Undocumented Latinx Immigrants Research Articles

Assessment of a Peer Support Group Intervention for Undocumented Latinx Immigrants With Kidney Failure

Most undocumented immigrants with kidney failure rely on emergency dialysis (defined as dialysis after a patient presents as critically ill) and experience significant depression and anxiety and high mortality. Culturally and language-concordant peer support group interventions may be associated with reduced depression and anxiety and may provide emotional support. To investigate the feasibility and acceptability of a single-group peer support group intervention. This qualitative and single-group prospective study for undocumented immigrants with kidney failure receiving emergency dialysis was conducted in Denver, Colorado, from December 2017 to July 2018. The 6-month intervention included peer support group meetings in the hospital while participants were hospitalized for emergency dialysis. Data were analyzed from March to June 2022. To assess feasibility, the recruitment, retention, implementation, and delivery for the intervention were tracked. To measure acceptability, interviews were conducted with participants using a structured format. To assess the value of the peer support group intervention, themes and subthemes were identified from interviews with participants and group meetings. Of 27 undocumented immigrants with kidney failure receiving emergency dialysis, 23 participants (9 females [39.1%] and 14 males [60.9%]; mean [SD] age, 47 [8] years) agreed to participate (recruitment rate, 85.2%). Among them, 5 individuals withdrew and did not attend meetings and 18 participants (retention rate, 78.3%) attended a mean of 6 of 12 meetings (50.0%). From interviews and meetings, 3 themes, with associated subthemes, were identified: camaraderie and emotional support from peers (subthemes: peer support is vital for people newly diagnosed with kidney failure, safe space to build relationships and share hardship with peers, hospital setting for peer support is ideal, solidarity to survive and change policy, and sustainability of the peer support group), solutions to improve care and resilience (subthemes: self-advocacy, self-motivation and optimism, kidney disease education, emotional support from peers caregivers, and faith), and emotional and physical aspects of receiving emergency dialysis (subthemes: psychosocial and physical distress, mixed experiences with language-concordant care, emotional exhaustion from end-of-life conversations, and gratitude for clinicians). This study found that peer support group intervention achieved feasibility and acceptability. The findings suggest that a peer support group may be a patient-centered strategy to build camaraderie and provide emotional support in kidney failure, especially for socially marginalized uninsured populations who report limited English proficiency.

Cuento de nunca acabar [never-ending story]: Compounding trauma and mental health among undocumented Latinx immigrants.

Research examining the effects of traumatic events on undocumented Latinx immigrants often focuses on assessing posttraumatic stress disorder or general psychological distress, which may obscure the field's understanding of how trauma exposure impacts other common mental health disorders (e.g., anxiety, depression). This study sought to assess the cumulative, individual, and timing effects of immigration-related traumatic events on anxiety and depressive symptoms among undocumented Latinx immigrants. Participants were 253 undocumented Latinx immigrants recruited using respondent-driven sampling who reported their history of immigration-related trauma exposure and symptoms of depression and anxiety. Results suggest that cumulative immigration-related trauma was significantly associated with increases in anxiety and depressive symptoms, τ = .26. Significant positive correlations were found for cumulative trauma at each point in the immigration process (i.e., before immigration, while in transit to the United States, and while living in the United States) such that increases in the number of events were associated with higher anxiety and depressive symptom levels, τ = .11-.29. Trauma frequency differed throughout the immigration process such that some events more commonly occurred before immigration or during transit to the United States, whereas others occurred while an individual resided in the United States. Random forest algorithms uncovered differences in the relative importance of individual traumatic events in explaining the variance of depressive, R2 = .13, and anxiety symptoms, R2 = .14. The findings highlight the importance of providing trauma-informed care when treating anxiety and depression among undocumented Latinx immigrants and considering multidimensional epidemiological approaches in assessing immigration-related trauma.

“I thought I was going to die there:” Socio-political contexts and the plight of undocumented Latinx in the COVID-19 pandemic

Since the beginning of the COVID-19 pandemic, certain U.S. population groups have suffered higher rates of infection and mortality than whites, including Latinx. Public health officials blamed these outcomes on overcrowded housing and work in essential industries prior to the vaccine's availability. We sought to illuminate the lived experience of these factors through a qualitative study of undocumented Latinx immigrant workers in the secondary economy (n ​= ​34). This study focuses on the intersectionality of social locations for undocumented Latinx immigrants living in a relatively affluent suburb and working in the construction and service sectors prior to the pandemic. Their narratives revealed how the pandemic created financial precarity through prolonged periods of unemployment and food insecurity. Workers described worry over unpaid bills, and potentially catastrophic episodes in which they treated severe COVID-19 with home remedies. Long spells of unemployment, food insecurity, inability to pay bills and lack of access to healthcare emerged because of socio-political contexts including the nature of low-wage labor and lack of a safety net.

