Cumulative Experiences of Immigration Enforcement Policy and the Physical and Mental Health Outcomes of Asian and Latinx Immigrants in the United States

Abstract

Immigration enforcement policies in the United States and other nations have long been enacted and implemented as intentional tools of racial control. There is mounting evidence that immigration raids, arrests, and deportations in the United States are associated with poor immigrant health outcomes, but this research has primarily focused on associations between health and single, specific enforcement actions or experiences that may not capture the entirety of immigrants’ experiences with racialized exclusion. Further, there has been little examination of Asian immigrants’ experiences with enforcement in the United States. This article assesses the relationship between Asian and Latinx immigrants’ physical and mental health and their cumulative experiences of immigration enforcement. We analyze responses to a 2018 population-based telephone survey of 1,103 Asian and Latin American immigrants in California. Participants were asked about seven distinct exclusionary immigration and local law enforcement experiences and their self-rated health (SRH) and psychological distress. We tested the association between each enforcement experience and SRH and psychological distress, controlling for covariates. After creating a cumulative measure of exclusion by summing participants’ total number of enforcement experiences, we examined the association between cumulative enforcement experiences and SRH and psychological distress and tested interactions by ethnicity and citizenship. While a greater proportion of Latinx than Asian participants reported enforcement experiences, each additional enforcement experience was associated with poorer self-rated health and greater psychological distress for both groups. This article suggests that the overall immigration enforcement system, from surveillance to deportation, is associated with worse health outcomes for immigrants.

Keywords

immigration enforcement immigrant health physical and mental health

Introduction

Immigration enforcement policies in the United States and other nations have long been enacted and implemented as intentional tools of racial control (Ngai 2004; Bosworth, Parmar, and Vázquez 2018). There is mounting evidence that enforcement practices in the United States are associated with poor outcomes among immigrants and communities of color, particularly among Latinx persons (Perreira and Pedroza 2019). Most existing health and migration research has focused on the health impact of single immigration enforcement policies or forms of enforcement (e.g., 287(g),¹ raids, arrests, or deportation) or the general climate surrounding immigration enforcement (e.g., changes in state policy) and examines almost exclusively Latinxs (e.g., Rhodes et al. 2015; Vargas et al. 2018; Lopez et al. 2017; Novak, Geronimus, and Martinez-Cardoso 2017). Yet both health and migration scholars recognize that immigration enforcement policies include multiple forms of racialized surveillance, policing, and deportation (Kline 2019; Armenta 2017a).

In this article, we conceptualize immigration enforcement policy in the United States as a system that reinforces structural racism, potentially harming immigrant health through multiple, accumulating forms of racialized exclusion. We use a unique data set from California that includes both Asian and Latinx² immigrants to assess how their experiences with multiple forms of immigration enforcement are associated with self-rated health and psychological distress. We, first, discuss current knowledge regarding the relationship between immigration enforcement policies and the health of both foreign- and US-born Asian and Latinx populations. We, then, use structural racism as a framework to examine immigration enforcement policy as a system that can harm the health of both Latinx and Asian immigrants through accumulated exposure to multiple enforcement experiences. Finally, we present results showing that while Asian immigrants in our sample had fewer experiences with enforcement than did Latinx immigrants, the cumulative experiences of both groups were associated with the same likelihood of poor general health and mental health outcomes.

Enforcement Policy and the Well-Being of Asian and Latinx Immigrants

The intersection of immigration policy, race/ethnicity, and citizenship/legal status influences immigrant health (Bacong and Menjívar 2021; Viruell-Fuentes, Miranda, and Abdulrahim 2012). In the United States, Asian and Latinx noncitizens, particularly those who are undocumented or have temporary statuses, experience worse outcomes than their citizen counterparts on many health and social indicators (Torres and Young 2016; Patler and Laster Pirtle 2017; Patler 2018). Undocumented Latinxs, for example, face barriers to health care, experience poor mental health, and have worse outcomes than documented and US-citizen Latinxs for some chronic diseases (Arbona et al. 2010; Fuentes-Afflick and Hessol 2009; Goldman, Smith, and Sood 2005; Hacker et al. 2011; Korinek and Smith 2011; Martinez et al. 2013; Young and Pebley 2017). Similarly, Asian noncitizens, compared to Asian US citizens, often report higher levels of psychological distress, and undocumented Asian young adults experience barriers to health care, such as discrimination, stigma, and medical mistrust, associated with increased depressive symptoms (Gee et al. 2016; Sudhinaraset et al. 2020).

Immigration policies can impact immigrant health by influencing citizenship and racial stratification and determining the extent to which different immigrant groups are granted rights and protections or targeted by immigration enforcement (Young and Wallace 2019). However, influenced by diverse migratory processes and immigration admissions, enforcement, and integration policies, Asian and Latinx immigrants have experienced distinct trajectories of citizenship stratification and racialization in the United States (Alegria et al. 2004; Gee and Ford 2011; Escudero 2020). Research on the relationship between immigration policies and population health suggest that there are differences in how immigration policy may influence the health of Asian and Latinx immigrants. For example, a study of state-level immigrant policies in the United States found a positive relationship between inclusive policies and health insurance rates among Latinx noncitizens, but not among Asian noncitizens (Young et al. 2017). Latinxs are less likely to be naturalized than other groups (Gonzalez-Barrera 2018) and currently constitute the majority of undocumented immigrants in the United States and the vast majority of those deported annually (ICE 2019). Asian immigrants in the United States, by contrast, are not generally portrayed or perceived in popular culture as being undocumented (Sudhinaraset et al. 2017a), yet about 14 percent of Asian immigrants are undocumented and represent the nation's fastest-growing undocumented group (MPI 2018).

Immigration enforcement policy has directly shaped the legality and racial positions of Latinxs in the United States, historically and currently (Ngai 2004; Hernández 2008; Asad and Clair 2018). Border policies, the expansion of interior immigration enforcement, and numerous state-level restrictive policies, such as Arizona's SB 1070,³ have targeted Latinx migration and integration (Golash-Boza 2015; Saenz, Menjivar, and Garcia 2012; Armenta and Alvarez 2017). In part because many policies have targeted this population, most of what is known about immigration enforcement policies’ health impact is based on studies among US- and foreign-born Latinxs (e.g., Perreira and Pedroza 2019). The passage of enforcement-focused, restrictive state and local policies is associated with changes in Latinx health care-seeking behavior, self-rated health, and birth outcomes (Torche and Sirois 2019; Toomey et al. 2014; Anderson and Finch 2014). Poor health outcomes among Latinxs are also associated with direct enforcement experiences, including observing or encountering immigration agents in the local community, home raids, living in communities with active local law enforcement collaboration with immigration officials, being deported, or having a family member deported (Lopez et al. 2017; Novak, Geronimus, and Martinez-Cardoso 2017; Rhodes et al. 2015; Ro, Bruckner, and Duquette-Rury 2020; Toomey et al. 2014; Wang and Kaushal 2018; Horyniak et al. 2017; Pinedo 2020; Brabeck and Qingwen 2010; Vargas et al. 2018). As these studies show, specific enforcement policies or practices may harm Latinx health by creating barriers to accessing care (e.g., distrust of public programs; avoidance of driving to clinics), limiting access to social institutions (e.g., education) and material goods, and creating chronic stress (Philbin et al. 2018).

