to manually code the content of a random subset of 800 tweets. A total of 161,135 unique tweets related to pediatric cancer were identified. Sentiment analyses showed that there were more positive words than negative words. Via the Bing lexicon, the most common positive words were support, love, amazing, heaven, and happy, and the most common negative words were grief, risk, hard, abuse, and miss. Via the NRC lexicon, most tweets were categorized under sentiment types of positive, trust, and joy. Overall positive sentiment was consistent across lexicons and confirmed with supplemental ChatGPT (version 3.0) analysis. Percent agreement between raters for qualitative coding was 91%, and the top 10 codes were awareness, personal experiences, research, caregiver experiences, patient experiences, policy and the law, treatment, end of life, pharmaceuticals and drugs, and survivorship. Qualitative content analysis showed that Twitter users commonly used the social media platform to promote public awareness of pediatric cancer and to share personal experiences with pediatric cancer from the perspective of patients or survivors and their caregivers. Twitter was frequently used for health knowledge dissemination of research findings and federal policies that support treatment and affordable medical care. Twitter may serve as an effective means for researchers to examine pediatric cancer communication and public sentiment around the globe. Despite the public mental health crisis during the COVID-19 pandemic, overall sentiments of pediatric cancer-related tweets were positive. Content of pediatric cancer tweets focused on health and treatment information, social support, and raising awareness of pediatric cancer.

The Effect of Gang Organization on Coordinated Sex Trafficking

ABSTRACT The contribution of this article is to examine gang-organized sex trafficking by placing human trafficking research in conversation with gang research. Human trafficking researchers have not systematically focused on gangs in the US, and gang researchers in the US have not studied sex trafficking connected to gangs. For both reasons, there is a significant lack of primary data on traffickers - especially those in gangs - and significant misperceptions about both have driven the predominant and ineffective policy of apprehension and prosecution. This study investigated the prevalence of organized (gang-directed) versus disorganized (entrepreneurial) activity reported by gangs involved in San Diego’s underground sex economy (UGSE). Regression analysis was used to examine whether organized gangs were more likely than disorganized gangs to direct coordinated sex trafficking operations. The study finds a significant, positive association between gang organization and gang-directed sex trafficking, but it also finds that the majority of sex trafficking in San Diego is disorganized. Accordingly, we argue for a reorientation of current efforts under the United States’ federal policy framework (commonly referred to as the 4-P Framework) away from Prosecution, and toward Prevention - comprehensive, multi-agency approaches which have been shown to have the greatest impact on reducing violent crime. Since Prevention has been underutilized in the United States, our final contribution is to explore why Prevention has received less attention than Prosecution and Protection, and explore the principles and paradigms on which a preventive approach to gang-involved sex trafficking can be based.

Iimpact of federal LRPs on behavioral health workforce examined

In the midst of a national behavioral health workforce shortage, it is necessary to evaluate the nature and effectiveness of current federal policy strategies to address this public health crisis, study authors of a new policy review stated about identifying and characterizing the impact of federal loan repayment programs (LRPs) on the behavioral health workforce.

Federal Impacts on Buprenorphine Prescribing in Washington State, 2012 to 2022.

Objectives. To evaluate changes in monthly buprenorphine dispensation associated with federal prescribing policies in Washington State from 2012 to 2022. Methods. We conducted an interrupted time series analysis comparing monthly buprenorphine prescriptions dispensed per 1000 population after the Comprehensive Addiction and Recovery Act (CARA), Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT), and new prescribing rules during the COVID-19 pandemic. Buprenorphine formulated for opioid use disorder was included from the Washington State Prescription Monitoring Program. A log-linear autoregressive model measured linear trend changes. Results. Physician prescribing increased by 1.63% (95% confidence interval [CI] = 1.41%, 1.85%) per month after CARA with sustained declines after SUPPORT. Nurse practitioner (NP) prescribing increased by 19.48% (95% CI = 18.8%, 20.16%) per month after CARA with physician assistants (PAs) showing similar trends. Following the implementation of SUPPORT, NP and PA trends continued to increase at a reduced growth rate of 3.96% (95% CI = 2.01%, 5.94%) and 1.87% (95% CI = 0.56%, 3.19%), respectively. No prescribers experienced increases during the COVID-19 pandemic. Conclusions. CARA nearly tripled the buprenorphine prescribing rate. The SUPPORT Act initiated sustained declines for physician prescribing, and the COVID-19 period reversed gains for PAs and NPs. The current opioid crisis requires expanded efforts in Washington State. (Am J Public Health. Published online ahead of print May 2, 2024:e1-e9. https://doi.org/10.2105/AJPH.2024.307649).

