Messaging inclusion with consequence: U.S. sanctuary cities and immigrant wellbeing

Highlights

• •Frontline workers have a unique insight into the distinction between messaging versus practicing sanctuary policies.
• •Interviewers with workers from two sanctuary cities, Boston and Seattle, reveal significant tensions between how sanctuary cities are messaged and how they function, complicating efforts to attend to immigrants’ material needs and inclusion across domains.
• •Workers conceptualize sanctuary as a set of multidimensional practices, processes, and ethics rather than a geographic space and identify themselves as actors of sanctuary.
• •Understanding sanctuary as a multidimension process informs policies and institutional practices to attend to long-term and short-term goals to address immigrant safety, inclusion, and wellbeing.

Abstract

In the United States (U.S.), sanctuary cities have increasingly garnered public attention as places dedicated to increasing immigrant safety, inclusion, and health. These cities primarily rely on limiting local police cooperation with federal immigration enforcement to deter immigrant detention and deportation. However, sanctuary policies’ inability to extend immigrants’ legal rights and their reliance on police as ushers of sanctuary may complicate how these spaces attend to their stated goals. In this paper, we examine how organizational workers conceptualize sanctuary, safety, and immigrant health and wellbeing within sanctuary cities. We draw on interviews with organizational workers in two sanctuary cities: Boston, Massachusetts and Seattle, Washington collected between February and August 2018. Our findings reveal that immigrants continue to face structural barriers to housing, safe employment, education, and healthcare within sanctuary cities with consequences to wellbeing. Workers’ definitions of safety draw on interconnected structural exclusion that prevent immigrants from accessing basic needs and fail to account for historically rooted forms of racism and nativism. Organizational workers identified tensions between messages of sanctuary and what local sanctuary policies offer in practice, providing insight into consequences of institutionalizing a grassroots social movement. As organizational workers negotiate these tensions, they must develop everyday sanctuary practices to extend immigrant inclusion, safety, health, and wellbeing.

1. Introduction

Popular discussion of sanctuary cities has become more pronounced in the United States (U.S.) following 2016, when the Trump administration proposed an end local jurisdictions’ ability to pass sanctuary policies (Lasch et al., 2018; Paik, 2017; Roy, 2019). The Trump administration accused sanctuary cities of violating federal law by attempting to shield undocumented immigrants from deportation (Lasch et al., 2018). In response, cities increasingly proposed and passed sanctuary policies to resist punitive immigration policy and anti-immigrant rhetoric. As more sanctuary cities emerge, scholarship examining sanctuary cities and practices have likewise grown. Much research focuses on how these spaces offer immigrants’ protection from federal policy, while others have begun to explore their limitations in addressing immigrants’ needs within them (Lasch et al., 2018; Paik, 2017; Roy, 2019; Bauder, 2017; Kaufmann, 2019; Kuge, 2020; Ortiz et al., 2021). In this paper, we examine how organizational workers conceptualize sanctuary policies in addressing immigrants’ safety, needs, and health. In addition, we explore how messages of sanctuary may conflict with workers’ understandings of sanctuary in practice.

1.1. The growth of sanctuary cities

Immigrant exclusion has been a fundamental feature of U.S. policy since its founding (Daniels, 2004). Under the former Trump administration, policies of immigrant exclusion were significantly reinforced. During his term in office, former President Trump passed ‘zero-tolerance’ policies on immigration and referred to immigrants as ‘invaders’ and ‘illegal criminal aliens’ (Bacon, 2018; Buff, 2019; Domonoske and Gognzales, 2018; Walia, 2021). Government officials threatened to prosecute immigrant parents for entering the U.S. without legal authorization and endangering their children by “smuggling” them into the country (Buff, 2019). The Department of Homeland Security (DHS) routinely prosecuted asylum seekers as criminals (Buff, 2019). Though the Trump administration offers a recent example, populist approaches to immigration comprise historical and bipartisan foundations of policies targeting immigrants (Paik, 2017; Roy, 2019; Walia, 2021). For example, the 1996 Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) militarized the U.S. Southern border—making it more deadly and dangerous to cross—and deterred migration by excluding many immigrants from federally-funded benefits, including welfare and health care (Abrego et al., 2017; Espenshade et al., 1997; Hagan et al., 2003; Jones-Correa and de Graauw, 2013; Kerwin, 2018). The IIRIRA also established the 287(g) program that allows local police to partner with federal immigration enforcement agencies, including Immigration Customs Enforcement (ICE) (Kerwin, 2018; Varsanyi et al., 2012). It is this cooperation that sanctuary cities attempt to limit.

Naomi Paik (Paik et al., 2019) emphasizes how the concept of ‘sanctuary’ conveys a spatial notion of protection and has a historically antagonistic relationship with the state—serving as a reminder that the nation-state does not have exclusive control over what happens within it. Contemporary sanctuary policies and practices originate from grassroots organizing in the 1980s following U.S. involvement in Central America that resulted in the forced displacement of thousands of Central Americans who were later denied asylum claims by the U.S. (Roy, 2019; Bauder, 2017; Paik et al., 2019; Garcia, 2021). In response, faith communities and solidarity organizations mobilized to support asylum seekers while working to expose violent U.S. foreign policy and politicized restrictions on migration and legal recognition (Roy, 2019; Buff, 2019).