As is the case for Latinx immigrants, policies that regulate admission to the United States and interior enforcement also influence Asian immigrants’ position in US citizenship and racial hierarchies (Molina 2006; Ngai 2004). However, the potential harms created by immigration enforcement policy for Asian immigrant health have received little attention. Asian immigrants’ vulnerability to enforcement policy stems from distinct legal and racial mechanisms (Hsin and Aptekar 2021). In contrast to Latinxs, many Asian groups have been racialized in the United States as “model minorities,” despite contending with xenophobic attitudes that reinforce their position as perpetual, and deportable, foreigners (Lachica Buenavista 2018).

The growing population of undocumented Asian immigrants, in particular, experience “non-linear migration routes” (Hsin and Aptekar 2021, p. 13), which can involve unsafe and often-exorbitant costs to travel through multiple countries prior to reaching the United States, admissions to the United States on a tourist or noncitizen visa (e.g., student visa), and a years-long asylum application process (ibid.). Recent research on Asian immigrants indicates that undocumented and noncitizen Asians encounter extensive exposure to migration control regimes both at the border and in the US interior and, as a result, traumatic migration processes (Yellow Horse and Vargas 2021). For example, a recent study of undocumented Chinese immigrants in New York City found that many faced a financially and emotionally costly pathway to enter the country and few options for obtaining lawful permanent residency once they arrived (Hsin and Aptekar 2021).

Once living in the United States, Asian undocumented immigrants may experience illegality in hidden and potentially stigmatizing ways. For example, evidence indicates that undocumented Asian youth experience pronounced intra-ethnic conflict, resulting from the high level of stigma associated with undocumented status, even within their own ethnic communities (Sudhinaraset et al. 2017a; Hsin and Aptekar 2021). Intra-ethnic conflict, in turn, can lead to low levels of social capital among undocumented Asian youth and limited support in navigating resources, including physical and mental healthcare services (Sudhinaraset et al. 2017a).

Recent evidence supports concerns that the same forms of immigration enforcement associated with Latinx health outcomes are also associated with Asian immigrant health outcomes. For example, Yellow Horse and Vargas (2021) found that fears of deportation mediated the relationship between legal status and depressive symptoms among Asian noncitizens, including those with temporary visas and those ineligible for citizenship. Exacerbating these underlying challenges, the racialized rhetoric and politics around the COVID-19 epidemic have stoked anti-Asian racism and hate in the United States, contributing to calls for the exclusion of Chinese immigrants specifically and Asians more broadly (Dubey 2020).

Existing research on immigration enforcement policy and health has largely focused on specific policies, such as highly visible raids or state omnibus legislation (e.g., Arizona's SB 1070) (Torche and Sirois 2019; Novak, Geronimus, and Martinez-Cardoso 2017). As a result, this work may not capture the extent to which Asian and Latinx immigrants encounter multiple forms of immigration enforcement in their daily lives. Ethnographic research on Latinx immigrants in different communities across the United States provides evidence that enforcement policies, as a whole, produce “pathogenic” environments that shape their health pathways, including their sense of safety in their communities, health care decision-making, and vulnerability to violations of workplace rights (Armenta 2017b; Kline 2017; LeBrón et al. 2018a; Menjívar and Bejarano 2004; Dreby 2012). There have not been, however, population-level assessments of the patterns of either Asian or Latinx immigrants’ experiences with distinct forms of this racialized exclusion. An emphasis on specific enforcement practices, such as deportation, which overwhelmingly affect Latinxs may overlook other forms of enforcement, such as racial profiling, that both groups experience, albeit in different ways (Gee et al. 2009; Golash-Boza and Hondagneu-Sotelo 2013; LeBrón et al. 2018a). The focus on Latinxs in the health literature may inadvertently reinforce assumptions regarding Latinxs’ vulnerabilities to poor health and obscure similar or distinct vulnerabilities among Asian immigrants. Lack of attention to the distinct experiences and diversity of the 19 + Asian ethnic groups represented in the United States (Budiman and Ruiz 2021) further reinforces the “model minority” myth stereotype and overlooks the needs of diverse Asian immigrants, including those who may bear the brunt of discrimination and profiling due to having darker skin (Samari, Alcalá, and Sharif 2018). The cumulative exposure to the multiple forms of racialized exclusion produced by an overarching system of immigration enforcement policy likely has a negative impact on the health status and psychological well-being of both Asians and Latinxs.

Structural Racism Framework: The Health Impact of Cumulative Racialized Exclusion

Conceptualizing immigration enforcement policy as a manifestation of structural racism provides a lens for examining how immigrant health may be influenced by the cumulative experiences of racialized exclusion among both Asian and Latinx immigrants. Structural racism is a system of policies, institutions, social ideologies, and social processes that produce social, economic, and political inequities across racial and ethnic groups (Gee and Ford 2011). Racial inequities harm health through multiple pathways of physical and psychological risks that expose marginalized groups to day-to-day stressors and produce barriers to resources and opportunities (Bailey et al. 2017; Gee and Ford 2011). Exposure to social, economic, and racial inequities over time and during critical life periods can result in ongoing and accumulating exposure to disadvantage, which can harm health (Torres and Young 2016; Riosmena et al. 2015; Pearlin et al. 2005).

Immigration enforcement policies reinforce the mechanisms of structural racism that are linked to poor health outcomes in multiple ways. First, the mechanisms of structural racism are dynamic and evolve over time, based on changing political and social conditions (Carbado 2011; Laster Pirtle 2020). Similarly, over the course of US history, immigration and enforcement policy has regulated, and restricted, the entrance and rights of immigrant populations through changing policy and legal mechanisms (Ngai 2004; Motomura 2007). The Chinese Exclusion Acts of the late-19th century, for example, explicitly barred new migration from China and the naturalization of Chinese immigrants already residing in the United States (Tichenor 2002). In 1924, the Border Patrol was created to possess and implement independent policing powers to control Mexican migrants (Ngai 2004). While targeting different ethnic groups, these policies sought to reinforce the nation's racial hierarchy and produce racial exclusion from US territory, as well as to limit access to health care, safe living conditions, and jobs for recent immigrants from Mexico, China, Japan, the Philippines, and other nations (Molina 2011). Evidence suggests that immigrants who entered the United States during more restrictive policy regimes may experience deterioration in their mental health later in life (Miranda et al. 2011). While the specific policy mechanisms have changed over time, Asian and Latinx immigrants are “linked by a shared experience of US government oppression” (Escudero 2020, p. 51).

