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Federal, State, and Local Immigrant-Related Policies and Child Health Outcomes: a Systematic Review.

ABSTRACT: The passage of US immigrant-related policies at the federal, state, and local level is on the rise. These policies may affect child health through several mechanisms. We performed a systematic review of English-language, peer-reviewed, quantitative studies examining US immigrant-related policies and the mental and physical health of youth in immigrant families. We searched PubMed and five social science databases for studies published between 1986 and 2019. Two independent reviewers screened the studies and appraised study quality. Of the final 17 studies, ten studies examined birth outcomes and seven studies examined other outcomes in childhood and adolescence (e.g., self-rated health). Generally, exclusionary policies were associated with worse health outcomes and inclusive policies were associated with better health outcomes. Several studies did not observe an association, but only one study found an association of the opposite direction. In that study, similar trends in different policy environments and across foreign-born and US-born women suggest alternative causes for the observed association. Overall, we find that exclusionary policies are, at best, neutral, but likely harmful towards child wellbeing, while inclusive policies can be beneficial.

SUBMITTER: Crookes DM

PROVIDER: S-EPMC7870024 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Federal, State, and Local Immigrant-Related Policies and Child Health Outcomes: a Systematic Review.

Crookes Danielle M DM Stanhope Kaitlyn K KK Kim Ye Ji YJ Lummus Elizabeth E Suglia Shakira F SF

Journal of racial and ethnic health disparities 20210208 2

The passage of US immigrant-related policies at the federal, state, and local level is on the rise. These policies may affect child health through several mechanisms. We performed a systematic review of English-language, peer-reviewed, quantitative studies examining US immigrant-related policies and the mental and physical health of youth in immigrant families. We searched PubMed and five social science databases for studies published between 1986 and 2019. Two independent reviewers screened the ...[more]

PMID: 33559110

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Project description:ImportanceThe association of state-level immigrant policies with uninsurance among Latino youths remains unknown.ObjectiveTo assess the association of state-level immigrant integration and criminalization policies with health insurance coverage among US-born Latino youths by maternal citizenship.Design, setting, and participantsThis cross-sectional study analyzed secondary data from the American Community Survey, January 1, 2016, to December 31, 2018, for US-born Latino youths (age, ≤17 years) and their mothers (age, 18-64 years) as well as state-level indicators of immigrant integration and criminalization policies (in all 50 states and the District of Columbia).ExposuresImmigrant integration and criminalization policies.Main outcomes and measuresThe main outcome was maternal reports of youth uninsurance status at the time of the American Community Survey interview. Variation in youth uninsurance by maternal citizenship, state immigrant integration policy context, and state immigrant criminalization policy context were examined. All analyses were conducted with weighted survey data.ResultsOf the 226 691 US-born Latino youths (115 431 [50.92%] male; mean [SD] age, 7.66 [4.92] years) included in the study, 36.64% (95% CI, 36.21%-36.92%) had noncitizen mothers. Overall, 7.09% (95% CI, 6.78%-7.41%) of noncitizen mothers reported that their youths were uninsured compared with 4.68% (95% CI, 4.49%-4.88%) of citizen mothers. Of uninsured youths who resided in states with a low level of immigrant integration policies, 9.10% (8.22%-10.06%) had noncitizen mothers and 4.75% (95% CI, 4.19%-5.37%) had citizen mothers; of uninsured youths who resided in states with high criminalization policies, 9.37% (95% CI, 8.90%-9.87%) had noncitizen mothers and 5.91% (95% CI, 5.64%-6.20%) had citizen mothers. In states with few immigrant integration policies, the probability of uninsurance among youths with noncitizen mothers was 3.3% (95% CI, 2.3%-4.4%) higher than that among youths with citizen mothers. Among youths with noncitizen mothers, the difference in the probability of uninsurance between those residing in states with a low level vs a high level of immigrant integration policies was 2.1% (95% CI, 0.6%-3.6%). Among youths residing in states with high levels of immigrant criminalization policies, those with noncitizen mothers had a 2.6% (95% CI, 1.9%-3.0%) higher probability of being uninsured compared with those whose mothers were citizens. Among youths with noncitizen mothers, the difference in the probability of uninsurance between those who resided in a state with a low level vs a state with a high level of immigrant criminalization policies was 1.7% (95% CI, 0.7%-2.7%).Conclusions and relevanceThe findings of this cross-sectional study suggest that among US-born Latino youths, disparities in uninsurance by maternal citizenship are associated with state-level immigrant integration and criminalization policies and that anti-immigrant policies may be associated with disparities in health care access for US-born Latino youths.

Project description:Introduction Opioid overdose deaths in the United States have climbed sharply over the past two decades. Simultaneously, increased awareness of inadequately treated chronic pain has resulted in increased opioid analgesic prescribing. The correlation between these two phenomena has led policymakers to posit that they are causally linked, and to implement policy changes supporting safe opioid prescribing. Purpose To evaluate the impact of its Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS) program, the US Food and Drug Administration (FDA) requested the opioid manufacturers responsible for implementing that program provide information regarding opioid policy changes from 2016 to 2018. FDA also requested a survey of state requirements for pain and opioid prescribing continuing education (CE), the number of prescribers affected by those requirements, the extent to which a REMS-compliant CE program would meet each state’s requirements, and the number of relevant CE programs available. Results Results indicate that 527 federal and state opioid-related policies (statutes, rules/regulations, and guidelines) were approved during the 2016–2018 study period. While the largest number of these policies focused on prescription drug monitoring programs, 170 specifically imposed limits on opioid prescribing and an additional 35 specifically referred to, or incorporated, the Centers for Disease Control and Prevention opioid prescribing guideline. We also found that 46 states and the District of Columbia mandated some amount of pain or opioid prescribing CE for prescribers renewing their licenses. These mandates potentially affected as many as 1.7 million prescribers. In 69% of cases, a REMS-compliant CE program would fully meet the state mandates for various types of prescribers. Conclusion The severity and complexity of the problems of pain management and opioid overdose have led to large-scale intervention by policymakers. Assessing the impact of these changes is difficult, at best, but will be necessary if interventions are to be refined to increase their effectiveness.

Dataset Information

Federal, State, and Local Immigrant-Related Policies and Child Health Outcomes: a Systematic Review.

Publications

Federal, State, and Local Immigrant-Related Policies and Child Health Outcomes: a Systematic Review.

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