The 1980′s Sanctuary Movement paved the way for the New Sanctuary Movement, which mobilized following the post-9/11 securitization of the border (Lasch et al., 2018; Bauder, 2017; Buff, 2019). Although no immigration policies have been passed by Congress since the IIRIRA (1996), other “homeland security” laws like the Patriot Act (2001) and the Real ID Act (2005) further deprived non-citizens from accessing social resources (Buff, 2019). Like the original Sanctuary Movement, the New Sanctuary Movement relies on coalitions across religious and solidary organizations (Garcia, 2021) and encourages local jurisdictions to pass sanctuary policies to limit police cooperation with federal immigration enforcement (Lasch et al., 2018; Bauder, 2017). In 2017, at least 600 counties attempted to delimit conditions under which local police collaborate with federal immigration enforcement (Paik, 2017; Wong et al., 2019). As of 2018, there were about 400 subnational jurisdictions with sanctuary policies throughout the U.S., incorporating roughly half of the U.S. population (Kuge, 2020).

1.2. Sanctuary in practice

Although sanctuary cities are embedded in popular discussion, there remains no legal definition of a ‘sanctuary city’ resulting in a gradient of policy protections between different sanctuary or ‘welcoming’ cities. Typically, these cities are understood as areas that enact local policy to establish noncooperation between police and federal immigration enforcement agencies to foster immigrant safety, inclusion, and health (Lasch et al., 2018; Paik, 2017; Bauder, 2017; Kaufmann, 2019; Ortiz et al., 2021). Lasch and colleagues (Lasch et al., 2018) outline five potential approaches that localities may adopt to be considered a ‘sanctuary’: (1) barring investigation of civil and criminal immigration violations by local police; (2) limiting compliance with immigration detainers and warrants; (3) refusing ICE access to local jails; (4) limiting local police's disclosure of sensitive information; and (5) restricting local participation in operations with federal immigration enforcement. Localities may adopt any or all of these approaches to be considered a sanctuary city, leading to important contextual differences between them.

While local sanctuary policies operate on a wide gradient, most attempt to help unauthorised immigrants cope with federal immigration policies (Bauder, 2017). There is some evidence that inclusive state and local immigration climates may be associated with less poverty among immigrants in general and improve healthcare utilization among undocumented immigrants in particular (De Trinidad Young et al., 2018; Marrow, 2012; Potochnick, 2014). Inclusive local policies may help shape federal immigration policies, including increased recognition of the health and health care needs of immigrants (Aboii, 2016). Local policies also help reframe narratives around migration and highlight the injustices of immigration raids (Paik, 2017). However, scholars have also pointed to the limitations of sanctuary cities due to their inability to extend immigrants’ legal rights and their reliance on local police, who disproportionately target people of color and may reinforce the racialization of immigrants (Gomberg-Muñoz and Wences, 2021).

1.3. Addressing structural oppression

Because most sanctuary cities focus on limiting local police cooperation with federal immigration enforcement, they may fail to address the myriad of ways immigrants are structurally excluded from essential resources. Broad definitions of safety, that incorporate immigrants’ material needs in addition to risk of detention and deportation, are particularly relevant given the breadth of scholarship outlining the effects of ‘illegality’ or ‘illegalization’. ‘Illegality’ can be conceptualized as both a legal and social construct impacting how immigrants are treated within society and their relationship to the state (Garcia, 2021; Menjívar, 2021). ‘Illegalization’ emphasizes the processes by which some immigrants are rendered ‘illegal’ and in turn operate in spaces of precarity (Bauder, 2014). In the U.S., one's legal status dictates healthcare coverage and social resource access, health risks, vulnerability to violence, and wages in the labor market (Menjívar, 2006; Young et al., 2019). Federal immigration policies reinforce definitions of national belonging that conflate citizenship and racial or ethnic identifications, increasing vulnerability to arrest and social exclusion for those labeled “illegal” or foreign (Menjívar and Abrego, 2012).

Although some sanctuary cities have attempted to limit structural oppression by expanding access to city resources, such as driver's licenses and health insurance (Marrow, 2012; Darling and Bauder, 2019), immigrants continue to face barriers to social and health resources. Understanding how localities address these challenges is necessary. Yet, much research on sanctuary cities has focused on policies and laws hindering deportation and detention by local police's cooperation with immigration enforcement (Lasch et al., 2018; Bauder, 2017; Villazor, 2010). Relatively less is known about their ability to foster immigrant safety and inclusion beyond limiting vulnerability to detention and deportation or how messages of sanctuary cities may complicate their practices on the ground. We identify how organizational workers in two sanctuary cities—Boston, Massachusetts and Seattle, Washington—conceptualize the role of sanctuary policy in addressing immigrant safety, inclusion, and wellbeing. Additionally, we examine how workers negotiate tensions between how sanctuary cities are messaged and how they operate in practice.

