Public health impact of local immigration enforcement policies: Assessing barriers to health services among immigrant latinos in North Carolina

Background: Little is known about the public health impact of local immigration enforcement policies such as the 287(g) and Secure Communities programs. We sought to understand how immigration enforcement affects use of public health services and to identify next steps to address barriers to services among immigrant Latinos in North Carolina (NC).

Methods: We conducted six focus groups and 17 interviews with Latino adults across NC to explore the impact of immigration policies on their use of public health services. We also analyzed vital records data to determine whether prenatal care use by Latinas was affected by local implementation of 287(g). Finally, we conducted an empowerment-based forum with public health leaders to discuss findings and develop recommendations to translate knowledge into action.

Results: Participants reported little utilization of services, confusion about eligibility, and a paralyzing fear that jeopardized their physical and mental health overall. We found no statistically significant differences in use of prenatal care before and after implementation of 287(g) but did find that, compared to non-Latinas, Latinas seek prenatal care later, have fewer visits, and are less likely to receive any care. Over 90 public health leaders from 13 counties, including public health personnel, providers, community members, organizational representatives, and academic researchers, participated in the forum.

Conclusions: Clear examples emerged of how immigration enforcement policies negatively impacted the health of Latinos including children, and fear was generalized across counties. The community forum initiated statewide dialogue and collaboration to address the public health impact of local immigration enforcement.