Familias Divididas [divided families]: Transnational family separation and undocumented Latinx immigrant health.

Undocumented Latinx immigrants (ULIs) comprise a large segment of the U.S. population, yet they remain at high risk for diminished health outcomes due to increased exposure to adverse experiences and context. Transnational family separation and the distress that accompanies it is an example of a common adverse experience that is chronic and that impacts the lives of many ULIs. However, despite how chronic and central transnationalism is to the lives of ULIs, little is known about its relation to the health outcomes of ULIs. To that end, this study examined the relation between distress due to transnational family separation and the physical and mental health of ULIs. To do so, the study utilized respondent-driven sampling and path analysis methodologies to cross-sectionally examine how distress from transnational separation was related to the physical and mental health of ULIs (n = 229). Results revealed that as distress from transnational family separation increased so too did participant's depressive (β = .25, p < .001), anxiety (β = .18, p = .006), and physical symptoms (β = .24, p < .0001). Distress from transnational family separation was also more strongly related to physical and depressive symptoms than to anxiety symptoms. Considering these results, important systemic changes to our approach to healthcare delivery and access among ULIs communities are needed to promote the well-being of this at-risk population. Recommendations for doing so are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

One more wall to cross: The role of psychologists in addressing integrated health among undocumented Latinx immigrants in inpatient medical settings.

Over the past decade, there has been increased attention to the benefits of an integrated health-care care model in which psychologists play a vital role collaborating with other health providers to deliver services in inpatient medical settings, such as emergency departments and acute care medical units. Psychologists working in inpatient medical settings can facilitate access to mental health services and referrals, reduce mental health stigma, improve health outcomes associated with insight into psychosocial factors that affect health and illness, improve communication between patients and providers, and increase sensitivity in addressing the health needs of diverse patients. Psychological services in inpatient medical units can be particularly valuable for marginalized populations, such as undocumented Latinx immigrants, who may not otherwise have access to services that can address the compounded effect that psychosocial stressors may have on their physical health. We illustrate the critical role that psychologists can play in inpatient medical settings to address the complex health needs of Latinx immigrants. In this case study, an undocumented young woman presented to an emergency department with acute liver failure. We focus on psychologists' specific contributions as part of the integrated medical team and how it may have impacted treatment effectiveness. We also provide practical assessment and treatment recommendations, along with proposing advocacy efforts to facilitate access to culture and context sensitive treatments for undocumented immigrants with complex health issues. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Immigration enforcement exposures and COVID-19 vaccine intentions among undocumented immigrants in California

COVID-19 vaccines are effective in preventing COVID-19 infection, disease, and death. However, there is no data about vaccine intentions among the 10.7 million undocumented immigrants in the US. This study examined the associations between immigration enforcement exposure and vaccine intentions among undocumented immigrants in California. This community-engaged study partnered with immigrant organizations across California during the COVID-19 pandemic to recruit 366 study participants to an online survey regarding their attitudes about the COVID-19 vaccine and past exposure with the immigration enforcement system. Data collection occurred from September 2020 – February 2021 before the vaccine became available. Overall, 65% of study participants indicated that they would definitely get the vaccine were it to become available. In multivariable logistic regressions, an increase in immigration enforcement scores were associated with a 12% decrease in vaccine acceptance (aOR = 0.88, CI: 0.78–0.99). Additionally, undocumented women were 3.09 times more likely to report vaccine acceptance compared to undocumented men (CI: 1.79–5.35) and undocumented Asians were 57% less likely to report vaccine acceptance compared to undocumented Latinx immigrants (aOR = 0.43, CI: 0.21–0.88). Exposure to the immigration enforcement system may undermine public health efforts to prevent further transmission of COVID-19 by reducing acceptability of vaccines among immigrant populations.

Documentation Status and Self-Rated Physical Health Among Latinx Young Adult Immigrants: the Mediating Roles of Immigration and Healthcare Stress.

