Toward Evidence-Based Policies and Programs That Promote Immigrant Well-Being

In 2017, Texas set off the recent surge of restrictive state immigrant laws by passing Senate Bill 4.¹ Senate Bill 4 bans sanctuary policies, thereby requiring local law enforcement agencies to cooperate fully with Immigration and Customs Enforcement (ICE). It also allows law enforcement officers to ask crime victims and witnesses about their immigration statuses. Senate Bill 4 is one of many Texas laws that restrict immigrants’ rights and increase their risk of deportation. The state does not allow undocumented immigrants to obtain driver’s licenses, requires some employers to use E-Verify to confirm employees’ eligibility to work, and led a lawsuit that prevented Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) from being implemented.

A COMPLEX STORY

However, the story in Texas, as in other states nationwide, is more complex.¹ In 2001, Texas was one of the first states to allow undocumented students to receive in-state tuition and state financial aid. The state also allows undocumented pregnant parents to enroll in the Children’s Health Insurance Program. Texas has extensive protections regulating migrant farmworker housing, although they are rarely enforced.

The climate for immigrants in Texas even depends on where in the state they live. Before Senate Bill 4, Austin and Travis County, Texas, had sanctuary policies limiting cooperation with ICE. When Senate Bill 4 forced Austin to rescind these policies, the city passed a “freedom policy” that eliminates arrests for low-level offenses; this reduces immigrants’ risk of being identified by ICE and deported. Austin also provides free legal representation for immigrants facing deportation. In contrast, neighboring Burnet and Williamson counties are among 80 counties nationwide with 287(g) agreements allowing local law enforcement officers to enforce immigration law.²

A growing body of research³ indicates that immigration enforcement and anti-immigrant policies have harmful effects on health for immigrants, their families, and their communities. However, these studies generally fail to capture the complexity of such policy enforcement, as illustrated by the case in Texas. In the real world, immigrants live in cities, counties, and states with a mix of different types of immigrant policies, both restrictive and welcoming, and these policies are rapidly changing. Yet research oversimplifies the immigrant policy context by examining single policies in isolation or focusing on a small set of restrictive policies.

In this issue of AJPH, Young and Wallace (p. 1171) address this shortcoming by developing a conceptual framework that measures state immigrant policy along multiple dimensions. Criminalization policies (or enforcement policies⁴) are restrictive policies that “create mechanisms of surveillance and immigration enforcement that put noncitizens at risk for deportation” (Young and Wallace, p. 1171). These are distinguished from integration policies (or reception policies⁴), which expand noncitizens’ rights and “facilitat[e] access to health-promoting resources, regardless of citizenship status” (Young and Wallace, p. 1171). The major contribution of this framework is that it highlights the complexity of state policy climates. States are not strictly welcoming or hostile to immigrants but have a mix of laws; immigrants in a given state can experience both inclusion and deportability. Although this framework was developed to measure state policies, it can and should be expanded to include local (city and county) policies.

EVIDENCE ABOUT THE EFFECTS

As we advocate for decriminalization and integration policies, we need more evidence about their effects on immigrant communities. Despite mounting evidence on the harmful health consequences of anti-immigrant policies, we know very little about the effects of policies that expand immigrants’ rights. Are some policies particularly effective at reducing the risk for deportation and family separation, reducing stress, and enhancing health and well-being? Can they offset the harmful effects of immigration enforcement and anti-immigrant laws?³ Are there unintended negative consequences? For example, when states and counties limit cooperation with ICE, the total number of deportations decreases—but ICE responds by conducting high-profile neighborhood raids, which cause intense stress and fear in immigrant communities.⁵ Identifying intended and unintended effects will help advocates and policymakers decide which policies to prioritize.

Researchers should use Young and Wallace’s framework to develop a better understanding of the complex interactions between policies. For example, do integration policies promote health even when the jurisdiction also has criminalization policies? Integration policies provide access to important health-promoting resources; however, they may have minimal effect if immigrants are afraid to use them because of the presence of criminalization policies.

Studies also should examine the effects of policies at multiple levels: local, state, and federal. Most research has focused on state and federal policies. It is important to include local policies for several reasons. Some policies, such as those that limit cooperation with ICE, are more common at the local level; examining only state laws underestimates the prevalence of such decriminalizing policies. Focusing on only state laws also obscures important variation in policy climates within states. Federal immigration reform and welcoming state policies are crucial; however, in the short term, it may be more feasible to implement local policies that are innovative and responsive to local needs.⁶ Young and Wallace’s framework can be easily adapted to include local policies. Local decriminalizing policies include those that limit cooperation with ICE and prohibit local government employees from asking about individuals’ immigration statuses. Local integration policies include city- or county-funded health coverage available to all immigrants (e.g., Healthy San Francisco) and municipal identification cards.

Finally, we need more evidence about which individuals and communities are most affected by immigrant policies. Most studies focus on Latino immigrants. Future research should include immigrants from other world regions, disaggregating by country of origin when possible. Beyond the individual level, some evidence indicates that the effects of immigrant policies vary according to other characteristics of the communities where they are implemented.⁷ By further examining which communities are most affected, we may identify community characteristics and resources that buffer against harmful effects of restrictive policies.

IMPORTANT QUESTIONS

Research on state and local immigrant policies in the United States needs more sophisticated conceptual models and research methods.⁴ Young and Wallace contribute needed conceptual development. Important questions for researchers to consider in designing future studies include the following:

• •Should we incorporate policies that do not specifically target immigrants but disproportionately affect low-income, racial/ethnic minority, or limited English– proficiency populations?
• •Do we measure only the effects of policies that have been passed and implemented, or are there effects from introducing and debating immigrant policies, even if those policies do not pass?⁴
• •Is it adequate to simply count the number of immigrant policies in place in a jurisdiction, as Young and Wallace (and most other studies of state immigrant policies) do?
• •Most studies rely on one or a few common data sources for policy data; are these secondary sources complete and accurate?
• •It is difficult to measure implementation, but are there adequate proxies to measure the extent to which policies are implemented?⁴ For example, we could use ICE arrest and detainer data to confirm whether jurisdictions are fully cooperating with ICE.
• •How can studies be made more replicable (e.g., by sharing data and code)?

Recent shifts toward much more exclusive federal immigration policies and more intensive immigration enforcement threaten health for immigrants, their families, and their communities. Evidence-based policies and programs that promote immigrant well-being are urgently needed.