Evolution of Professional Standards: Reflecting on the Past to Inform the Future

Clearly defined professional standards result in better prepared professionals who positively impact outcomes for children and families by ensuring an effective workforce. This article describes the evolution of early intervention early/childhood special education preparation standards from the on-the-job competencies of the 1960s to the historic 2020 Initial Practice-Based Professional Standards for Early Interventionists/Early Childhood Special Educators (EI/ECSE Standards), in concert with the evolution of the profession itself. Influencing factors include (a) changes in federal legislation and policy, (b) ages and characteristics of children served, (c) growing knowledge of effective practices, (d) collaboration with other disciplines, and (e) ongoing advocacy for EI/ECSE as a profession. The article concludes with a vision for using these EI/ECSE Standards to guide the future local, state, and national agenda of the profession around preservice preparation and accreditation, professional development, state and federal policy, cross-disciplinary collaboration, and standards-informed research.

Universal School Meals During the Pandemic: A Mixed Methods Analysis of Parent Perceptions from California and Maine

In response to the COVID-19 pandemic, the United States Congress authorized the United States Department of Agriculture to waive a variety of school meal regulations and funded school meals daily for all students at no charge regardless of family income. Since federal Universal Free School Meals (UFSM) ended with the 2021-2022 school year, several states, including California and Maine, adopted state-level UFSM policies. This study aimed to understand parent perceptions of school meals and the federal and new state UFSM policies in California and Maine, including potential challenges and benefits to students and households. A mixed methods study design was used. A quantitative cross-sectional survey was administered, and semi-structured interviews were conducted in English and Spanish during the 2021-2022 school year. The quantitative survey was administered to parents of students in elementary, middle, and high schools in rural, suburban, and urban communities in California (n=1,110) and Maine (n=80). Qualitative interviews were then conducted with a subset of these parents in California (n=46) and Maine (n=20) using ZoomTM. Most survey participants (708 out of 1,190; 59.5%) and interviewees (40 out of 66; 60.6%) were parents of students who were eligible for free or reduced-price meals (FRPM). Parents' perceptions of UFSM, school meal quality, and experiences applying for FRPM were examined. Tests of proportions were used to analyze survey data. Using grounded theory, interview transcripts were analyzed qualitatively by 2 trained research assistants, applying principles of content analysis to identify themes and domains. Inter-rater reliability was conducted. Parents perceived that school meals and UFSM saved families money and time, as parents had fewer meals to purchase and prepare for their children. Additionally, UFSM reduced parents' stress and reduced stigma for children and for parents, who described feelings of embarrassment when they previously filled out paperwork for FRPM. While parent perceptions of school meal quality and healthfulness were mixed, most parents reported feeling grateful for school meals. Parents had mixed opinions on the quality and healthfulness of school meals, but believed UFSM saved them money and time and reduced their stress. Parents also felt UFSM reduced stigma for families.