Previous research has demonstrated that undocumented Latinx immigrants in the USA report worse physical health outcomes than documented immigrants. Some studies suggest that immigration-related stress and healthcare related-stress may explain this relationship, but none have tested it empirically. The purpose of this study was to determine if immigration-related stress and healthcare-related stress in the USA explain the relationship between documentation status and physical health among Latinx immigrants in North Carolina. The conceptual model was tested utilizing baseline data from a longitudinal, observational, community-engaged research study of young adult (18–44 years) Latinx immigrants residing in North Carolina (N = 391). Structural equation modeling was used to determine relationships among documentation status, healthcare, and immigration stress in the past six months, and self-rated physical health. Goodness-of-fit measures indicated that data fit the model well (RMSEA = .008; CFI = 1.0; TLI = .999; SRMR = .02; CD = .157). Undocumented individuals were more likely to experience immigration stress than their documented counterparts (beta = − 0.37, p < 0.001). Both immigration stress (beta = − 0.22, p < 0.01) and healthcare stress (beta = − 0.14, p < 0.05) were negatively related to physical health. Additionally, immigration stress was positively related to healthcare stress (beta = 0.72, p < 0.001). Results demonstrate that documentation status is an important social determinant of health. Passage of inclusive immigration and healthcare policies may lessen the stress experienced by Latinx immigrants and subsequently improve physical health.

Barriers to health care services among US-based undocumented Latinx immigrants within the sociopolitical climate under the Trump administration: A comparative analysis between client experiences and provider perceptions

As President Biden's administration works towards a ‘fair and humane’ immigration overhaul, it becomes critical to examine the implications of immigration policies/laws under the Trump administration on the well-being of undocumented residents to inform equitable reformations. We investigate challenges faced by undocumented Latinx immigrants in accessing health care services in the sociopolitical climate under the Trump administration. This study, which follows a similar study among frontline service providers, presents key findings from 23 in-depth interviews with Latinx individuals. Understanding their experiences is necessary to advance access to health-promoting services and uphold the human right to health. Our study participants' narratives document multiple barriers to health care services, many notably exacerbated by increasingly restrictive immigration policies/laws and heightened punitive interior enforcement practices under the Trump administration. As the nation awaits equitable immigration reform, health care organizations should immediately incorporate, amplify, or alter programs/practices to facilitate access among their undocumented clients. Focused organizational changes have the potential to reduce unmet health needs, minimize financial burdens for families, and curtail potential public health threats, the latter a particularly imperative goal within the current COVID-19 pandemic. We also distill conclusions drawn from our interviews with clients and their convergence with and divergence from conclusions drawn from our related research with providers. While providers recognize the negative impact of sociopolitical factors on their clients' access to health care services, client experiences illuminate potential gaps in their understanding. Bridging understanding between providers and clients can improve access, utilization, and retention in health care services.

Lessons learned from undocumented Latinx immigrants: How to build resilience and overcome distress in the face of adversity.

Living under chronic uncertainty, fear, and isolation is the experience of many undocumented immigrants particularly under the recent sociopolitical climate. Yet, despite facing chronic adversity and an uncertain future, undocumented immigrants are highly resilient. This paper draws upon the clinical and research expertise of leading Latinx psychologists working with diverse undocumented communities across the United States. Qualitative data from seven focus groups with undocumented Latinxs and 15 in-depth interviews with key informants were used to complement clinical insights to identify and highlight strategies of undocumented Latinxs that promote their resilience. Overall, six primary strategies emerged including cognitive reframing, behavioral adaptability, acceptance, sociability, courage, and ancestral or cultural pride. Within each of these primary strategies, two-to-five additional facets emerged. We also identified the positive effects of the aforementioned strategies, including the fostering of meaning, purpose, and hope. Our findings are essential to address biases and stigmatization against undocumented immigrants, as well as to inform strength-based interventions and services, as well as culturally and contextually sensitive resources. Health services providers working with undocumented Latinxs can identify and build on strengths in their patients to demonstrate accurate cultural understanding and also to support resilience. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Work Primacy and the Social Incorporation of Unaccompanied, Undocumented Latinx Youth in the United States

