Social Science and Medicine
Volume 174, 2017, Pages 169-178

Immigration policies and mental health morbidity among Latinos: A state-level analysis (Article)

Hatzenbuehler M.L.* , Prins S.J. , Flake M. , Philbin M. , Frazer M.S. , Hagen D. , Hirsch J.
  • a Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States
  • b Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States
  • c Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States
  • d Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States
  • e Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States
  • f French School of Public Health (EHESP) - Sorbonne Paris Cité, France
  • g Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States

Abstract

Rationale Despite abundant state-level policy activity in the U.S. related to immigration, no research has examined the mental health impact of the overall policy climate for Latinos, taking into account both inclusionary and exclusionary legislation. Objective To examine associations between the state-level policy climate related to immigration and mental health outcomes among Latinos. Methods We created a multi-sectoral policy climate index that included 14 policies in four domains (immigration, race/ethnicity, language, and agricultural worker protections). We then examined the relation of this policy climate index to two mental health outcomes (days of poor mental health and psychological distress) among Latinos from 31 states in the 2012 Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey of non-institutionalized individuals aged 18 years or older. Results Individuals in states with a more exclusionary immigration policy climate had higher rates of poor mental health days than participants in states with a less exclusionary policy climate (RR: 1.05, 95% CI: 1.00, 1.10). The association between state policies and the rate of poor mental health days was significantly higher among Latinos versus non-Latinos (RR for interaction term: 1.03, 95% CI: 1.01, 1.06). Furthermore, Latinos in states with a more exclusionary policy climate had 1.14 (95% CI: 1.04, 1.25) times the rate of poor mental health days than Latinos in states with a less exclusionary policy climate. Results were robust to individual- and state-level confounders. Sensitivity analyses indicated that results were specific to immigration policies, and not indicators of state political climate or of residential segregation. No relationship was observed between the immigration policy index and psychological distress. Conclusion These results suggest that restrictive immigration policies may be detrimental to the mental health of Latinos in the United States. © 2016 Elsevier Ltd

Author Keywords

immigration policies Social determinants Latino health Stigma Mental health discrimination United States

Index Keywords

depression health care policy agricultural worker mental health human immigration jurisprudence middle aged trends Ethnic Groups statistics and numerical data ethnic group controlled study Aged sensitivity analysis morbidity language behavioral risk factor surveillance system Hispanic Americans mental health care Mental Disorders Cross-Sectional Studies mental disease Surveys and Questionnaires United States cross-sectional study Humans racism Hispanic psychology male immigration policy female adverse outcome questionnaire race Latino people Article legislation and jurisprudence major clinical study adult distress syndrome outcome assessment ethnicity public policy
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85007504923&doi=10.1016%2fj.socscimed.2016.11.040&partnerID=40&md5=61ee7186d8ce26c961f1b138e5fab14d
DOI: 10.1016/j.socscimed.2016.11.040
ISSN: 02779536
Cited by: 48
Original Language: English