More recent developments in federal- and state-level immigration enforcement policies in the United States have extended the scope of immigrant policing, arrests, detention, and deportation. In the 1990s, federal immigration policy expanded enforcement agencies (e.g., Border Patrol) and encouraged local law enforcement collaboration in federal immigration enforcement (Varsanyi 2008). Policies such as 287(g) agreements and the Secure Communities Program allowed local law enforcement agencies (e.g., police, sheriff) to collaborate with federal agencies in immigration enforcement activities and gave state and local law enforcement agencies new discretion in their criminal justice enforcement actions (Varsanyi 2008; Stumpf 2006). Immigration enforcement, which falls under federal law in the United States, has, thus, been linked with local law enforcement policies and practices, which have historically fallen under criminal justice policies (Stumpf 2006). Local law enforcement policies and practice also have a long history of social and racial control (Armenta 2017a; Vitale 2017). By linking the regulation of international migration to local policing, immigrants’ experiences of local law enforcement policing have merged with their experiences of immigration enforcement (Morales and Curry 2021; Armenta and Alvarez 2017). As a result, Latinx immigrant communities have disproportionately experienced racial profiling, raids, arrests, and deportations (ICE 2019; Golash-Boza and Hondagneu-Sotelo 2013; Armenta 2017a). In addition, there is some evidence that Asian immigrant groups also have concerns about law enforcement bias (Wu, Smith, and Sun 2013), suggesting that current enforcement practices could pose harm to both groups. For all these reasons, in this article, we define immigration enforcement as the policies, practices, and potential encounters that encompass both federal immigration enforcement and/or local law enforcement.

In addition to being dynamic, the mechanisms of structural racism manifest in “ordinary,” everyday social patterns (Carbado 2011; Ford and Airhihenbuwa 2010). The enactment and implementation of immigration enforcement policies reinforce the mechanisms of structural racism by manifesting in immigrants’ lives as frequent exposures to discrimination and racialized anti-immigrant social climates, both of which have been linked to poor health outcomes, primarily among Latinx populations (Almeida et al. 2016; LeBrón et al. 2018b; Pérez, Fortuna, and Alegria 2008). Immigrants living in the United States now contend with numerous, daily points of potential contact with immigration enforcement, from the direct activities of immigration officials (e.g., workplace or home raids) to contact with police and local law enforcement personnel who may, or may not, be acting as agents of immigration authorities (Young and Wallace 2019). Among Latinxs, such contact has been shown to result in interactions with local law enforcement that are laden with discriminatory actions or attitudes (Armenta 2017b) and that may instill a fear of all authorities within such communities (Kline 2017). For Chinese and other Asian immigrants, these daily interactions may constitute “less visible forms of violence that can accumulate over time” (Hsin and Aptekar 2021, p. 3).

Current Study

Immigration enforcement policies currently produce practices of surveillance, policing, and deportation by which Asian and Latinx immigrants are exposed to evolving, but sustained and frequent, experiences of racialized exclusion. The accumulation of these experiences likely produces multiple pathways to worse general health and psychological distress – two population indicators that have been associated with structural racism (Gee and Ford 2011). Building on evidence that specific forms of immigration enforcement are associated with health outcomes among Latinx and Asian populations, we sought to examine the association between physical and mental health indicators and cumulative exposure to multiple enforcement policies (Figure 1). The measurement of enforcement experiences provides an indicator of the manifestation of structural racism as embodied in numerous forms of racialized exclusion. Evidence shows that such experiences may result in risks to physical and mental health through increased stress and ongoing barriers to health-promoting resources (Philbin et al. 2018). Our sample includes both Asian and Latinx immigrants, enabling us to examine patterns across both groups and to assess how exposure to the same forms of racialized exclusion (e.g., cumulative immigration enforcement experiences) may be associated with worse health outcomes for either group.

Figure 1.

Indicators of racialized exclusion: relationship with Asian and Latinx immigrant health.

Our first objective was to describe Latinx and Asian immigrants’ experiences with these forms of racialized exclusion. We use data from a unique study of Asian and Latinx immigrants’ experiences with public policies that asked participants to report if they had encountered any one of seven types of immigration enforcement, including surveillance, profiling, and deportation (Figure 1). We anticipated that a higher proportion of Latinx, compared to Asian, immigrants would report having had any of these experiences. However, we also anticipated observing a notable prevalence of enforcement experiences among Asian immigrants, indicating that, despite variations, both groups are exposed to forms of racialized exclusion.

Our second objective was to assess the extent to which Asian and Latinx immigrants’ overall experiences of racialized exclusion, measured by their cumulative enforcement experiences, were associated with self-assessed health status and psychological distress. We also assessed whether this relationship was stronger for Latinxs, who likely experience more targeted immigration enforcement, than for Asians, and for noncitizens without a Green Card,⁴ compared to Green Card holders and naturalized citizens. While we anticipated distinct patterns of racialized exclusion for Asians and Latinxs, we hypothesized that the cumulative enforcement experience could similarly influence both groups’ health. For example, Latinx immigrants may have experienced detention by border patrol while crossing the US-Mexico border on foot, whereas Asian immigrants arriving through customs at an airport may have been held for lengthy screening, potentially resulting in distrust of immigration enforcement agents and stress for both groups, albeit through distinct experiences. We hypothesized that more enforcement experiences would be associated with worse self-rated health and higher levels of psychological distress for all immigrants, with no variations by race or citizenship status.

Methods

Data

Data for this study come from the 2018 Research on Immigrant Health and State Policy (RIGHTS)⁵ survey and the 2018 California Health Interview Survey (CHIS).⁶ CHIS is the nation's largest state-level population health survey and collects data on health status, immigration characteristics, and other sociodemographic characteristics in multiple languages, including English, Spanish, Chinese (Mandarin and Cantonese), Vietnamese, and Korean (CHIS 2018). CHIS participants were invited to participate in the RIGHTS survey if they were age 18 or over and born in any Latin American country, including countries in the Caribbean, or Asian country, including countries in South Asia and Southeast Asia but excluding those in the Middle East. The RIGHTS survey was administered by phone in the same languages as CHIS and asked about participants’ experiences with policy exclusions. The RIGHTS survey asked respondents about exclusionary enforcement experiences across multiple domains, including law enforcement, defined as either experiences in which they were targeted by immigration enforcement policies or actions (e.g., deportation) or experiences in which a protective policy (e.g., “sanctuary” policy) did not protect them from immigration enforcement (e.g., seeing enforcement officials in their neighborhood) (Figure 1). The study sample is composed of RIGHTS and CHIS respondents in 2018 (N = 1,103). Access to the CHIS and RIGHTS data was granted through the University of California, Los Angeles Center for Health Policy Research Data Access Center, and IRB approval was obtained through the University of California, Los Angeles Office of the Human Research Protection Program.