Abstract This study investigates the social incorporation of unaccompanied, undocumented Latinx youth workers as they come of age in the United States. Based on research with undocumented Central American and Mexican young adults who grew up as unaccompanied minors in Los Angeles, California, the data reveal that the pressures of financial obligations to families in the sending country and their own sobrevivencia (survival) in the United States, along with limited financial and social resource and mobility, produce a social incorporation trajectory shaped by the primacy of work. Work primacy conditions youth’s educational opportunities, community embeddedness, and family relationships and limits unaccompanied, undocumented youth’s ability to establish and maintain social networks with consequences for their social incorporation. The precarious occupations within the secondary labor market that are characterized by long hours, low wages, labor market restrictions, and unsafe and unsanitary work conditions limit opportunities for socioeconomic mobility for all youth. Women and Indigenous youth are distinctly affected by work primacy. This research advances our understanding of immigrant youth’s lives by examining how institutional context, familial obligations across borders, and limited ethnic networks play a role in shaping the incorporation experiences of unaccompanied, undocumented Latinx immigrants as they come of age in the United States.

Perspectives on Kidney Disease Education and Recommendations for Improvement Among Latinx Patients Receiving Emergency-Only Hemodialysis

In most states, undocumented Latinx immigrants with kidney failure receive dialysis in acute care settings on an emergency-only basis. How much kidney disease education Latinx immigrants receive and how to improve kidney disease education and outreach among Latinx populations are unknown. To understand the kidney disease educational gaps of Latinx individuals who need but lack access to scheduled outpatient dialysis. This qualitative study used semistructured interviews in a Texas hospital system from March 2020 to January 2021 with 15 individuals who received emergency-only dialysis when they were first diagnosed with kidney failure. Demographic information was collected, and a thematic analysis was performed using the constant comparative method on interviews after they were audio-recorded, translated, and transcribed verbatim. Data analysis was performed from April 2020 to February 2021. Subthemes and themes from semistructured interviews. All 15 persons interviewed (9 male individuals [60%]; mean [SD] age, 51 [17] years) identified as Hispanic, 11 (73%) were born in Mexico, and none reported knowing about their kidney disease more than 6 months before starting dialysis. The themes identified were (1) lack of kidney disease awareness, (2) education provided was incomplete and poor quality, (3) lack of culturally concordant communication and care, (4) elements that Latinx patients receiving emergency-only dialysis want in their education, (5) facilitators of patient activation and coping, and (6) Latinx patient recommendations to improve community outreach. Latinx adults receiving emergency-only dialysis are usually unaware of their kidney disease until shortly before or after they start dialysis, and the education they receive is poor quality and often not culturally tailored. Participants made feasible recommendations on how to improve education and outreach among Latinx communities.

Policing Race and Performing State Power: Immigration Enforcement and Undocumented Latinx Immigrant Precarity in Central Florida

AbstractIn the United States, undocumented Latinx immigrants’ precarious social positions are rooted in aggressive immigration enforcement practices that create a contestant threat of detection and deportation. This threat extends into the US interior, and in some US cities, immigrant policing practices rely on law enforcement officers racially profiling Latinx immigrants. Several social scientists have described the numerous consequences of racially‐based immigrant policing, but insufficient scholarship examines the role urban and suburban spaces play in constructing the policing regimes that structure undocumented immigrants’ precarity. In this article, I examine the relationship between immigration enforcement regimes, automobiles, and the suburban roadways in a previously rural Central Florida exurb. Using frameworks of automobility, illegality, and necropolitics, I show how Central Florida’s expanding suburban infrastructure contributes to immigrant policing efforts. I further show how spectacles of immigration enforcement, such as parking border patrol vehicles along specific highways, are performances of state power to reinforce racial hierarchies. Overall, I argue that spatial and material conditions—such as driving vehicles that law enforcement officers associate with undocumented immigrants on specific roadways—serve to simultaneously underscore undocumented immigrants’ vulnerability and to signal to white residents how law enforcement officers maintain white supremacy by targeting undocumented Latinx drivers.

Fear of discovery as a deterrent to undocumented Latinx immigrants' reporting of crimes and the effects of political rhetoric.