2. Methods

The data used in this analysis were drawn from a pilot study among immigrant-serving organization workers (N = 54) in two sanctuary cities: Boston, Massachusetts (n = 35) and Seattle, Washington (n = 19). Study sites were chosen through existing connections among the research team. Boston and Seattle are similarly sized with around 700,000 and 745,000 residents respectively (U.S. Census Bureau 2018). About 28% of residents in Boston are foreign-born compared with 20% in Seattle (U.S. Census Bureau 2018). Both cities’ governments express politically progressive messages around immigration yet have distinct approaches to sanctuary policymaking (Davis, 2020). For this paper, we review policies enacted prior to August 2018, when data were collected. The 2014 Boston Trust Act (BTA) restricts local police from honoring ICE detainers without a criminal warrant; inquiring about an individual's immigrant status; providing personal information about an individual to immigration authorities; making arrests under ICE warrants; or preforming duties of an immigration an officer (Mayors Office 2019). The 2003 Seattle Ordinance 121,063 bars city employees from inquiring about an individual's immigration status unless police believe a felony has been committed or an individual has been previously deported (Woodring, 2019). A 2017 resolution prohibits ICE detainers from being honored without a judicial warrant and specifies that local police cannot operate as immigration officers. Moreover, Seattle has an Inclusive Equity Cabinet to advise the mayor on residents’ civil liberties and allocate funds for children and families affected by federal immigration policy (Seattle City Council 2017).

2.1. Participants

Participants were eligible if they worked for an immigrant-serving organization and were identified through snowball sampling to ensure inclusion of diverse organizations and account for concern over immigration enforcement. Snowball sampling techniques are appropriate when working with marginalized populations to gain trust and improve sampling (Harding, 2013). Participants worked in a variety of domains, including health, law, advocacy, activist, faith-based, or governmental organizations. While we did not collect participants’ immigration status, some identified themselves as immigrants in interviews.

2.2. Data collection

Our semi-structured interview guide explored participants’ work responsibilities; conceptualization of safety and sanctuary; experiences with immigrant communities; challenges and facilitators to providing services; concerns among immigrant clients; and the role of sanctuary policies in fostering immigrant safety, inclusion, and wellbeing. Interviews were conducted between February and August 2018, after the Trump administration had accelerated immigration enforcement but prior to proposed public charge inadmissibility policies in October 2018 that would prevent migration or pathways to citizenship for those deemed to be a risk of becoming a “public charge” to the government (Artiga et al., 2019). Participants consented to have their interviews audio recorded. Interviews were transcribed verbatim. Participation was confidential and all interviews were de-identified prior to analysis. This study received full approval from Northeastern University Institutional Review Board.

2.3. Analysis

Our analysis techniques were derived from modified grounded theory. Modified grounded theory involves inductive, theoretical coding in conjunction with constant comparative coding to develop theory (Strauss and Corbin, 1994). This approach is well-suited to examine experiences (Creswell, 2007) and power dynamics (Strauss and Corbin, 1994), helping to bridge the gap between theory and empirical research (Harding, 2013; Charmaz and Belgrave, 2007). First, the research team reviewed transcripts line by line, to develop an open coding scheme. Next, in line with axial coding, we reviewed initial codes to identify categories through multiple, iterative steps including memo making. These categories revolved around participants’ concerns over economic security, labor and wage discrimination, housing instability, detention, and deportation. Finally, selective coding allowed us to connect these categories around a one core category to illuminate theory underlying these themes. A theoretically focused coding approach allows for examination of relationships between concepts and build greater theoretical sensitivity than earlier coding (Creswell, 2007). Once saturation was met and no new themes emerged, codes were organized into a codebook and applied across the dataset by the first author with input from the other authors. Transcribed interviews were managed, reviewed, and coded in NVivo (QSR International Pty Ltd 2018).

2.4. Theory

In our analysis process, we found that workers’ descriptions of structural exclusion in policy and across institutions limits immigrants’ access to resources and legal rights. Therefore, we felt selective coding was best informed by and that our results contribute to the structural violence framework. Structural violence (Galtung, 1969) refers to historical and deliberate inequities of power that result in harm over time (Viruell-Fuentes et al., 2012). These inequities shape the distribution of resources that constrain one's health and wellbeing, including access to basic resources like healthcare, food, education, and housing (Galtung, 1969; Lee, 2016). While lack of access to material resources may not result in immediate harm, structural violence explains how this leads to harm over one's life course (Menjívar and Abrego, 2012; Galtung, 1969; Lee, 2016). In the context of migration, structural violence is rooted in daily uncertainties or precarious access to fair wages, food, housing, and health care (Menjívar and Abrego, 2012), often through policy constraints (Holmes, 2013; Konczal and Varga, 2012). Federal and state policies can be considered structural forms of violence because they are rooted and concealed in discriminatory daily practices that reinforce and reproduce inequalities based on (perceived) legal status (Menjívar and Abrego, 2012). Some scholars have named this the “axis of stratification” by legal status (Menjívar, 2006; Young et al., 2019), legal violence (Menjívar and Abrego, 2012), or categorical violence (Castañeda et al., 2016), to describe how immigration policies reinforce definitions of national belonging that conflate citizenship and racial or ethnic identifications, increasing health risks for those deemed “illegal” or foreign (Menjívar and Abrego, 2012). Our findings illuminate indirect pathways through which structural violence harms immigrant health and wellbeing in two sanctuary cities.