Measures

Dependent measures of self-rated health (SRH) and psychological distress and covariates came from the CHIS survey. The independent measure of enforcement experiences came from the RIGHTS survey.

Self-rated health (SRH). Respondents were asked to describe their health as Excellent, Very Good, Good, Fair, or Poor. Fair and Poor were combined into one category. SRH levels were numerically coded such that increasing values indicated better health.

Psychological distress past year. The Kessler 6 (K6) is a well-validated non-specific psychological distress scale that uses six survey items to conduct population-level screening for clinically significant levels of mental distress (primarily depression and anxiety) (Prochaska et al. 2012). The response scale ranges from “none of the time” to “all of the time,” and respondents’ final score is a summation of responses to each question (range 0–24). We used this score as a continuous variable, rather than threshold indicator, to assess broad population-level variations.

Immigration enforcement experiences. The RIGHTS survey asked respondents to report if they had ever stayed inside to avoid police or immigration officials, seen immigration officials in their neighborhood, been watched by law enforcement, been stopped by law enforcement for no reason, been asked to show proof of citizenship by law enforcement, been deported, or known someone who had been deported. From each survey item, we created a dichotomous variable that categorized respondents as Yes = 1 (ever having) or No = 0 (not ever having) the experience. To assess respondents’ cumulative experiences with enforcement, we created a continuous variable by summing the total number of all enforcement experiences (Range 0–6).

Covariates. We classified respondents born in Latin America as Latinx and respondents born in Asia as Asian. We also included variables for citizenship status (naturalized, green card holder, non-green card holder), age, gender, education level (high school graduation, no high school graduation), employment status (employed, unemployed, out of labor force), poverty (at and below or above 200 percent Federal Poverty Level). Because there is some evidence that individuals may respond differently to the SRH question based on language and culture (Viruell-Fuentes et al. 2011), we included a measure of interview language (English vs. other) as a covariate to account for this potential bias.

Analysis

First, we described the characteristics and immigration enforcement experiences of the study sample. We examined the distributions of ethnicity, citizenship, and sociodemographic variables for Asian and Latinx respondents and, then, examined the proportions of Asian and Latinx respondents that reported each individual enforcement experience. Second, we examined the relationships between individual enforcement experiences and self-rated health and psychological distress. Stratifying by Asian and Latinx, we tested unadjusted, bivariate ordinal logistic and OLS regression models of the relationship between each enforcement experience and the two outcomes. Then, stratifying by Asian and Latinx, we tested ordinal logistic and OLS regression models of each enforcement experience and the two outcomes, controlling for age, sex, education level, employment, poverty level, citizenship, and language. Third, we assessed how the cumulative enforcement experiences were associated with SRH and psychological distress. We tested an ordinal logistic regression model of the association between immigration enforcement experiences and SRH and an OLS regression model of the association between enforcement experiences and psychological distress, controlling for covariates. Finally, to further assess whether the relationship between enforcement experiences and the outcomes varied by group characteristics, for each model, we tested interaction terms for enforcement experiences and race/ethnicity and citizenship. All analyses were conducted in Stata 16, using the SVY command with survey weights developed for the RIGHTS survey to produce population-representative estimates.

Sensitivity Analyses

We conducted sensitivity analyses to estimate the proportions of Asian and Latinx respondents that reported each individual enforcement experience adjusted by age and gender to assess if the patterns were, in part, driven by sociodemographic characteristics. Adjusted proportions were estimated by testing logistic regression models of the odds of experiencing each individual enforcement experience, controlling for age and gender, and then calculating the predicted probability of each. The Online Appendix presents the results showing that there were no substantive differences between the unadjusted and adjusted proportions of Asians’ and Latinx's enforcement experiences.

We also conducted sensitivity analysis to examine cumulative enforcement experiences as a categorical measure. Based on their total number of enforcement experiences, respondents were classified as having had no experiences, one experience, or multiple experiences. We tested an ordinal logistic regression model and an OLS regression model of the association between this categorical measure and SRH and psychological distress, respectively. A global test showed that the categorical measure was significant in each model. The Online Appendix presents the models. There was no significant difference in outcomes among respondents who had no, compared to one, enforcement experience, suggesting possibly similar outcomes among these two groups. By contrast, there was a significant difference in outcomes between respondents who had no enforcement experiences and those who had one experience, compared to those with multiple experiences. This finding corresponds with the findings presented below that increased numbers of experiences were associated with worse physical and mental health outcomes.

Results

Characteristics of Asian and Latinx Respondents

Table 1 shows weighted characteristics of Asian and Latinx respondents and the full sample. Overall, about 59 percent of the sample was Latinx, and 41 percent was Asian. About 21 percent were noncitizens without green cards, 26 percent were noncitizens with green cards, and 54 percent were naturalized citizens. Over half of participants were female (54 percent), had at least a high school diploma (65 percent), were in the labor market and employed (59 percent), and were below the 200 percent Federal Poverty Level (54 percent). Over half the sample completed the survey in a language other than English (53 percent). Among participants, 13 percent reported having Excellent health, 14 percent Very Good health, 35 percent Good health, and 37 percent Fair/Poor health. Participants had a mean K6 score of 4.3.

Table 1.

Characteristics of Asian and Latinx Respondents.

	All (n = 1103) % or Mean (sd)	Asian (n = 452) % or Mean (sd)	Latinx (n = 651) % or Mean (sd)
Ethnicity
Asian	41%	-	-
Latinx	59%	-	-
Citizenship
Noncitizen, non-greencard holder	21%	8%	30%
Noncitizen, greencard holder	26%	22%	28%
Naturalized citizen	54%	70%	42%
Age	49.0 (0.8)	51 (1.5)	47 (0.8)
Sex
Female	54%	56%	52%
Male	46%	44%	48%
Education level
High school graduation or higher	65%	84%	52%
No high school graduation	35%	16%	48%
Employment status
Employed	59%	56%	61%
Unemployed	4%	5%	3%
Out of labor force	37%	39%	36%
Income
At or above 200% Federal Poverty Level	46%	64%	34%
Below 200% Federal Poverty Level	54%	36%	66%
Language of interview
English	47%	59%	39%
Non-English	53%	41%	61%
Self-reported health
Excellent	13%	16%	11%
Very good	14%	21%	10%
Good	35%	30%	39%
Fair/poor	37%	33%	40%
K6 score	4.3	3.79	4.63

Notes: Source: RIGHTS Study and CHIS, 2018 (n = 1103).

sd = standard deviation.

