Project Summary/Abstract
Over the past decade, up to 1,000,000 US citizen children have experienced the trauma of parental deportation
and family separation, and an additional 4,000,000 children with undocumented parents face the risk of parental
deportation. These children experience extreme adversity as a result of their parents’ undocumented status. This
adversity will translate to worse health, educational, and economic outcomes across the life course. Immigration
enforcement—the arrest, detention, and deportation of immigrants from the United States—exacerbates these
health risks. Local policies that expand immigrants’ rights and access to services and material resources
(immigrant integration policies) and that limit local government officials’ involvement in immigration enforcement
(sanctuary policies) could be important tools for promoting health for these children. Little evidence exists for the
effectiveness of these policies. The main goal of this study is to evaluate whether local sanctuary and integration
policies improve health care access, physical health, and mental health for children with immigrant parents. A
methodological innovation of this study is the use of a new comprehensive, longitudinal, nationwide database of
state, county, and municipal sanctuary and integration policies, compiled by the research team. This database
will be merged with a nationally-representative sample from the 2005–2019 National Health Interview Survey
consisting of approximately 35,000 US-born children with likely-undocumented, noncitizen parents from Mexico,
El Salvador, Guatemala, and Honduras. This study will use rigorous quasi-experimental methods to test the
following hypotheses: 1) Passage of sanctuary and integration policies is associated with higher levels of health
insurance coverage, better access to preventive medical and dental care, fewer emotional difficulties, better
parent-rated health, and lower rates of disability for children with likely-undocumented parents [Specific Aim 1].
2) Children living in jurisdictions with sanctuary and integration policies will not be as negatively impacted by
immigration enforcement, compared to children living in jurisdictions without such policies [Specific Aim 2]. First,
this study will use a difference-in-differences design to examine whether these outcomes improve when
jurisdictions pass sanctuary and integration policies. Next, a moderation analysis will be conducted to examine
whether the health impacts of immigration enforcement vary across jurisdictions with and without sanctuary and
integration policies. This study will produce rigorous translational research that will help policymakers,
practitioners, and immigrant-serving organizations choose effective policies to promote health equity for
immigrant families. This will be the first study to examine the health impacts of county and municipal policies that
expand immigrants’ rights and limit local involvement in immigration enforcement. This study will also be the first
to examine how immigrant policies at multiple levels interact with immigration enforcement to impact health.
