Immigration Policies and Discrimination within the Framework of Social Determinants of Health

Background and Purpose:  Latinos in the U.S are perceived as the ethnic group in the U.S. that experiences the most discrimination (Pew Hispanic Center, 2010). In California, the social political context is unique which historically has supported anti-immigrant legislation (e.g., Prop 187), yet more recently has passed immigrant supportive legislation such as driver’s licenses for undocumented, instate tuition for undocumented youth (HB540), and the Dream Act; and recently has been exploring the possibility of health care insurance for undocumented immigrants. New immigration policies and the anti-immigrant sentiment can act as giving permission to others to instigate and discriminate people they perceive as undocumented.  Healthy People 2020 newest initiative aims to identify ways to create social and physical environments to promote good health for all by implementing a social determinants of health framework. Social determinants of health account for conditions in the environment, such as socio political environment, that impact health. This study examines the discrimination immigrants’ experience due to the social-political environment and links the results to the social determinants of health framework.

Methods: Study participants were recruited from a school district in a community in Southern California with a high number or Latino immigrants in January 2011. A total of six focus groups were completed in Spanish with a total of 108 participants.  Participants were all Latino; 91% were immigrants with a mean of 14 years in the U.S.; 93% were female; and 71% had less than 9 years of education.  A flexible interview was used. Questions included issues about the changes in the enforcement of immigration law and the impact in the participants and people they know; how these changes affected their children’s future and how; and how do they cope with the laws and enforcement practices.

Results: In the context of anti-immigrant legislation, enforcement, and sentiment, participants' quotes fell into the following overarching themes  – experiences of discrimination in their work environment, discrimination experienced by children in school, discrimination in public spaces/everyday activities, discrimination when interacting with public officials, and limited social interactions. We found that the data corresponded with three domains of the Social Determinants of Health outlined by Healthy People 2020 including economic stability, education, and social and community context.

Conclusions and implications: The need of a comprehensive immigration reform and the increasing number of anti-immigration policies in different states in the U.S. has exacerbated the abuses towards the immigrant community. Results in this study tell us how some participants are resisting to discriminatory comments or actions, yet this can create more hostility if they appropriate services and policies are not in place to protect and serve immigrants. Social service providers need to be aware of what is happening in their environments particularly in the work place (economic stability), schools (education), and the community (social and community context). As service providers we need to be prepared to advocate and provide the appropriate services in the communities we serve; since these is placing the immigrant’s health at risk.