Analyses weighted.

There were notable differences between Asian and Latinx respondents. A lower proportion of Asian, compared to Latinx, respondents were noncitizen, non-green card holders (8 vs. 30 percent), had less than a high school education (16 vs. 48 percent), and were below the 200 percent Federal Poverty level (36 vs. 66 percent). A higher proportion of Asian, compared to Latinx, respondents reported Excellent (16 vs. 11 percent) or Very Good health (21 percent vs. 10 percent), while a lower proportion reported Good (30 vs. 39 percent) or Fair/Poor health (33 vs. 40 percent). Asian respondents had a mean K6 score of 3.79, compared to Latinxs, who had a mean score of 4.63.

Patterns of Enforcement Experiences for Latinx and Asian Immigrants

Table 2 describes the enforcement experiences among Asian and Latinx respondents and shows that higher proportions of Latinxs experienced racialized exclusion. Among Latinxs, a quarter reported having ever stayed indoors to avoid police or immigration officials, 15 percent reported having seen immigration officials in their neighborhood, and almost 10 percent reported having been asked by law enforcement to prove their citizenship. In contrast, among Asian participants, almost none reported these experiences (≤2 percent). Among Latinxs, 14 and 16 percent reported being watched or stopped by law enforcement, respectively, while 4 and 9 percent of Asians reported being watched or stopped, respectively. Finally, among Latinxs, 5 percent of participants reported having been deported, and 47 percent knew someone who had been deported. Almost no Asian respondents had been deported, while 8 percent knew someone who had.

Table 2.

Proportions of Asian and Latinx Respondents Reporting Each Enforcement Experience.

	Asian (n = 452) %	Latinx (n = 651) %
Stayed indoors to avoid enforcement	0.4%	25.6%
Seen immigration in neighborhood	2.0%	14.9%
Asked to prove citizenship	2.0%	9.5%
Watched by law enforcement	4.1%	14.2%
Stopped by police	9.1%	16.3%
Deported	0.3%	5.1%
Know someone deported	8.1%	47.2%

Notes: Source: RIGHTS Study and CHIS, 2018 (n = 1103).

Analyses weighted.

Individual Enforcement Experiences and Health Outcomes

Table 3 shows the unadjusted and adjusted associations between each individual enforcement experience and the two outcomes - self-rated health and psychological distress - for Asians and Latinxs. Among Asian respondents, only having seen immigration officials in their neighborhood (OR = 0.2, p < .01) was associated with SRH in the unadjusted models, and no individual enforcement experience was associated with SRH in adjusted models. Only having been deported (ß = 7.91, p < .01) was associated with K6 score in the unadjusted models, while both having seen immigration officials in their neighborhood (ß = 3.45, p < .01) and having been deported (ß = 9.84, p < .01) were significant in the adjusted models.

Table 3.

Unadjusted and Adjusted Associations Between Each Experience of Enforcement (a) Self-Rated Health and (b) Psychological Distress (K6).

	Asian Respondents				Latinx Respondents
	(a) Self-Reported Health		(b) K6 Score		(a) Self-Reported Health		(b) K6 Score
	Unadjusted	Adjusted^a	Unadjusted	Adjusted^a	Unadjusted	Adjusted^a	Unadjusted	Adjusted^a
Enforcement experiences	OR	OR	ß	ß	OR	OR	ß	ß
Stayed indoors to avoid enforcement	2.14	3.75	4.91	5.51	0.81	0.71	1.26	1.02
Seen immigration in neighborhood	0.2**	0.52	1.83	3.45**	0.7	0.57*	0.74	1.19*
Asked to prove citizenship	1.14	4.23	1.86	1.33	0.52	0.46	2.09*	3.04*
Watched by law enforcement	0.63	0.25	−0.13	−1.18	1.17	0.85	0.33	0.62
Stopped by police	0.61	0.28	0.37	0.12	0.66	0.42*	0.59	1.22
Deported	0.61	0.69	7.91**	9.84**	0.60	0.82	−0.66	−0.94
Know someone deported	0.61	0.29	0.35	1.07	1.07	0.92	0.71	0.65

Notes: Source: RIGHTS Study and CHIS, 2018 (n = 1103)

Analyses weighted.

*p < .05.

**p < .01.

Each model controls for age, sex, education level, employment, poverty level, citizenship, and language.

Among Latinx respondents, no experiences were significant in the unadjusted models, but having seen immigration officials in their neighborhood (OR = 0.60, p < .05) and having been stopped by law enforcement (OR = 0.42, p < .05) were associated with decreased odds of reporting better health in the adjusted models. In the adjusted models, having been asked to prove citizenship to law enforcement (ß = 3.04, p < .05) was associated with psychological distress. Having seen immigration officials in their neighborhood (ß = 1.19, p < .05) and having been asked to prove citizenship to law enforcement (ß = 3.04, p < .05) were associated with increases in the K6 score in the adjusted models. In adjusted models for the full sample (i.e., both Asian and Latinx respondents) (data not shown in Table 3), only having seen enforcement officials in their neighborhood (OR = 0.53, p < .05) and having been stopped by law enforcement (OR = 0.42, p < .05) were associated with worse self-rated health. Only having seen enforcement officials in your neighborhood (ß = 1.35, p < .05) and having been asked by police to prove citizenship (ß = 2.63, p < .01) were associated with psychological distress.

Cumulative Enforcement Experiences and Health Outcomes

We, next, assessed the association between cumulative immigration enforcement experiences and SRH and psychological distress. In the adjusted ordinal logistic regression model (Table 4, Model 1), the level of enforcement experiences was associated with worse general health. Each additional enforcement experience was associated with 24 percent decreased odds of reporting a better level of health (OR = 0.76, p < .01). Race/ethnicity, citizenship, gender, education level, employment status, and poverty level were not associated with self-rated health. Having completed the interview in English was associated with an increased odds of reporting better health, and age was associated with worse health.

Table 4.

Ordinal Logistic Regression Models of Association Between (1) Cumulative Enforcement Experiences and Self-Rated Health (SRH); (2) the Interaction Between Cumulative Enforcement Experiences and Ethnicity and SRH; (3) the Interaction Between Cumulative Enforcement Experiences and Citizenship and SRH.