Carrots, Sticks, and the Evolution of U.S. Climate Policy

The Inflation Reduction Act (IRA), enacted by Congress in 2022, is the most significant federal investment in decarbonization in U.S. history. The law makes hundreds of billions of dollars available for clean energy tax credits, grants to state and local governments, and other financial incentives for public and private investments. The IRA’s focus on incentives, or “carrots,” marks a significant departure from the emphasis on prescriptive regulations and penalties, or “sticks,” that are prominent in federal and state climate policies that predate the IRA. This Article situates the IRA within the existing climate policy framework and explores the long-term impacts of the new law. The Article begins with an overview of regulations and tax incentives to reduce greenhouse gas emissions leading up to 2007. The Article then discusses the emphasis on pricing carbon through federal Cap-and-Trade legislation from 2003 to 2011, and the return to prescriptive regulation under the Clean Air Act when those federal bills failed. The Article contrasts these efforts with the positive financial incentives included in the IRA, tracking the evolution of the bill and the political and economic circumstances that created the policy window for Congress to pass such an impactful law. The Article concludes with a discussion of the lasting impacts of the IRA and the interplay between the existing policy instruments.

Qualitative Study of Food Insecurity in Hospitalized Pediatric Patients during the COVID-19 Pandemic.

Food insecurity (FI) is defined as limited or uncertain access to sufficient food for a healthy and active lifestyle. Our objective was to explore how the coronavirus disease 2019 (COVID-19) pandemic affected the FI status of pediatric patients and their families through interviewing caregivers who screen positive for FI. Caregivers of all hospitalized patients at a tertiary children's hospital who screen positive for FI with a two-question screening tool were approached about enrolling in the study. Those who consented completed a presurvey and participated in a semistructured individual interview. Interviews were audio recorded, transcribed, and analyzed according to the guidelines of thematic analysis using NVivo 12. Interviews were conducted with 15 caregivers between July 2021 and January 2022. Caregivers were 100% female and 80% Black, 13% White, and 7% Hispanic/Latinx, with a mean age of 33 years. Seventy-three percent did not experience FI until the COVID-19 pandemic. Themes include lost wages, mothers forced out of the workforce due to childcare limitations, inflation and shortages of goods, increased stress/anxiety for caregivers and children, the centrality of extended family support, and the necessity/inadequacy of federal food programs. The COVID-19 pandemic impacted unemployment and poverty and consequently exacerbated FI. Our findings point to the need to focus on proximal societal solutions, such as federal policies aimed at food assistance and childcare. Understanding the challenges related to FI that caregivers and patients experience can improve screening, support, and treatment of patients presenting for care and inform the design of necessary interventions for individuals and communities beyond COVID-19.

Policies for Other People: Reflections from an Economist on Research and Federal Policy Regarding Indigenous Nations in Canada after 1975

Comment les gouvernements colonisateurs établissent-ils des politiques relatives aux peuples et aux nations autochtones? Une façon de faire est de répondre à la recherche. Cependant, la recherche est aussi influencée par les politiques publiques et les narratifs sociaux qui les sous-tendent. Dans le présent article, je me penche sur la documentation publiée dans la plus importante publication sur les politiques publiques du Canada, Analyse de politiques, depuis 1975 et sur des articles publiés dans des revues économiques pour mieux comprendre l’état actuel du dialogue sur les politiques publiques au Canada, comme créé par la présente revue et des économistes. Moins de 3 % de tous les articles d’ Analyse de politiques depuis sa création jusqu'au présent numéro traitent de contextes autochtones. Le pourcentage est encore plus bas dans les 400 principales revues économiques, avec 21 articles. La majorité de cette documentation est axée sur l’éducation et les marchés du travail ou sur l'autonomie gouvernementale ou les droits des autochtones, ces derniers étant beaucoup plus présents après l'an 2000. Je discute de ces deux volets de documentation et je confirme les résultats des articles sur le marché du travail avec des données plus récentes. À l'examen de la documentation, il est devenu clair qu'il reste encore beaucoup à faire pour que la recherche reflète la pleine réalité économique des nations autochtones et pour que les politiques tiennent compte de la vie économique autochtone. Note des rédacteurs : Le premier volume de Canadian Public Policy/Analyse de politiques a été publié en 1975. Ce volume-ci est le cinquantième. Pour commémorer cet événement, nous avons organisé une série de conférences qui sont publiées dans ce numéro spécial. Dr. Feir a donné cette conférence dans la portion virtuelle des réunions de l'Association canadienne d’économique en mai 2023.

