School of Social Sciences, Humanities and Arts, University of California Merced.
Milbank Q. 2023 Dec;101(4):1348-1374. doi: 10.1111/1468-0009.12671. Epub 2023 Sep 14.
Policy Points Inclusive state immigrant policies that expand rights and resources for immigrants may improve population health, but little is known about their local-level implementation. Local actors that have anti-immigrant attitudes can hinder the implementation of state policies, whereas the persistent influence of anti-immigrant federal policies reinforces barriers to accessing health and other resources granted by state policies. Local actors that serve immigrants and support state policy implementation lack the resources to counter anti-immigrant climates and federal policy threats.
In the United States, inclusive state-level policies can advance immigrant health and health care access by extending noncitizens' access to public benefits, workplace rights, and protections from immigration enforcement. Although state policies carry promise as structural population health interventions, there has been little examination of their implementation at the local level. Local jurisdictions play multiple roles in state policy implementation and possess distinct immigration climates. Examining the local implementation of state immigrant policy can address challenges and opportunities to ensure the health benefits of inclusive policies are realized equitably across states' regions.
To examine the local implementation of state immigrant policies, we selected a purposive sample of California counties with large immigrant populations and distinct social and political dynamics and conducted and analyzed in-depth interviews with 20 community-based organizations that provided health, safety net, and other services.
We found that there were tensions between the inclusionary goals of state immigrant policies and local anti-immigrant climates and federal policy changes. First, there were tensions between state policy goals and resistance from local law enforcement agencies and policymakers (e.g., Board of Supervisors). Second, because of the ongoing threats from federal immigration policies, there was a mismatch between the services and resources provided by state policies and local community needs. Finally, organizations that served immigrants were responsible for contributing to policy implementation but lacked resources to meet community needs while countering local resistance and federal policy threats.
This study contributes knowledge regarding the challenges that emerge after state immigrant policies are enacted. The tensions among state immigrant policies, local immigration climates, and federal policy changes indicate that state immigrant policies are not implemented equally across state communities, resulting in challenges and limited benefits from policies for many immigrant communities.
目的：本研究旨在探讨美国地方层面州级移民政策的实施情况。
背景：州级政策可通过扩大非公民享有公共福利、工作场所权利和免受移民执法的保护来增进移民健康和获得医疗保健的机会。尽管州级政策有望成为结构性人口健康干预措施，但对其在地方层面的实施情况研究甚少。地方司法管辖区在州级政策实施中发挥着多种作用，并具有独特的移民氛围。考察州级移民政策的地方实施情况，可解决实施过程中的挑战和机遇，以确保各州不同地区都能公平地实现包容性政策的健康效益。
方法：我们选择了加利福尼亚州拥有大量移民人口且具有独特社会和政治动态的县作为有目的的样本，并对 20 个提供健康、安全网和其他服务的社区组织进行了深入访谈并分析。
发现：我们发现州级移民政策的包容性目标与地方反移民氛围和联邦政策变化之间存在紧张关系。首先，州政策目标与地方执法机构和政策制定者（如监事会）的抵制之间存在紧张关系。其次，由于联邦移民政策的持续威胁，州政策提供的服务和资源与当地社区的需求不匹配。最后，为移民服务的组织负责推动政策实施，但缺乏资源来满足社区需求，同时应对地方阻力和联邦政策威胁。
结论：本研究为州级移民政策实施后面临的挑战提供了知识。州级移民政策、地方移民氛围和联邦政策变化之间的紧张关系表明，州级移民政策在各州社区的实施并不均衡，导致许多移民社区面临政策挑战和有限的政策效益。