	Model 1	Model 2	Model 3
	OR (SE)	OR (SE)	OR (SE)
Experiences of enforcement	0.76** (0.08)	0.55 (0.18)	0.86 (0.12)
Ethnicity
Latinx	0.92 (0.24)	0.79 (0.21)	0.90 (0.25)
Asian	(ref)	(ref)	(ref)
Citizenship
Noncitizen, non-green card holder	0.62 (0.20)	0.62 (0.19)	0.79 (0.33)
Noncitizen, green card holder	0.82 (0.22)	0.78 (0.21)	0.96 (0.30)
Naturalized citizen	(ref)	(ref)	(ref)
Age	0.97** (0.01)	0.97** (0.01)	0.97** (0.01)
Sex
Female	1.03 (0.23)	1.02 (0.23)	1.03 (0.23)
Male	(ref)	(ref)	(ref)
Education Level
High school graduation or higher	0.76 (0.20)	0.75 (0.20)	0.76 (0.20)
No high school graduation	(ref)	(ref)	(ref)
Employment status
Unemployed	1.30 (0.81)	1.35 (0.89)	1.27 (0.79)
Out of labor force	0.61 (0.17)	0.61 (0.16)	0.61 (0.17)
Employed	(ref)	(ref)	(ref)
Income
Below 200% Federal Poverty Level	0.75 (0.18)	0.74 (0.18)	0.75 (0.18)
At or above 200% Federal Poverty Level	(ref)	(ref)	(ref)
Interview language
English	2.34** (0.60)	2.41** (0.63)	2.30** (0.59)
Non-English	(ref)	(ref)	(ref)
Ethnicity × Experiences of enforcement
Latinx × Experiences of enforcement	-	1.45 (0.51)	-
Asian × Experiences of enforcement	-	(ref)	-
Citizenship × Experiences of enforcement
Noncitizen, non-green card holder × Experiences of enforcement	-	-	0.78 (0.17)
Noncitizen, green card holder × Experiences of enforcement	-	-	0.81 (0.16)
Naturalized citizen × Experiences of enforcement	-	-	(ref)

Notes: Source: RIGHTS Study and CHIS, 2018 (n = 1103).

Analyses weighted.

*p < .05.

**p < .01.

In the adjusted OLS regression model (Table 5, Model 1), the level of enforcement experiences was associated with an increase in psychological distress. Each additional enforcement experience was associated with a 0.5-point increase in the K6 scale (ß = 0.5, p < .01). Race/ethnicity, age, education level, and poverty level were not associated with distress. Being a noncitizen green-card holder, compared to a naturalized citizen, was associated with a 1.66-point higher K6 score (ß = 1.66, p < .05), while being a noncitizen non-green-card holder, compared to a naturalized citizen, was not associated with an increased K6 score. Being female, compared to male, was associated with a 1.19 higher K6 score (ß = 1.19, p < .05). Being unemployed, compared to being employed, was associated with a 2.25 lower K6 score (ß = -2.25, p < .01).

Table 5.

OLS Regression Models of the Associations Between (1) Cumulative Enforcement Experiences and Psychological Distress (K6); (2) the Interaction Between Cumulative Enforcement Experiences and Ethnicity and K6; (3) the Interaction Between Cumulative Enforcement Experiences and Citizenship and K6.

	Model 1	Model 2	Model 3
	ß (SE)	ß (SE)	ß (SE)
Experiences of enforcement	0.50** (0.19)	0.56 (0.47)	0.31 (0.24)
Ethnicity
Latinx	−0.10 (0.58)	−0.07 (0.69)	−0.17 (0.59)
Asian	(ref)	(ref)	(ref)
Citizenship
Noncitizen, non-green card holder	1.06 (0.69)	1.06 (0.69)	1.20 (0.94)
Noncitizen, green card holder	1.66* (0.70)	1.67* (0.70)	1.03 (0.86)
Naturalized citizen	(ref)	(ref)	(ref)
Age	−0.03 (0.02)	−0.03 (0.02)	−0.03 (0.02)
Sex
Female	1.19* (0.51)	1.19* (0.51)	1.20* (0.50)
Male	(ref)	(ref)	(ref)
Education Level
High school graduation or higher	−0.71 (0.61)	−0.70 (0.61)	−0.73 (0.62)
No high school graduation	(ref)	(ref)	(ref)
Employment status
Unemployed	−2.25** (0.84)	−2.30** (0.84)	−2.21** (0.78)
Out of labor force	0.59 (0.65)	0.58 (0.65)	0.55 (0.65)
Employed	(ref)	(ref)	(ref)
Income
Below 200% Federal Poverty Level	0.00 (0.66)	0.00 (0.65)	0.01 (0.66)
At or above 200% Federal Poverty Level	(ref)	(ref)	(ref)
Interview language
English	1.01 (0.64)	1.01 (0.66)	0.96 (0.65)
Non-English	(ref)	(ref)	(ref)
Ethnicity × Experiences of enforcement
Latinx × Experiences of enforcement	-	−0.07 (0.50)	-
Asian × Experiences of enforcement	-	(ref)	-
Citizenship × Experiences of enforcement
Noncitizen, non-green card holder × Experiences of enforcement	-	-	−0.06 (0.43)
Noncitizen, green card holder × Experiences of enforcement	-	-	0.71 (0.47)
Naturalized citizen × Experiences of enforcement	-	-	(ref)

Notes: Source: RIGHTS Study and CHIS, 2018 (n=1103).

Analyses weighted.

*p<.05.

**p<.01.

To determine if the relationship between enforcement experiences and SRH or psychological distress varied between Asian and Latinx respondents, we ran interaction models (Table 4, Model 2 and Table 5, Model 2). We used a chi-square test to assess the significance of the interaction and found that there was no significant difference in the association between the level of enforcement experiences and either SRH or the K6 score between Asian and Latinx respondents. To determine if the relationship between enforcement experiences and SRH or psychological distress varied by respondents’ citizenship status, we also tested interaction models (Table 4, Model 3 and Table 5, Model 3). We used a chi-square test to assess the significance of the interaction and, similar to race/ethnicity, found that there was no significant difference in the association between the level of enforcement experiences and either SRH or K6 score, based on respondents’ citizenship status.

Discussion

In this article, we examined the extent to which Asian and Latinx immigrants’ experiences of racialized exclusion through surveillance, police profiling, and deportation were associated with physical and mental health outcomes. We found that a greater proportion of Latinx, compared to Asian, immigrants had experienced multiple forms of immigration enforcement. When testing the relationship between each specific immigration enforcement experience and outcomes, we found that most immigration enforcement experiences were not individually associated with the physical and mental health of each group. By contrast, when considering Asians’ and Latinx's cumulative number of immigration enforcement experiences, we found that each unit increase in immigration enforcement experiences was associated with worse self-rated health and an increase in psychological distress for both Asian and Latinx respondents. Below, we discuss this article's empirical contributions, which provide some of the first population-level evidence on the relationship between multiple forms of immigration enforcement and the health of both Asian and Latinx immigrants. From there, we discuss this article's conceptual contributions, which show how immigration enforcement policies can influence the health of both Asian and Latinx immigrants through accumulated exposures to multiple forms of racialized exclusion. We end with a discussion of how these findings can inform future research among different immigrant populations, including in other nations.