3. Results

Organizational workers described a gradient in sanctuary policies across the U.S. aimed to expand immigrants’ safety, inclusion, and health. This gradient, coupled with an inability to extend immigrants’ legal rights, led many participants to identify tensions between how sanctuary cities are messaged and how they are enacted. For example, messages of sanctuary may rely on narrow definitions of “safety” that doffer from organizational workers’ definitions that include mitigating structural exclusion across institutions (e.g., in housing, employment, legal system, and health care). Furthermore, participants noted that risks of detention, discrimination, and exclusion remain salient concerns. Finally, reliance on local police as enforcers of ‘sanctuary’ raised additional tensions in messages of safety among immigrant communities targeted by police. Some participants specifically identified ongoing structural discrimination informed by historical, intersecting, and systemic manifestations of racism and nativism. Tensions between how sanctuary cities are messaged and their limitations were conceptualized as unintended consequences of institutionalizing a grassroots social movement into policy. Participants negotiated tensions by identifying, developing, and implementing sanctuary practices to address policy limitations.

3.1. Defining safety in sanctuary cities

When asked to define ‘safety’, organizational workers described interrelated structural components in addition to protection from detentions and deportation.

Safety goes beyond being protected from attacks and is more about generally feeling secure in your environment…being able to go to school, being able to access health services, being able to obtain food, housing without…being harassed by law enforcement. (Boston 11, Activist Organization)

Concerns about their housing…I think people would consider that feeling unsafe, even if it's not a direct threat to their physical safety. (Boston 20, Faith Organization)

Addressing immigrants’ material needs and ensuring immigrants are free of discrimination were crucial to increasing immigrant safety. Participants identified increasing gentrification, labor exploitation, and lack of access to basic resources like food, education, and healthcare ran counter to messages of safety within sanctuary cities. Organizational workers noted how access to resources were not necessarily addressed by policies that primarily focus on limiting police cooperation with federal immigration enforcement.

Participants noted that interconnected structural and institutional exclusion was of particular concern for immigrants with precarious or undocumented legal status.

If you don't have a [legal] status, if you don't have a stable job that pays benefits, then getting access to healthcare is really difficult. (Seattle, Advocacy Organization)

However, federal policy and anti-immigrant rhetoric increasingly blurred boundaries between legal status designations. Several participants felt that immigrants—of all legal statuses—remained concerned about safety and access to basic resources.

People's sense of safety in terms of what they're hearing…even though refugees really—by and large…should not feel as threatened by what they're hearing…they don't peel back all the layers of that. So, there's these different incidents that occur and they're very worried…they hear things in the national news and that translates into no one wants me here…Or their family can't come because their family keeps getting delayed in the process with the Muslim ban…they're also reacting to this blanket negative talk about immigrants, about people undocumented, about the border. (Seattle 14, Activist Organization)

Organizational workers’ definitions of safety extended beyond deterring detention and deportation to illuminate how messages of sanctuary may conflict with how organizational workers understand sanctuary in practice.

3.2. Defining ‘Sanctuary’: symbolic versus psychological

When asked to define ‘sanctuary’, some participants distinguished between ‘sanctuary’ as a historical concept and ‘sanctuary’ as defined by city government through local policy.

Sanctuary has existed for years—centuries…sanctuary looks like a lot of different things. So, it looks like making sure we help folks have a home, have somewhere to stay, have somewhere to sleep. It looks like the churches taking in folks who know that ICE is going to come for them. (Boston 17, Activist Organization).

Participants identified sanctuary policies’ restriction of local police's cooperation with ICE but noted a gradient between different sanctuary localities, making it difficult to offer a singular definition of ‘sanctuary’.

There is not a single definition that's applicable to every single city that calls themselves a sanctuary city. (Seattle 3, Advocacy Organization)

Instead, participants often distinguished between progressive and less progressive sanctuary cities.

[Sanctuary policies] include not sharing information with federal immigration enforcement …progressive sanctuary cities go even further to advance immigrants’ rights, like creating legal defense funds, or thinking about municipal IDs, or municipal voting…sanctuary policies can be anything on that spectrum. (Boston 8, Legal Organization)

Progressive sanctuary cities attempt to address structural exclusion across institutions in addition to limiting local police cooperation with federal immigration enforcement, while less progressive cities primarily aimed to restrict police cooperation with federal immigration enforcement.

Defining ‘sanctuary’ led participants to reflect on how cities enact sanctuary in practice. This is where nearly all participants discussed how sanctuary cities fall short in reaching their messaged goals.

Boston was declared a sanctuary city…but I have seen people get deported in Boston. To me, a sanctuary city would be where nobody gets deported, like at a baseline. (Boston 15, Activist)

For example, sanctuary policies that focus on local police's cooperation may not have the intended reach across the city where state police, or other non-city law enforcement, operate.