Comparing undocumented Latinx immigrants (UDLI), Latinx citizens/residents (LCR), and non-Latinx citizens/residents (NLCR), we sought to assess rates of crime victimization, fear of reporting crimes, causes of this fear, and whether political rhetoric from the U.S. President had changed the reporting of crimes. From October 2018 to February 2020, we conducted this in-person survey study, enrolling similar numbers of UDLI, LCR, and NLCR patients at two urban county hospital emergency departments (EDs) in San Francisco and Oakland, California. Our primary outcomes were responses to key survey questions regarding crime victimization, fear of reporting crimes and the effects of anti-immigrant rhetoric on reporting crimes. Of 667 patients approached, 531 (80%) participated and six participants were excluded: 165 (31.3%) were UDLI, 183 (34.7%) were LCR, and 177 (33.6%) were NLCR. Similar percentages of UDLI (34%), LCR (32%), and NLCR (39%) knew of someone (themselves, friends, or family) who was a victim of a crime. Similar percentages of UDLI (41%), LCR (46%), and NLCR (41%) stated that these victims were afraid to report this crime to the police. The primary reason for this fear in UDLI was fear of discovery and deportation (30%). Similar percentages of UDLI (63%), LCR (58%), and NLCR (46%) ultimately reported the crime to the police. Most (85%) respondents had heard the U.S. President's statements about measures against immigrants; 54% reported that they believe that because of these statements, people are more afraid to report a crime to the police. Fear of reporting crimes is common in ED patients. The most common fear in UDLI is fear of discovery and deportation. Political rhetoric against immigrants contributes to this fear.

Chronic Pain and Psychological Distress Among Undocumented Latinx Immigrants in the USA

Undocumented immigration is often accompanied by multiple and complex stressors, which over time may increase the risk for chronic pain. This study aimed to identify the prevalence of chronic pain and its association with psychological distress among undocumented Latinx immigrants in the USA. We used respondent-driven sampling to collect and analyze data from clinical interviews with 254 undocumented Latinx immigrants, enabling inference to a population of 22,000. Chronic pain was assessed using the World Health Organization Composite International Diagnostic Interview (CIDI) Chronic Conditions Module. For all analyses, inferential statistics accounted for design effects and sample weights to produce weighted estimates. We conducted logistic regression analyses to assess the association between chronic pain and psychological distress after controlling for age, years in the USA, and history of trauma. A total of 28% of undocumented Latinx immigrants reported having chronic pain, and 20% of those had clinically significant psychological distress. Significant differences in the prevalence of chronic pain were reported across age groups, years in the USA, and trauma history. After controlling for relevant covariates, chronic pain was significantly associated with psychological distress (OR = 1.06, 95% CI [1.02, 1.09]), age (OR = 1.05, 95% CI [1.02; 1.09]), and history of trauma (OR = 1.10 per additional traumatic event, 95% CI [1.02; 1.19]; C-statistic = 0.79). Among undocumented Latinx immigrants, chronic pain is significantly associated with psychological distress, older age, and trauma history. Given that undocumented immigrants have restricted access to healthcare and are at high risk for chronic pain, developing alternatives to facilitate access to chronic pain interventions and risk-reduction prevention are needed.

Effectiveness of Respondent-Driven Sampling for Conducting Health Studies Among Undocumented Immigrants at a Time of Heightened Immigration Enforcement.

This paper assessed the effectiveness of Respondent Driven Sampling (RDS) in recruiting undocumented Latinx immigrants for a prevalence health study at a time of heightened immigration enforcement. RDS was used to collect and analyze data from clinical interviews with 254 undocumented Latinx immigrant adults, enabling inference to a population of 22,000. 45% of the sample reported having a chronic medical condition. The desired sample size was achieved and exceeded with three initial recruits and 10 waves of recruitment across 9weeks. There was substantial cross-group mixing for recruitment in terms of sex and recency of immigration, which facilitated the emergence of diversity within recruitment chains. Primary factors that contributed to effective recruitment were location, flexibility, on-site childcare, and detailed explanation of the recruitment process. RDS is an effective recruitment method to study the health of undocumented Latinx immigrants, which is essential to informing intervention and policy.

Protective Factors to the Wellbeing of Undocumented Latinx Immigrants in the United States: A Socio-Ecological Approach

Undocumented immigrants often experience multiple chronic stressors that over time can increase health risk. This qualitative study used data from 7 focus groups and 15 key informant interviews to identify relevant protective factors to the heath of undocumented immigrants in the U.S. Findings showed that at the individual level, undocumented immigrants rely primarily on motivation to cope with adversity, while also relying on family support and community cohesion at the interpersonal level. At the policy level, safe neighborhoods and non-stigmatizing environments, protection from abuse/exploitation, and activism were identified as protective factors. English proficiency was also identified as important.