Our findings contribute some of the first population-level empirical comparative evidence for understanding the health influences of immigration enforcement for Asian and Latinx immigrants, the two largest immigrant groups in the United States (American Immigration Council 2019). While Asian and Latinx immigrants have distinct migration and racialization trajectories in the United States, both live under the same immigration enforcement system (Escudero 2020). Our findings are consistent with research and administrative data showing that Latinx immigrants are at higher risk of detection and apprehension than other groups (Golash-Boza and Hondagneu-Sotelo 2013). Our results expand on this finding to show that sizeable proportions of Latinx immigrants have also had other types of encounters with law enforcement and immigration agencies, from observing officials in their neighborhood to racial profiling.

We also provide some of the first population-level insight into the extent to which Asian immigrants in the United States experience different types of immigration enforcement. We found that, while a smaller proportion of Asian, compared to Latinx, respondents experienced immigration enforcement, their encounters were not rare. Indeed, these data indicate that immigration enforcement was an “ordinary” experience for many Asian immigrants in the United States (Carbado 2011). For example, close to one in 10 Asian respondents in our sample reported having been stopped by law enforcement for no reason, and about one in 12 knew someone who had been deported. Other studies find that about 44 percent of Asian undocumented young adults know someone who has been deported or detained (Manalo-Pedro and Sudhinaraset 2022). Our findings also suggest that different forms of immigration enforcement are most common for Latinx, compared to Asian, immigrants in the United States. For example, among Latinx immigrants knowing someone who was deported was the most common experience, while among Asians, racial profiling was the most common experience. These descriptive data reinforce evidence from ethnographic accounts (e.g., Escudero 2020; Kline 2019; Armenta 2017a) that describe how both Asian and Latinx immigrants navigate communities, workplaces, and other settings where contact with either local law enforcement or immigration authorities can result in enforcement actions, from racial profiling to arrest. While other studies have included race-specific empirical data or single immigration enforcement measures (e.g., Vargas et al. 2018; Lopez et al. 2017; Novak, Geronimus, and Martinez-Cardoso 2017), our data represent a population-based dataset across both Latinx and Asian immigrants involving multiple immigration enforcement experiences.

Our findings also strengthen conceptual understandings of the relationship between immigration enforcement and health, which has been under-theorized in health and migration literatures. Specifically, we find that health inequities may be due to or driven by not only a singular or specific policy, action, or encounter but by the processes of experiencing multiple types of racialized exclusion. In our findings, only a few immigration enforcement experiences were individually associated with either self-rated health or psychological distress. For example, among Latinx respondents, having seen immigration officials in their neighborhood and having been stopped by law enforcement were associated with SRH, and among Asian respondents, having been deported was associated with psychological distress. While past studies focused on single measures of immigration enforcement and its impact on health provide critical evidence that specific experiences with immigration enforcement are traumatic and can result in a variety of pathways to poor health for individuals (Lopez et al. 2018), we consider how immigration enforcement actions collectively produce a system that can appear through multiple forms of contact with local law enforcement and/or immigration authorities. Conceptualized as a system that reinforces structural racism, immigration enforcement policies are dynamic and evolve over time and manifest in immigrants’ day-to-day lives in “ordinary” ways (Carbado 2011; Laster Pirtle 2020) through policing and surveillance enacted by both local law enforcement and immigration authorities. Thus, at a population level, examination of single forms of immigration enforcement may underestimate the immigration enforcement system's broader impact on immigrant health in the United States.

This article also contributes nuanced understanding of the relationship between immigration enforcement and health for Asian and Latinx immigrants. By examining the cumulative impact of immigration enforcement on both Asian and Latinx immigrants, we show that, despite differences in the frequency of enforcement experiences between Latinx and Asian respondents, the relationships between immigration enforcement experiences and physical and mental health were similar for Asian and Latinx immigrants and naturalized citizens, green card holders, and non-green card holders. Race/ethnic categories are often used as measures of racial/ethnic difference in population health research, implying there are intrinsic differences between race/ethnic groups, such as Latinx and Asian immigrants, rather than differences in groups’ exposure to racialized exclusion (Boyd et al. 2020). Race/ethnic categories, as scholars have pointed, are proxies for racism and experiences of individuals’ racialized positions (Ford and Harawa 2010). Our examination of racialized exclusion, therefore, goes beyond race/ethnic categories to measure the racialized experiences across Latinx and Asian populations. Our findings suggest that the ultimate associations between health and immigration enforcement policies are likely similar for different immigrant groups, even if they have distinct migration, racialization, or citizenship status trajectories in the United States.

One interpretation of these findings is that different types of immigration enforcement may have similar influences on mental and physical health outcomes. For example, having a family member deported and having been racially profiled are very different experiences; however, from the perspective of structural racism, both are forms of racialized exclusion that may result in psychosocial stress and harmful economic impacts. Research among individuals who have experienced the deportation of a family member show that a family member's deportation is both psychologically distressing and economically damaging for these individuals (Boyce and Launius 2020; Golash-Boza 2019); similarly, Latinx immigrants’ frequent racial profiling or contact with local law enforcement produces fear and distrust, as well as costly traffic or other fines (Armenta and Rosales 2019).

Another interpretation of our findings is that the implications or significance of immigration enforcement experiences may be distinct for Asian and Latinx immigrants but, ultimately, similarly harmful. For example, the psychological distress that Latinx immigrants may experience following immigration enforcement experiences may stem from ongoing vigilance due to their high level of contact with individuals who have been deported or their awareness that Latinxs frequently encounter such enforcement (Vargas et al. 2018; Kline 2019). By contrast, psychological distress for Asian immigrants may stem more from stigma or lack of solidarity following an enforcement experience within their communities (Sudhinaraset et al. 2017a). The specific psychosocial or physical impacts of immigration enforcement may vary between the groups, but the ultimate magnitude of the relationship between immigration enforcement and health may be the same. Both interpretations align with cumulative disadvantage models of racial discrimination to suggest that exposure over time and the frequency of enforcement experiences are associated with poorer health outcomes for immigrants and populations of color (Forde et al. 2019; Riosmena et al. 2015). More research is needed to understand both the similarities and differences in how immigration enforcement shapes the health of Asian and Latinx immigrants, as well as other immigrant groups in the United States and elsewhere.

Our findings can inform future research on the relationship between health and immigration enforcement among different immigrant groups. Structural frameworks, such as this article's application of structural racism, make immigration enforcement itself the focus of measurement and analysis. Measuring immigrants’ direct experiences of immigration enforcement provide an approach to examine patterns of racialized exclusion among Latinxs, Asians, and other groups and the association between racialized exclusion and health outcomes.