It [sanctuary policy] only applies to the city police and not to the other, say half a dozen law enforcement jurisdictions that operate within the city. For example, it doesn't apply to port authority; it doesn't apply to King County police…who can operate within the city. And people don't make a distinction…if you pull the average person off of the street and say ‘if you ran into a cop in Seattle, who would they be working for?’, they could probably list two maybe three jurisdictions, when there are at least half a dozen. Then when you start thinking about the Federal stuff, there's even more, right? (Seattle 1, Faith Organization)

Other participants noted that most sanctuary policies concentrate around urban centers but do not necessarily apply to enforcement outside of the urban center, leaving undocumented immigrants vulnerable to detention and deportation in surrounding areas.

The tensions between how sanctuary cities are messaged and how they function led some organizational workers to reflect on the use of the term ‘sanctuary’.

How meaningful…is the sanctuary project? I would say from a psychological in the sense…it's very meaningful. Legalistically, it's trash—it's nothing. (Seattle 11, Advocacy Organization)

Nearly all participants emphasized that sanctuary policies may foster a sense of inclusion, but some added that taking actions toward inclusion through allocating funds or creating programs is equally important.

Any city can make such declaration as a political promise or just trying to brush up their image…you're claiming you're a sanctuary city and then what are you committing to that in terms of funds, programs, and specifics? (Boston 1, Activist Organization)

As a result, some organizational workers described the city's use of the term ‘sanctuary’ was a political gesture or symbolic if it failed to enact additional policies and practices to mitigate immigrants’ structural exclusion.

For some organizational workers, tensions between symbolic sanctuary and sanctuary in practice reflect contradictions between federal and local policy domains.

One very hard reality is that there is no way to guarantee anyone's safety and at the end of the day. Even the best [local] policies cannot…make up for bad policies at the federal level or implementation practices of an administration who's looking to basically deport as many immigrants as possible. (Boston 6, Government Organization)

Participants noted how localities had little ability to regulate federal immigration policy and prevent immigration enforcement from operating within the city.

Just because there are these…[sanctuary] policies or ordinances in place, it doesn't mean that federal agents and ICE don't get to be present. (Seattle 7, Legal Organization)

Localities’ inability to prevent federal immigration enforcement was at odds with how many organizational workers’ understood ‘safety’ and ‘sanctuary’.

3.3. Messaging sanctuary

Many participants felt that messages of sanctuary offered public support around immigration, while others cautioned that these messages could obscure sanctuary cities’ limitations.

[Sanctuary policy] helps alleviate fear, but maybe not in ways that are realistic…it's a false sense of security, but I think it definitely alleviates the fear for sure.” (Boston 1, Activist Organization)

Messages of sanctuary may perpetuate a false sense of security among immigrants residing within them who remain vulnerable to the harmful impacts of federal immigration policies and practices.

We don't want to use ‘sanctuary’ because it's a misleading term because ICE can come into any part of the city…We don't to tell people Seattle is a sanctuary but then have them think ‘Oh, great. That means ICE won't get me here and I'll be safe’. And then all of a sudden, ICE comes and gets them. (Seattle 13, Government Organization)

This led some participants to balance wanting immigrants to feel welcome while also understanding on-going risks. Others chose to avoid using the term ‘sanctuary’ altogether.

As organizational workers negotiated the limits of sanctuary policy in enacting sanctuary practices, many described sanctuary cities help foster discussion around federal immigration policies and practices.

We can't stop necessarily what's happening at the federal level, but we can call attention to it…why should our tax dollars support a profit-making [immigrant detention] enterprise…we can't immediately change that. We can continue to look for the day where that system is changed. (Seattle 10, Faith Organization)

I think the sanctuary is great in terms of changing public opinion…A lot of people who hadn't necessarily thought of immigration before kind of want to jump on that bandwagon. (Boston 16, Advocacy Organization)

Yet, a few participants noted how increasing discussions following the 2016 Presidential election ignored historical policies and practices targeting immigrants.

It's really odd to me that the term [sanctuary] has really just reemerged recently in response to the rhetoric from the current [Trump] administration, given that ICE was created by the Bush administration…I don't remember there being much push back to the created of the Department of Homeland Security and the creation of ICE…when Obama was heavily deporting people. The communities that were targeted—which was predominantly the Latinx community—was pushing back but not really the rest of the country in the way that people want to push back now…the idea of an entire city being a sanctuary knowing the way that local law enforcement and federal law enforcement both operate with really racist and Islamophobic foundations at both levels. (Boston 11, Faith Organization)

For this participant, the influx in adoption of sanctuary policies in response to the Trump administration felt inconsistent with (in)action under previous administrations that likewise targeted immigrants. Moreover, deeming the city a sanctuary without addressing interconnected structural discrimination (e.g., mass incarceration and immigrant detention) felt at odds with the ethics and history of the Sanctuary Movement that these policies sprouted from.

3.4. Institutionalizing the sanctuary movement: consequences and actors

Tensions between messages of sanctuary and how they operate on the ground were conceptualized as a result of institutionalizing a grassroots movement into policy. Participants noted the impacts of institutionalization in two ways. First, sanctuary policies focus less on challenging U.S. imperialism and systems of oppression that continue to reproduce immigrants’ precarity compared to the Sanctuary Movement. Second, institutionalization shifts the actors involved in providing sanctuary from religious congregations and solidarity organizations to local police, who may further contradict messages of safety.

