From the Department of Health Sciences and College of Social Sciences and Humanities, Department of Anthropology and Sociology, Bouvé College of Health Sciences, Northeastern University, Boston, MA.
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA.
Epidemiology. 2022 Jul 1;33(4):593-605. doi: 10.1097/EDE.0000000000001480. Epub 2022 Apr 12.
US federal and subfederal immigrant-related policy activity has increased in recent years. We hypothesize that these policies are structural determinants of health for Latinx communities, operating through access to resources, discriminatory enforcement, and stress.
We searched seven databases for quantitative studies, published as of September 2021, examining the association between the presence of federal, state, or local immigrant-related policy(ies), over time or cross-sectionally, and mental or physical health outcomes among immigrant or US-born Latinx adults. We rated studies on methodologic quality.
Eleven studies were included. Policies included federal and state policies. Health outcomes included mental health (seven studies), self-rated health (n = 6), and physical disability (n = 1). Among immigrant, noncitizen, or Spanish-preferring Latinx adults, exclusionary policies were associated with poor self-rated health, physical disability, and poor mental health. Inclusive policies were associated with better health, although null findings were more common than among studies of exclusionary policies. Only three studies separately examined policy effects on US-born or citizen Latinx adults and these findings were often null. All studies received a weak overall study quality rating; among quality domains, studies were strongest in confounding control and weakest in outcome information bias and reporting missing data approaches.
These results support the hypothesis that immigrant-related policies, especially exclusionary policies, are structural drivers of health for immigrant or noncitizen Latinx adults. However, evidence is scant among US-born or citizen Latinx adults. Studies of policies and physical health outcomes besides disability are lacking, as are results disaggregated by nativity and/or citizenship status.
近年来，美国联邦和州以下各级与移民相关的政策活动有所增加。我们假设这些政策是拉丁裔社区健康的结构性决定因素，其作用途径包括获得资源、歧视性执法和压力。
我们在七个数据库中搜索了定量研究，这些研究截至 2021 年 9 月发表，考察了联邦、州或地方与移民相关政策的存在（无论是随时间推移还是跨截面）与移民或美国出生的拉丁裔成年人的心理健康或身体健康结果之间的关联。我们对研究进行了方法学质量评估。
纳入了 11 项研究。政策包括联邦和州的政策。健康结果包括心理健康（7 项研究）、自我报告的健康状况（n=6）和身体残疾（n=1）。在移民、非公民或偏好西班牙语的拉丁裔成年人中，排斥性政策与自我报告的健康状况差、身体残疾和心理健康差有关。包容性政策与更好的健康相关，但无效应的研究比排斥性政策的研究更为常见。仅有 3 项研究分别考察了政策对美国出生或公民身份的拉丁裔成年人的影响，这些研究的结果往往是无效应的。所有研究的总体研究质量评分均较低；在质量领域中，研究在混杂控制方面最强，在结局信息偏倚和报告缺失数据方法方面最弱。
这些结果支持了这样一种假设，即与移民相关的政策，尤其是排斥性政策，是移民或非公民拉丁裔成年人健康的结构性驱动因素。然而，在美国出生或公民身份的拉丁裔成年人中，证据很少。缺乏针对残疾以外的政策和身体健康结果的研究，也缺乏按出生国和/或公民身份进行结果细分的研究。
