Fielding School of Public Health, Community Health Sciences Jonathan and Karin, University of California Los Angeles, Los Angeles, CA, USA.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
BMC Public Health. 2022 Aug 16;22(1):1558. doi: 10.1186/s12889-022-13994-0.
Undocumented immigrants are expected to face increased risks related to COVID-19 due to marginalizing restrictive immigration policies. However, few studies have assessed the prevalence of direct encounters with the immigration enforcement system among the undocumented and its impacts on their COVID-related health behaviors and outcomes. In this study, we quantify undocumented immigrants' lifetime exposure to various immigration enforcement tactics and their association with delays in COVID-19 testing and healthcare behaviors.
This cross-sectional study included a non-random sample of 326 Asian and Latinx undocumented immigrants in California from September 2020 to February 2021. The primary exposure was immigration enforcement encounter scores ranging from 0-9, assessed through self-reports of direct experiences with the immigration system, immigration officials, and law enforcement. The main outcomes were positive test for COVID-19, had or suspected having COVID-19, and delayed or avoided testing and/or treatment for COVID-19 due to immigration status. We used multivariable logistic regression models to examine the association between the primary exposure and outcomes of interest.
Among 326 participants, 7% had received a positive COVID-19 test result, while 43% reported having or suspected having COVID-19. Almost 13% delayed or avoided COVID-19 testing and/or treatment because of their immigration status. Overall, an increase in immigration enforcement encounters was associated with higher odds of suspecting having had COVID-19 (aOR = 1.13; 95% CI: 1.01,1.26). Reporting an additional enforcement encounter was associated with higher odds of delaying or avoiding testing and/or treatment because of immigration status (aOR = 1.53, 95% CI: 1.26,1.86). Compared to their Latino counterparts, Asian respondents were more likely to report higher odds of delaying or avoiding testing and/or treatment (aOR = 3.13, 95% CI: 1.17,8.42). There were no significant associations between the enforcement score and testing positive for COVID-19. Additionally, while Latinxs were more likely to report immigration enforcement encounters than Asians, there were no differences in the effects of race on COVID-19 testing and healthcare behaviors in models with race as an interaction term (p < 0.05).
Immigration enforcement encounters compound barriers to COVID-19 testing and treatment for undocumented immigrants.
由于边缘化的限制移民政策，预计无证移民将面临与 COVID-19 相关的风险增加。然而，很少有研究评估无证移民直接遭遇移民执法系统的普遍性及其对他们与 COVID 相关的健康行为和结果的影响。在这项研究中，我们量化了无证移民一生中接触各种移民执法策略的情况，并评估了这些策略与 COVID-19 检测和医疗保健行为延迟之间的关联。
这是一项横断面研究，纳入了 2020 年 9 月至 2021 年 2 月期间来自加利福尼亚州的 326 名亚洲和拉丁裔无证移民的非随机样本。主要暴露因素是移民执法遭遇评分，范围为 0-9，通过自我报告直接接触移民系统、移民官员和执法人员来评估。主要结果是 COVID-19 检测呈阳性、有或怀疑患有 COVID-19 以及因移民身份而延迟或避免 COVID-19 检测和/或治疗。我们使用多变量逻辑回归模型来检验主要暴露因素与感兴趣的结果之间的关联。
在 326 名参与者中，7%的人 COVID-19 检测结果呈阳性，而 43%的人报告有或怀疑患有 COVID-19。由于移民身份，近 13%的人延迟或避免 COVID-19 检测和/或治疗。总体而言，移民执法遭遇次数的增加与怀疑患有 COVID-19 的几率较高相关（aOR=1.13；95%CI：1.01，1.26）。报告额外的执法遭遇与因移民身份而延迟或避免检测和/或治疗的几率较高相关（aOR=1.53，95%CI：1.26，1.86）。与拉丁裔受访者相比，亚洲受访者更有可能报告因移民身份而延迟或避免检测和/或治疗的几率较高（aOR=3.13，95%CI：1.17，8.42）。执法评分与 COVID-19 检测呈阳性之间没有显著关联。此外，尽管拉丁裔人比亚洲人更有可能报告移民执法遭遇，但在包含种族作为交互项的模型中，种族对 COVID-19 检测和医疗保健行为的影响没有差异（p<0.05）。
移民执法遭遇使无证移民的 COVID-19 检测和治疗更加困难。
