Bioethics Forum Essay
New Homeland Security Rules and Health Care Access for Undocumented Immigrants
On February 21, the Department of Homeland Security released new policies prioritizing deportation of undocumented immigrants. Will this policy shift affect health care access for this population of 11 million? Two public health studies from Arizona suggest that immigration crackdowns change health-seeking behavior.
During and following the 2010 enactment of Arizona SB 1070, a highly controversial law reflecting state lawmakers’ goal of “attrition through enforcement,” public health researchers conducting an unrelated study of childhood obesity among residents of a Latino neighborhood in Flagstaff noticed that the new law was creating “a generalized climate of fear . . . . In a neighborhood with no major grocery store and several fast food and gas station markets, fear of travel in public could severely skew food purchasing and consumption behaviors . . .. Residents also reported reluctance to allow their children to engage in physical exercise outside the home.” Community health professionals interviewed “noted dramatic changes in clinic intake and service use, suggesting rapid behavioral change” among neighborhood residents.
A later study that focused on the impact of SB 1070 on health-seeking behavior among families of Mexican origin found that parents were less likely to take babies to the doctor and adolescents were less likely to seek routine health care. These effects were not limited to immigrants; U.S.-born citizens were also reluctant to use public assistance. The study’s authors concluded that “this law is likely associated with heightened perceptions of fear and lack of community safety, even among . . . U.S. citizens.”
In 2012, the U.S. Supreme Court struck down certain provisions of Arizona’s law, and decisions by lower courts weakened similar laws in other states.