Those working in advocacy and activist organizations distinguished between narratives of sanctuary adopted by local governments and sanctuary activists, reflecting concern over how ‘sanctuary’ changes when embedded in the state.

The Sanctuary movement happened in the 80s…we [The U.S.] did not consider the people fleeing the violence there to be refugees. We considered them economic-migrants and therefore, it was harder for them to find [legal] status…That's why so many, predominantly faith groups…started the sanctuary movement, which was harboring people who were in the country unlawfully because our government did not see them as refugees…Nothing that we're doing right now…beside from a couple of faith groups, is anything like that. So, it's very hard to use that same term. (Boston 4, Advocacy Organization)

These participants distinguished “true” sanctuary, which attends to immigrants’ material needs, versus symbolic sanctuary, that shifts public perception around immigration by enacting policy.

The more we try to have the state absorb something that for years has been a way to combat the state, then it's not going to mean anything anymore. (Boston 17, Activist Organization)

As local governments and police become the ushers of ‘sanctuary’, some participants expressed concern that the sanctuary movements’ conceptualization of ‘sanctuary’ and the movements’ goals may become increasingly symbolic.

Reliance on police as actors of sanctuary raised challenges for several participants given longstanding practices of racial profiling by the police. Multiple workers described how police disproportionally target Black and non-white individuals, including immigrants who have become increasingly racialized, further contradicting messages of safety in sanctuary cities.

I think a lot of people in Boston, particularly from more privileged communities who are not regularly policed, believe that Boston is a progressive city…I think for communities and Muslim folks who are in low-income neighborhoods, who are Black, who are just generally, are more policed know that local law enforcement are not necessarily to be trusted. (Boston 11, Faith Organization)

Critiques on the reliance of police to enact sanctuary stemmed from mistrust of police in general and specific stories about police collaborating with ICE.

We do believe that there were some deportations as a result [of local police coordination with ICE]. I can't prove that… (Seattle 16, Advocacy Organization)

Widespread mistrust of police created doubt about how sanctuary policies were enforced, which was concerning given that nearly all participants acknowledged that ICE continued operating in each city. Additionally, some described the police presence in public institutions as security could limit immigrants’ civic participation and inclusion.

Although all participants voiced frustration over the limitations of sanctuary policy in attending to immigrant safety and enacting sanctuary, their suggestions to address these limitations varied. Some organizational workers described working within the current system by passing additional policies, modeled after other localities or states, that attend to a broader definition of safety to mitigate exclusion across institutions. Others advocated for more radical solutions, calling for non-reformist, or reforms that go beyond maintaining the status quo but aim to dismantle structural oppression by abolishing ICE and the police state, or coalition building across groups.

California is the best example just in terms of healthcare, in terms of in-state tuition for undocumented students…all of these policies have passed in some other states…(Boston 28, Activist Organization)

The immediate question is about abolishing ICE, right…really getting rid of it, not just kind of replacing it or renaming…Getting rid of this…incredibly militarized police whose sole function is to go in and terrorize these communities. That's the immediate question of safety. (Boston 30, Activist Organization)

In negotiating how to address immigrant safety, many participants distinguished between immediate needs: preventing detention and deportation, increasing access to legal funds and resources, housing, health care, and education—and long-term goals: immigration reform and/or abolition.

3.5. Consequences for immigrant health

Similar to participants’ broadly definition of safety, many described a broad definition of health, highlighting how structural violence operates through multiple pathways and leads to harm overtime.

There are numerous issues to deal with…health—mental health is a part of that. But also general health [like] housing, education, legal services. (Boston 2, Legal Organization)

Organizational workers identified how exclusion across institutions within and beyond sanctuary cities added to immigrants’ stress leading to range of health problems.

Our clients have lots of concerns. Their immigration status is often just one of many. Housing, mental health, healthcare, employment, food, education, all the things. (Boston 8, Legal Organization)

The fact is, the longer someone is here in the US – a person of color – the worse they tend to do mental health wise, physically…everything just seems to go higher and higher…I think part of it is racism and the stress of all that but a lot of it is feeling like there's no one to talk to and that you can't trust anybody. (Boston 19, Health Organization)

Health workers framed the effects of prolonged stress—from anti-immigrant rhetoric, interactions with law enforcement, and barriers to basic resources—as contributing to growing rates of anxiety, depression, and the exacerbation of chronic conditions among their immigrant patients.

Despite increased health risks, several participants acknowledged barriers for immigrants in accessing healthcare within sanctuary cities, creating a negative feedback loop of harm.

I think that there's really a lot of deep trauma that people have…because people are afraid to even access health services, especially if their immigration status is at risk, people don't have a lot of options to deal with those fears and the trauma of being constantly afraid. (Boston 11, Faith Organization)

By acknowledging this negative feedback loop, participants complicate approaches that focus on police cooperation or expanding immigrants’ eligibility without additionally addressing the widespread effects of anti-immigration rhetoric, federal policy, and institutional mistrust.

