Immigration and Immigrant Policies, Health, and Health Equity in the United States

More than 281 million people worldwide live outside their country of birth, and 15% of the United States population (50.6 million people) are immigrants.¹ As migration rises across the globe, attention to the health of migrants and immigrants is a vital aspect of public health in the United States and worldwide. Immigrants’ rights and access to opportunities and health-promoting resources are directly linked with their health and health care access.^2–9 Policies and social mobilization surrounding immigrant health are particularly important to examine, since immigration and health are two politically contentious social issues that frequently converge.^3,4,10 Further, the well-being of immigrant communities has implications for entire societies, making immigration an increasingly important topic of discussion, debate, policy, practice, and research.^10,11

In this Perspective, using the United States as a case study, we review existing literature regarding societal ideologies, policy, research, and practice toward immigration and immigrants, with a focus on gains and successes to promote immigrant health, continuing problems that have implications for immigrant health, potential solutions, and implications for public health over the coming decades. We situate research and action on immigration and health in a global context, then describe key concepts central to immigrant health. We then focus on structural factors that shape the health and well-being of immigrant communities in destination countries, namely immigration and immigrant policies. As public health professionals, we ground this review in a human rights perspective that values the health and well-being of all people regardless of nationality, mode of migration, or legal status. We also ground our discussion in structural racism and health equity lenses, as these provide rigorous perspectives for assessing how policies and other structural factors influence immigrant health. We close by suggesting structural interventions that are necessary to address the societal and political factors that contribute to immigrants’ poor health in the United States and globally.

References

1.  McAuliffe M, Khadria B. World migration report 2020. International Organization for Migration. https://publications.iom.int/system/files/pdf/wmr_2020.pdf. Published 2019. Accessed February 13, 2023.
2. Young M-EDT, Beltrán-Sánchez H, Wallace SP. States with fewer criminalizing immigrant policies have smaller health care inequities between citizens and noncitizens. BMC Public Health. 2020;20(1):1460. https://doi.org/10.1186/s12889-020-09525-4.
3. Wallace SP, Young M-EDT, Rodriguez MA, Brindis CD. A social determinants of health framework identifying state-level immigrant policies and their influence on health. SSM Popul Health. 2018;7:016-16. https://doi.org/10.1016/j.ssmph.2018.10.016.
4. Kline N. Pathogenic Policing: Immigration Enforcement and Health in the U.S. South. New Brunswick, NJ: Rutgers University Press;2019.
5. Lopez WD, Collins KM, Cervantes GR, Reynosa D, Salazar JC, Novak NL. Large-scale immigration worksite raids and mixed status families: separation, financial crisis, and family role rearrangement. Fam Community Health. 2022;45(2):59-66.
6. Lopez WD. Separated: Family and Community in the Aftermath of an Immigration Raid. Baltimore, MD: Johns Hopkins University Press; 2019.
7. LeBrón AMW, Schulz AJ, Gamboa C, Reyes A, Viruell-Fuentes EA, Israel BA. “They are clipping our wings”: health implications of restrictive immigrant policies for Mexican-origin women in a northern border community. Race Soc Probl. 2018:1-19. https://doi.org/10.1007/s12552-018-9238-0.
8. LeBrón AMW, Schulz AJ, Mentz GB, et al. Impact of change over time in self-reported discrimination on blood pressure: implications for inequities in cardiovascular risk for a multi-racial urban community. Ethn Health. 2018. https://doi.org/10.1080/13557858.2018.1425378.
9. Novak NL, Geronimus AT, Martinez-Cardoso AM. Change in birth outcomes among infants born to Latina mothers after a major immigration raid. Int J Epidemiol. 2017;46(3):839-849. https://doi.org/10.1093/ije/dyw346.
10. Castañeda H, Holmes SM, Madrigal DS, Young M-ED, Beyeler N, Quesada J. Immigration as a social determinant of health. Annu Rev Public Health. 2015;36:375-392.
11. Viruell-Fuentes EA, Miranda PY, Abdulrahim S. More than culture: structural racism, intersectionality theory, and immigrant health. Soc Sci Med. 2012;75(12):2099-2106. https://doi.org/10.1016/j.socscimed.2011.12.037.