Do States’ Immigrant-Friendly Policies Improve the Health of Children of Immigrants?

Image of a child at a medical appointment.

"This study examines the health impacts of local and state immigration-related policies that support undocumented immigrants and their families. States and localities have adopted two types of “immigrant-friendly” policies: (1) allowing undocumented immigrants to obtain driver’s licenses and (2) limiting state/local law enforcement’s involvement in federal immigration enforcement efforts (i.e., sanctuary policies). In the past years, the federal government has increased pressure on states/localities to participate in federal immigration enforcement, through threats of reduced federal funding (Chau and Morse, 2012) and immigration raids that specifically target “sanctuary” places (Ortiz, 2017).

"Assessing the impact of these policies on health is particularly salient because of the current COVID-19 pandemic. If the 10.5 million undocumented immigrants living in the United States are unable or afraid to access health care, this could worsen the pandemic, as well as threaten their lives. Recent studies have illustrated the negative health outcomes for undocumented immigrants and their families, including their U.S. citizen children, when state/local law enforcement vigorously participate in federal immigration enforcement efforts. However, we know of no study to date that has examined the health impacts of “immigrant-friendly” policies, such as local/state sanctuary policies and state driver’s licenses policies.

"The research question we sought to answer in this study was “Do sanctuary policies and driver’s licenses for undocumented immigrants increase the chances that children of these immigrants will receive adequate medical and dental care?” We focused on access to preventive health care, including whether children in immigrant families (1) have a usual source of care (USC) provider, (2) have unmet medical needs, (3) visited the dentist in the past year, or (4) had recent well-child visits. We merged policy data from a database of state-level immigrant policies with data from the Medical Expenditure Panel Survey (MEPS), and examined variation in immigrant children’s health outcomes in different state policy contexts.

"Our analyses demonstrated that sanctuary policies and driver’s licenses for undocumented immigrants improved preventive health outcomes among children of immigrants. At varying levels of significance, these policies were shown to increase the likelihood that children, especially Latino children, living with non-citizen, immigrant parents have a usual source-of-care (USC) provider, and that they significantly reduce the likelihood that children in these households have unmet medical needs. The study also demonstrated that these policies significantly increase the likelihood that Latino children living with non-citizen, immigrant parents receive preventive dental care. This effect held regardless of whether the children were U.S. citizens.

"These results are important given the wide variation in state responses to recent upswings in federal immigration enforcement and the importance of access to health care in addressing an epidemic such as COVID-19. We hope that a clearer understanding of the health impacts of driver’s license and sanctuary policies can help inform immigration policy decisions at the state and local level..."