Some participants critiqued policies or practices that fail to acknowledge how oppression operates systemically.

It's always challenging because people sometimes have a tendency and especially, I think a lot of the big news networks and…mainstream media…to kind of treat all of these issues as being separate things…kind of make the immigration struggle look like its own. [It's] only about Latinx people for example, which is not the case…the tactics all the same and it's the same state apparatus that's attacking…I'm like, this is why these issues are connected.” (Boston 29, Activist Organization)

Multiple participants described intersecting and overlapping structures that reproduce immigrants’ precarious social and legal positions with negative impacts on health. Acknowledging how various institutions perpetuate structural violence offers an opportunity to unite organizations across domains (e.g., labor, health, and legal), rather than a perspective that immigrant “is not my organizations’ issue”. One participant described historical immigrant and racial U.S. policies to further demonstrate longstanding intersectional oppression.

As citizenship became a concept, that's where [it] housed this notion of race…Giving citizenship to black slaves was really the point where citizenship became tangible…it matters to the immigrants’ rights movement because of the fact that we are people of color and we do face another component, which is imperialism…there wasn't just slavery in the US, it was slavery across the world both because of colonialization and…imperialism…also just recognizing that policy in itself is created to leave out people of color. (Boston 17, Activist Organization)

By invoking the links between citizenship, racism, and imperialism, this participant frames the gaps left by contemporary ‘sanctuary’ policy in opposition to the Sanctuary Movement, which recognized the need to counter intersectional oppression and U.S. imperialism in sanctuary practice.

The limitations participants identified in sanctuary policies ability to address structural violence and its role in immigrant health, led several workers to claim their own role as actors of sanctuary.

[The] public health [department] did this thing where they defined their waiting areas as ’private spaces’, which allows them to say to ICE, if ICE shows up, that you have to have a warrant to come in. (Seattle 1, Faith Organization).

For health organizations, sanctuary practices facilitate immigrants’ safety and include: designating waiting rooms are private spaces, not capturing sensitive information in medical records, limiting police in their organization, and/or offering services or resources to immigrants regardless of legal status.

We've offered very specific guidance…about what we should write in the charts…And now, we've tried to tell people please don't document immigration status at all on the assumption that those records are subpoena-able. (Boston 12, Health Organization).

While many participants were aware that sanctuary practices remain limited, they conceptualized them as acts of resistance fundamental in addressing immigrant safety, inclusion, and health.

3.6. Limitations

There are three important aspects of our study design that inform and circumscribe the interpretation of our results. First, and most importantly, our reliance on snowball sampling techniques likely limited the diversity of experiences and thoughts represented by our participants. While this approach helps mitigate mistrust to support recruitment and data collection, future research may employ alternative sampling strategies to explore how a broader range of organizational workers conceptualize and enact sanctuary. Second, Seattle and Boston are two of many sanctuary cities in the U.S. While our findings provide conceptual insight into sanctuary as a complex process, we are not able to offer analysis of how this process varies between sites. Future research may examine important differences between sub-national contexts to better understand how structural violence operates and is resisted. Third, we focused on organizational workers, who offer unique, frontline perspectives on the messaging and formulation of sanctuary policies. A sample that focuses on immigrants’ perspectives may offer additional insights on their impacts not presented here.

4. Discussion

Organizational workers in Boston and Seattle conceptualized sanctuary, safety, and health distinct from public messages about sanctuary cities. These distinctions illuminate tensions between how sanctuary is messaged and what it looks like in practice. More specifically, participants described how immigrants continue to face barriers in housing, employment, health care, education, and accessing resources. Persistent institutional exclusion, despite local sanctuary policies, reflect how structural violence operates through an interconnected web conceptualized in Fig. 1. Research exploring the diversity of sanctuary policies has highlighted the role of local factors, including composition of immigrant populations, competition between foreign-born and native born for local resources, local political and partisan dynamics, and activism or social movement organizations within an area shape immigrant policies and practices (Collingwood et al., 2023; de Graauw, 2022). For example, participants occasionally referenced San Francisco, which has passed additional policies of immigrant inclusion, including expanded access to drivers’ licenses, workplace protection, inclusion in education, and access to healthcare. De Graauw (2022) explores the role of mayors in addressing immigrant policies to support immigrants in San Francisco throughout federal and local political contexts (de Graauw, 2022). This suggests that examination of the gradient between sanctuary policies are necessary to fully understand their reach and impact.

Fig. 1.

Interconnected web of safety and health.

Organizational workers negotiate the limitations of sanctuary policies by developing practices to mitigate the web of structural violence, becoming everyday actors of sanctuary. As such, organizational workers are essential in envisioning and enacting sanctuary in practice. Participants emphasized the need to address immigrants’ material conditions, work across institutions, and acknowledge how historically rooted intersectional and interlocking forms of oppression (e.g., racism and nativism) work in tandem. Broad definitions of safety and health help expand understandings of sanctuary, illustrate ties to the Sanctuary Movement, and offer spaces for organizations to mitigate limitations of policy by adopting sanctuary practices (Houston et al., 2022). In this way, our findings contribute to existing scholarship conceptualizing sanctuary as more than a policy, status, or geographic space but rather a multidimensional set of practices, ethics, and processes (Houston et al., 2022; Houston, 2019).

