Local Variation in Immigrant Demographic Growth and County Policy Responses: Understanding Immigrant Integration Efforts and their Implications for Health Equity

This presentation discusses the health policy response of local government, in particular, cities and counties, to population changes in their communities. Since the 1990s, new population trends in immigrant and refugee migration have affected non-traditional gateway states, such as Georgia, Minnesota, Nevada, and North Carolina. During this same time, we have seen national policy disinvest in federally funded health care for immigrants and devolve that authority and responsibility to states and local governments. Additionally, the lack of a national comprehensive immigration reform plan has forced states and localities to take immigrant related matters into their own hands. As a result, local governments are facing new challenges in trying to address the public health and welfare needs of their communities.

Drawing from various disciplines (political science, demography and public health) this study first examines the variation of demographic trends in immigration at the state and county levels. Second, we introduce a framework for analyzing and understanding local policy responses based on case studies of eight counties. Findings from this research are important to policy makers, researchers and health equity advocates in understanding of the role of local governments in health policy making, the impact of immigration on localities, and potential solutions for eliminating health inequalities.