Future population health studies can expand knowledge on the health impact of other types of enforcement experiences among different immigrant groups. Enforcement policies continue to evolve to impose racialized control over and exclusion of specific migrant groups, likely creating other forms of racialized exclusion. For example, since September 11, 2001, South Asian immigrants in the United States have experienced anti-terrorism policies that have targeted the deportation of individuals from Muslim-majority countries (Samari, Alcalá, and Sharif 2018). Recently arrived Central American and Caribbean immigrants have routinely been subjected to monitoring devices, such as ankle monitors or electronic surveillance (Martinez-Aranda 2022). These distinct forms of contact with law and immigration enforcement reflect how enforcement has changed in recent years to adapt and extend racial exclusion to new political and demographic circumstances and merit further study.

In addition, future studies should examine immigrant groups, such as Black immigrants and those from the Middle East and North Africa, that were not explicitly included in this study. The intersections of anti-Black racism and the immigration enforcement system likely influence Black immigrants’ health access and health status. Black immigrants in the United States, for example, are more likely to be detained for criminal convictions than other immigrants and are disproportionality represented in the criminal enforcement system (Morgan-Trostle, Zheng, and Lipscombe 2017), experiences that could be captured in future measures of immigration enforcement. Similarly, future studies should examine the experiences of immigrants from the Middle East and North Africa, especially the various communities that comprise the Muslim community (including South Asians, Indonesians, and others), and elucidate the impact of Islamophobia, anti-Muslim racism, and the enforcement system on health (Samari, Alcalá, and Sharif 2018).

In addition, examining the patterns of immigration enforcement outside the United States offers a critical opportunity to advance knowledge on immigration enforcement and health. Similar to the United States, nations like Great Britain, Germany, and Australia have deployed migration control and interior enforcement policies in recent decades that may impact immigrant health outcomes (Bosworth, Parmar, and Vázquez 2018). A structural racism lens provides an approach to better understand how evolving policies, actions, and the “ordinary” manifestations of surveillance, policing, and deportation across national contexts may be related to health outcomes among diverse immigrant groups. As in the United States, policies and actions in other nations have linked immigration enforcement with law enforcement and criminal justice policy (van der Woude, Barker, and van der Leun 2017), and migrants across the globe increasingly encounter racialized policing practices at the regional, national, and local scales (Chacon and Coutin 2018). For example, despite the elimination of interior border control within the European Union, member-states such as the Netherlands can still check the immigration status of individuals traveling within their borders (van der Woude and Brouwer 2017). In Australia, non-white migrants reported being targeted by immigration enforcement due to racialized assumptions about their citizenship (Boon-Kuo 2018). Studies that provide both cross-race/ethnic and cross-national comparisons of how a range of immigration enforcement experiences are linked to health can advance knowledge in this area.

Promoting immigrant health in the United States and around the globe involves addressing the negative impact of immigration enforcement policies. In the short term, our findings highlight that public health policies and interventions should consider and address the range of experiences immigrants may have with immigration enforcement. Those who have been exposed to immigration enforcement may require trauma-informed care and tailored interventions to support their use of health care and other resources (Saadi et al. 2020). Immigration enforcement data are typically under-represented in the literature on Asians in particular, and this erasure obfuscates Asian immigrants’ health needs and contributes to the model minority myth (Sudhinaraset et al. 2017b), further excluding Asian immigrants from programs and policies from which they may benefit. These findings also point to the need to move beyond individual-level interventions and toward those that address structural factors. In the longer term, immigrant health practitioners and policy advocates should contribute to policy change. Multiple US states have enacted “sanctuary”-type policies to disentangle law enforcement and immigration enforcement (Young and Wallace 2019), while at the federal level, ongoing advocacy can work to dismantle the nation's immigration enforcement system (Young and Wallace 2021). These long-term efforts require ongoing research; the growing emphasis in health research to name racism and structural racism as health determinants provide approaches to advance empirical evidence on immigration enforcement and health (Boyd et al. 2020).

This article has some limitations. First, because it uses cross-sectional data, our analysis does not support an assessment of causality. For example, we do not know when experiences with immigration enforcement occurred and whether they pre-dated early experiences of poor mental health. Second, our measure of cumulative enforcement experiences, while novel, groups together experiences that are qualitatively distinct. As discussed above, future research should examine other forms of enforcement and other measures of experiences to further understand variations in how they affect physical and mental health processes. Third, California, the site of this research, is known to be more inclusive and less criminalizing for immigrants, compared to other US states (Young and Wallace 2019). Future studies should examine other settings across the United States, including states that have enacted more criminalizing policies. Finally, while this article broadly included immigrants from Asia and Latin America, the sample size presents limitations. Our finding that there was no interaction by race/ethnicity or citizenship status may be due to a lack of power. In addition, our sample was not large enough to examine sub-ethnicities who may experience unique racialization and does not include immigrants from the Middle East or Africa. While this article does include immigrants from the Caribbean, it does not have the power to assess the unique experiences of Black immigrants. For example, studies of Dominican immigrants have provided insights into the relative contributions of being identified as Black by outsiders while having a Latinx/Spanish-speaking immigrant identity within their community (Itzigsohn, Giorguli, and Vazquez 2005).

Despite these limitations, our findings contribute empirical evidence regarding the relationship between immigration enforcement experiences and health outcomes for both Asian and Latinx immigrants. We found that the overall experiences of racialized exclusion are associated with an increased risk of poor health for both groups. Immigration enforcement experiences function to reinforce health inequities in the United States through multiple forms of racialized exclusion that have changed over time and that become an “ordinary” and everyday aspect of immigrant life. As US immigration policy continues to change, migration and health scholars and advocates have a role to play in bringing attention to the immigration enforcement system's negative health impacts.

Supplemental Material

sj-docx-1-mrx-10.1177_01979183221126726 - Supplemental material for Cumulative Experiences of Immigration Enforcement Policy and the Physical and Mental Health Outcomes of Asian and Latinx Immigrants in the United States

Supplemental material, sj-docx-1-mrx-10.1177_01979183221126726 for Cumulative Experiences of Immigration Enforcement Policy and the Physical and Mental Health Outcomes of Asian and Latinx Immigrants in the United States by Maria-Elena De Trinidad Young, Lei Chen, May Sudhinaraset, Altaf Saadi, Kathryn G. Kietzman, and Steven P. Wallace in International Migration Review

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Institute on Minority Health and Health Disparities (Grant number R01 MD012292).

ORCID iD

Maria-Elena De Trinidad Young

Supplemental Material

The supplemental material for this article is available online.

Notes

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