Ettinger de Cuba Stephanie, Miller Daniel P, Raifman Julia, Cutts Diana B, Bovell-Ammon Allison, Frank Deborah A, Jones David K
Health Law, Policy & Management, Boston University School of Public Health and Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, United States.
Human Behavior, Research, and Policy, Boston University School of Social Work, Boston, MA, United States.
Health Aff Sch. 2023 Jul 10;1(2):qxad023. doi: 10.1093/haschl/qxad023. eCollection 2023 Aug.
Widespread fear among immigrants from hostile 2016 presidential campaign rhetoric decreased social and health care service enrollment (chilling effect). Health care utilization effects among immigrant families with young children are unknown. We examined whether former President Trump's election had chilling effects on well-child visit (WCV) schedule adherence, hospitalizations, and emergency department (ED) visits among children of immigrant vs US-born mothers in 3 US cities. Cross-sectional surveys of children <4 years receiving care in hospitals were linked to 2015-2018 electronic health records. We applied difference-in-difference analysis with a 12-month pre/post-election study period. Trump's election was associated with a 5-percentage-point decrease (-0.05; 95% CI: -0.08, -0.02) in WCV adherence for children of immigrant vs US-born mothers with no difference in hospitalizations or ED visits. Secondary analyses extending the treatment period to a leaked draft of proposed changes to public charge rules also showed significantly decreased WCV adherence among children of immigrant vs US-born mothers. Findings indicate likely missed opportunities for American Academy of Pediatrics-recommended early childhood vaccinations, health and developmental screenings, and family support. Policies and rhetoric promoting immigrant inclusion create a more just and equitable society for all US children.
2016年总统竞选期间充满敌意的言论引发了移民群体的广泛恐惧，导致社会和医疗服务登记人数减少（寒蝉效应）。有年幼儿童的移民家庭的医疗服务利用情况尚不清楚。我们研究了前总统特朗普的当选是否对美国三个城市中移民母亲与美国本土母亲的孩子的健康儿童体检（WCV）计划依从性、住院率和急诊就诊率产生了寒蝉效应。对在医院接受治疗的4岁以下儿童进行的横断面调查与2015 - 2018年的电子健康记录相关联。我们在选举前/后12个月的研究期间应用了差分分析。特朗普的当选与移民母亲的孩子相比美国本土母亲的孩子的WCV依从性下降5个百分点（-0.05；95%置信区间：-0.08，-0.02）相关，住院率或急诊就诊率没有差异。将治疗期延长至公共负担规则拟议变更的泄露草案的二次分析也显示，移民母亲的孩子与美国本土母亲的孩子相比，WCV依从性显著下降。研究结果表明，美国儿科学会推荐的幼儿疫苗接种、健康和发育筛查以及家庭支持可能错失了机会。促进移民融入的政策和言论为所有美国儿童创造了一个更加公正和公平的社会。