National science foundation grant awardees' perspectives on Article X and sexual harassment in science.

Federal scientific agencies seek to make an impact on the continued prevalence of sexual harassment in the scientific academic community beyond institutional self-regulation. The National Science Foundation's Article X, released in 2018, is one of the most significant and ambitious federal policy initiatives to address sexual harassment. The present article presents the results of the first study to examine scientists' knowledge and attitudes about this important recent policy. We found, although overall knowledge about Article X was fairly low, the majority of participants responded positively to it. Crucially, impressions of the policy varied based on past experience and demographic factors. Individuals who had experienced harassment in the past year were less likely to believe the policy would help reduce sexual harassment in the sciences compared to those who had not experienced harassment (OR = 0.47, 95% CI:0.23-0.97, p = .034) and had greater odds of endorsing that the policy failed to go far enough (OR = 2.77, 95% CI:1.15-6.66, p = .023). Associations between demographic factors and views of the policy were less pronounced, but it is notable that, compared to their White counterparts, Black participants were more likely to believe the policy went too far (OR = 5.87, 95% CI:1.04-33.17, p = .045). Additionally, concerns were raised about the institutional enforcement of these policies and the existence of sufficient protections for survivors. Our work has implications for NSF's continued evaluation of the efficacy of this program as well as for other federal agencies implementing or considering similar policies.

College Student Sex Work: A Qualitative Content Analysis of U.S. Higher Education Sex Work Policies

ABSTRACT Using content analysis methodology, we explore sex work policies at 255 U.S. colleges and universities as articulated in codes of student conduct to understand the potential impact of those policies on college student sex workers. The findings indicate U.S. colleges and universities largely do not articulate clear policies for students involved in sex work. However, many policies include language and framing that potentially governs some sex work. These articulations often rely on flattening differences in sex work, trafficking, and carceral logics, which result in misalignment between research, rhetoric, and policy at some institutions. Such ambiguities in institutional policy may result from the conflation of sex work with sex trafficking at the federal or state policy level. In addition to the marginalization imparted to student sex workers, unjustified exposure to stigma and shame on their respective college campuses negatively impacts students’ well-being. We recommend the current laissez-faire approach by institutional policymakers be replaced with a more intentional approach whereby the well-being of all students is maintained at its core and unclear policy language clarified.

The legacy of immigration policies and employment exclusion: Assessing the relationship between employment exclusions and immigrant health

Restrictive federal and state immigration policies create conditions of employment exclusion that may negatively influence the health of immigrants. In particular, these policy effects are reflected in labor market and workplace experiences that determine the types of work and employment opportunities that immigrants are able to access and pursue. This study examines the relationship between both cumulative and individual measures of employment exclusion and self-rated health and psychological distress among Asian and Latino immigrants in California, and whether this relationship is modified by legal status. We used data from the Research on Immigrant Health and State Policy (RIGHTS) study (n = 2010). We used both multivariable logistic regression and linear regression models for our analyses. For cumulative models, labor market exclusion was associated with poor health (OR = 1.21, 95% CI: 1.01, 1.46). Workplace exclusion was also associated with poor self-rated health (OR = 1.45, 95% CI: 1.15, 1.82) and increased psychological distress (β = 0.69, 95% CI: 0.31, 1.07). For individual measures of employment exclusion, settling for a job – a labor market exclusion – and working in a dangerous job and experiencing wage theft – workplace exclusions – were associated with poor health and increased psychological distress. There was no evidence that the association between employment exclusions and health varied by legal status. These findings demonstrate that the combined effect of employment exclusions is detrimental to immigrant health. To improve population health, public health researchers should continue to interrogate the policy conditions at the federal, state, and local level that exclude immigrants from employment opportunities and workplace protections.