Impact of Arizona’s SB 1070 Immigration Law on Utilization of Health Care and Public Assistance Among Mexican-Origin Adolescent Mothers and Their Mother Figures

摘要

Objectives. We examined the impact of Arizona’s “Supporting Our Law Enforcement and Safe Neighborhoods Act” (SB 1070, enacted July 29, 2010) on the utilization of preventive health care and public assistance among Mexican-origin families. Methods. Data came from 142 adolescent mothers and 137 mother figures who participated in a quasi-experimental, ongoing longitudinal study of the health and development of Mexican-origin adolescent mothers and their infants (4 waves; March 2007–December 2011). We used general estimating equations to determine whether utilization of preventive health care and public assistance differed before versus after SB 1070’s enactment. Results. Adolescents reported declines in use of public assistance and were less likely to take their baby to the doctor; compared with older adolescents, younger adolescents were less likely to use preventive health care after SB 1070. Mother figures were less likely to use public assistance after SB 1070 if they were born in the United States and if their post–SB 1070 interview was closer to the law’s enactment. Conclusions. Findings suggest that immigration policies such as SB 1070 may contribute to decreases in use of preventive health care and public assistance among high-risk populations. Psychosocial stressors adversely affect health, are socially patterned, and contribute to health disparities. 1–3 Most research on stress has focused on exposure to individual stressors, but evidence is growing that macro stressors—large-scale events such as disasters, economic recessions, military conflict, and terrorist events—can also adversely affect health. 4,5 A growing body of research has suggested that public policies that reflect macro-level exclusion can also harm the health of stigmatized populations. For example, state-level policies that discriminate against lesbian, gay, and bisexual populations have been associated with increased risk of psychiatric disorders and suicide among those populations. 6–8 Research has also suggested that policies that discriminate against immigrant groups can adversely affect their mental health. 9,10 According to social stress theory, 11 a minority group’s disadvantaged social position in dominant society exposes its members to more stressful conditions and events (e.g., discrimination, macro-level exclusion), and this resultant stress contributes to disparate health risks. Research on exposure to stressors and health has indicated that stress can affect health not only by leading to negative emotions and subsequent physiological changes, but also by changing health behaviors, including the utilization of health care. 11 Recent research on discrimination and health, for example, has documented that perceived discrimination by health care providers is associated with delays in seeking treatment, lower adherence to medical regimens, and lower rates of follow-up. 12 However, relatively little attention has been given to the impact that recent state-level immigration laws have had on the utilization of health care services among Latino populations, with the exception of a recent study that documented changes in health-seeking behaviors among Latinos in northern Arizona. 13 Research on the impact of such state-level policies on public health for Latino individuals living in the United States is particularly important given that Latinos represent a significant portion of the uninsured population and are more likely to be hospitalized for preventable causes than non-Latino Whites. 14 Furthermore, a recent study found that by reducing the number of preventable hospitalizations among Latinos to the rates of non-Latino Whites, the United States could have saved approximately $900 million. 14 Arizona Senate Bill 1070, 15 the Support Our Law Enforcement and Safe Neighborhoods Act, was state legislation that empowered police to detain individuals who were not able to prove their citizenship on request. Opponents of the law argued that it essentially legalized racial and ethnic profiling by law enforcement in the state of Arizona. Since the enactment of SB 1070 in Arizona, other state legislatures have passed similar policies. 16 Furthermore, the US Supreme Court upheld a key portion of the law, enabling police officers to request proof of legal immigration status of someone they suspect is undocumented. 16 Some research has suggested that although the stated intentions of policies such as SB 1070 are to increase the general feeling of safety among citizens, they actually increase fear among Latino and other minority populations because of racial profiling and harassment from authorities within their communities. 10,13,17 One recent study of Arizona’s SB 1070 documented that participants in a predominately Latino community in northern Arizona perceived that their communities were less safe, and health care and community service providers reported a drop in services immediately after the passage of SB 1070. 13 Moreover, in a separa