Examining sanctuary cities requires understanding their role within federal policy. Sanctuary cities are geographically limited and are not immune to federal immigration enforcement. Rather, they most often rely on restricting local police's collaboration with federal immigration enforcement. This focus limits their ability to address federal immigration practices and other facets of immigrant safety, inclusion, health that remain salient concerns within sanctuary cities. Many of these limitations have been previously identified. Roy (Roy, 2019) argues that sanctuary cities have limited scope, despite being hailed as symbols of resistance and contends that liberal conceptualizations of sanctuary fail to challenge the criminalization of immigrants that remain integral to punitive immigration policy. Bauder (Bauder, 2017) argues that sanctuary cities are not able to address the root of the oppression they seek to counter.

Participants situated the ongoing structural exclusion and discrimination against immigrants as historical, intersecting, and systemic manifestations of racism and nativism. In doing so, participants offer further insight into the limits of sanctuary policy. This is particularly concerning given the increased racialization of immigrants (Viruell-Fuentes et al., 2012; Asad and Clair, 2018; Sáenz and Manges Douglas, 2015). Sanctuary cities’ reliance on local police as actors of sanctuary, given longstanding practices of violent policing and racial profiling within immigrant and historically oppressed communities, contradict messages of safety. Organizational workers’ concerns over reliance on police are not unjustified. Paik (Paik, 2017) writes that sanctuary policies often leave loopholes for law enforcement to circumvent the protections offered in these spaces. As a result, ICE has continued to meet deportation orders and expectations under the Trump administration (Paik, 2017). In making these connections, participants remind us that immigration enforcement cannot be unlinked from historical practices of racism and nativism that require challenging the carceral state (Viruell-Fuentes et al., 2012; Asad and Clair, 2018; Hunt et al., 2004). As Paik (Paik, 2017) argues, the limits of sanctuary are not only external (e.g., due to federal policy), but also the result of how the liberal sanctuary frameworks legitimize law enforcement, neutralizing the ability to contest the carceral state. Similarly, Kuge (Kuge, 2020) notes that when sanctuary legislation becomes the only strategy for managing productive neoliberal subjects, it fails to challenge systems that contribute to inequities.

Although sanctuary policies cannot extend immigrants’ legal rights (Paik, 2017; Kaufmann, 2019), participants note that these policies are useful in disrupting detention and deportation and shifting public narratives around immigration. Paik (2017) argues that sanctuary policies help stabilize immigrants’ access to resources and highlight the injustice of raids, arrests, detentions, and deportations. In this way, sanctuary policies have utility as a process toward increasing immigrant safety and wellbeing. Yet, these benefits may not be accurately reflected in their messaging. Rather than liberal sanctuary frameworks that center police, an abolitionist framework may focus on resisting ICE and other oppressive practices that criminalize communities (Paik, 2017). Reducing and preventing detention and deportation is essential to short term goals. But so, too, is understanding the limits of focusing on short term solutions without holding long term goals in perspective. Local policies may offer temporary and geographically bounded protections for immigrants in sanctuary cities. Within these bounds, participants highlight their role as non-state actors of sanctuary practice. Their descriptive of intersectional understandings of oppression and structural exclusion emphasize the necessity for intra-organizational collaboration to address immigrants’ material needs on the ground. That is, sanctuary policies alone cannot attend to immigrant safety and health without simultaneously advancing immigrant rights, addressing their structural and material needs, and working to dismantle systems of oppression at the root of structural inequities.

5. Conclusion

Our study contributes to a nascent but growing body of scholarship calling for structural analysis of immigrant health, examining interconnected pathways of oppression and its harm. Our findings contribute to research outlining tensions between how sanctuary cities are messaged and how they operate, which may unintentionally promote a false sense of safety among immigrants residing within them (Bauder, 2017). Organizational workers framed these tensions as a result of divergent definitions between state actors, workers, and activists. However, within this tension, workers identify additional practices and policies of resistance that progressive localities may enact to meet short-term and long-term goals. Long-term goals articulated by some participants in our study included working toward dismantling immigration practices and state violence through reform or abolition. Short-term goals identified additional policies that governments could adopt. For example, policies that expand access to drivers’ licenses, aid with tuition or education, provide and protect rights for undocumented workers, expand state and local access to social and health resources, including housing assistance and health insurance. Some of these practices have been adopted in cities outside of Boston and Seattle. Organizational practices were also identified, including not capturing documentation status in medical records, avoid using security officers in uniform to prevent misidentification as police or immigration officers, clarifying social resource eligibility information for immigrants, and continuing activism and coalition building to promote immigrant safety, inclusion, and wellbeing across domains.

6. Statements and declarations

Our pilot study was funded by the Global Resilience Institute at Northeastern University. The authors declare no conflicts of interest.

Declaration of Competing Interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:

Alisa K. Lincoln reports financial support was provided by Northeastern University.