The unintended health consequence of Trump’s push for immigration reform

Restrictive changes to immigration policies may impact healthcare access for immigrants already residing in the US. A recent study published in BMC Health Services Research investigated this by conducting focus groups with health workers in Texas. This blog post, written by the authors of the study, explores the issue and what it means for immigrants' health.

Since taking office in 2017, the Trump administration has pursued restrictive immigration reform as a top priority. Building on campaign promises, President Trump has declared a national emergency to fund a wall on the US-Mexico border, tried to end the DACA program that allows undocumented children to remain in the US, and threatened to change public charge rules. Last month, President Trump doubled down by announcing an immigration reform proposal that would increase border security and limit visas given to relatives of US residents.

In the wake of a statement by President Trump on immigration, health clinics were deserted.

While a well-regulated immigration system is certainly important, recent reports suggest that the Trump administration’s efforts could lead to an unintended consequence: reducing health access and outcomes for immigrants already in the US. Scholarly research into this possibility however, is just starting to emerge.

Given the large Hispanic immigrant population here in Texas, our research team decided to explore the relationship ourselves, investigating if and how the Trump administration’s immigration efforts have affected Hispanic immigrant health in newly published research in BMC Health Services Research.

To study this relationship, we conducted focus groups with health advocates and Community Health Workers across the state of Texas. These health workers serve as bridge figures between vulnerable populations like immigrant communities and the health system. In detailed discussions held in major cities (Houston and Dallas), border regions (El Paso and McAllen), and more rural parts of Texas, these experienced health workers provided insight into the barriers faced by documented and undocumented Hispanics across the state. Our research identified several key changes in Hispanic health that the Trump administration’s efforts have brought about.

Fear is on the rise

Across our discussions with these health workers, perhaps the most common theme was that fear is on the rise among Hispanic populations. While fear is ever-present in daily life for undocumented immigrants, our participants noted growing fear in the current political environment. For example, one health worker noted that “when he (President Trump) became president, it was noticeable the fear was rising” and another noted that it is “immobilizing people” and that “fear has become a factor of life.” Interestingly, health workers in Houston noted that this fear was particularly problematic during Hurricane Harvey – as many Hispanics avoided the help they needed because in some cases, Customs and Border Patrol boats were being used for water rescues.

The policies and rhetoric of the Trump administration have been particularly impactful for children

Policies and rhetoric matter for health

This fear, which health workers attributed to the Trump administration’s policy efforts as well as the President’s rhetoric, is decreasing access to needed health services for Hispanics across Texas. For example, one health worker noted that in the wake of a statement by President Trump on immigration, health clinics were deserted: “It was like a Friday… he [Trump] was threatening to deport people left and right. That next Monday and almost the entire week, our clinics, everybody didn’t even cancel, they didn’t show up. They were terrified.” Our participants have suggested that this trend is pervasive across Texas. As the President and his administration continue to emphasize immigration, people are avoiding engaging in many of the activities typical in daily life, including visits to health care providers.

Children’s nutrition is at risk

Fearful parents may withdraw their children from nutritional support programs. © FatCamera / Getty Images / iStock

According to health workers in Texas, the policies and rhetoric of the Trump administration have been particularly impactful for children. Our research suggests that children who are eligible for food assistance through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP) are not getting the nutritional services they need. Some immigrant parents, fearful of their enrollment information being shared with Immigration and Customs Enforcement, are dis-enrolling their families in these programs that provide important nutritional services. As one health worker noted, many clients “say I’m not renewing because if I renew I’m going to get deported. So we lost a lot of people… their kids are the ones that were suffering.”

Looking ahead

Together, our research suggests that as the Trump administration continues to pursue a hard line on immigration, Hispanic health access could continue to decline. As fear rises, many are not seeking out the social services that they need, affecting documented and undocumented immigrants in Texas, as well as their children. With additional immigration reforms under consideration, health officials in Texas and beyond need to be aware that vulnerable populations may be facing additional barriers to getting the care they need.

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