“Because they are connected”: Linking structural inequalities in farmworker organizing

Agriculture in the United States (US), long dominated by white male interests, is rooted in entrenched structural inequalities. Prominent among them is the power of growers over a dependable low-wage racialized and gendered workforce that is disciplined with the threat of their disposability. Workers and other activists have long responded with opposition. We advance radical food geography scholarship with a relational understanding of the structural inequalities that farmworkers experience and their resistance through farmworker movements, by centering the perspectives and experiences of activists with an intersectional praxis. We begin with a review of the compounding economic, political, and social inequalities experienced by farmworkers in the US in the context of xenophobic enforcement-first approaches to policing documented and undocumented Latinx immigrants. We then present a case study of Community to Community Development (C2C) in Washington state, an example of the radical frontlines of resistance by farmworker advocacy groups, as they link systems of oppression, especially with regard to class, immigration status, gender, and race. Ultimately, we argue for elevating more intersectional forms of organizing in the food system. In doing so, we encourage radical food geographers to conduct scholarship-activism more open to the many intersections between social position and structural inequality and resistance.

Application of the Minority Stress Theory: Understanding the Mental Health of Undocumented Latinx Immigrants.

This paper applies the Minority Stress framework to data collected from an ongoing community-based participatory research project with health and social service agencies in Southeast Michigan. We examine the stressors and coping strategies employed by undocumented Latinx immigrants and their families to manage immigration-related stress. We conducted in-depth interviews with 23 immigrant clients at Federally Qualified Health Care Centers (FQHC) in Southeast Michigan and 28 in-depth interviews with staff at two FQHC's and a non-profit agency serving immigrants. Findings suggest that immigrants face heightened anxiety and adverse mental health outcomes because of unique minority identity-related stressors created by a growing anti-immigrant social environment. Chronic stress experienced stems from restrictive immigration policies, anti-immigrant rhetoric in the media and by political leaders, fear of deportation, discriminatory events, concealment, and internalized anti-immigrant sentiment. Though identity can be an important effect modifier in the stress process, social isolation in the immigrant community has heightened the impact of stress and impeded coping strategies. These stressors have resulted in distrust in community resources, uncertainty about future health benefits, delayed medical care, and adverse mental health outcomes. Findings provide a framework for understanding the unique stressors experienced by immigrants and strategies for interventions by social service agencies.

The Health of Undocumented Latinx Immigrants: What We Know and Future Directions.

Undocumented Latinx immigrants experience unique factors prior to migration, during migration, and after migration that shape their health. Our review summarizes the limited but growing literature highlighting how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect the mental and physical health of undocumented Latinx immigrants. We also discuss how policies and social ties can promote their health. We focus on areas of particular concern, including health care, mental health, and HIV. Future research should use interdisciplinary approaches and intersectional frameworks to understand and address health inequities. Conducting research with undocumented Latinx immigrant communities requires community engagement, assurance of confidentiality, and creative recruitment and retention strategies. Recommendations for public health practice include investing in community health centers and organizations to ensure access to health and social services; presenting results with sufficient contextualization to interpret their generalizability; and advocating for federal-, state-, and local-level policy changes that reduce the negative health consequences associated with being undocumented.

Hispanic Health Paradox at the Border: Substance, Alcohol, and Tobacco Use among Latinx Immigrants Seeking Free or Reduced-Cost Care in Southernmost Texas.

Although substantial research has explored the Hispanic health paradox (HHP) and suggests that Latinx immigrants experience positive health outcomes relative to those born in the United States, less research has assessed the role of immigration status. Our aim was to examine this role in Latinx health. Using survey data collected at two free/reduced-cost clinics in southernmost Texas, we examined differences in the mental and self-rated health, substance, alcohol, and tobacco use of low-income patients by undocumented/documented immigrant and US-born/naturalized citizen status (N = 588). Based on ordinary least squares regression results, undocumented Latinx immigrants report lower negative self-rated health (coefficient -0.27, 95% confidence interval -0.50 to -0.01) and lower depressive symptoms (coefficient -0.34, 95% confidence interval -0.67 to -0.02]) compared with their US citizen peers (P < 0.05). Logistic regression results suggest that undocumented and documented Latinx immigrants do not differ in alcohol, tobacco, or substance use relative to their citizen peers. Despite facing potentially adverse social environments, undocumented Latinx immigrants experience positive health outcomes relative to US-born/naturalized citizen peers.