Association Between Health Care Utilization and Immigration Enforcement Events in San Francisco

Vasil Yasenov | Jens Hainmueller | Michael Hotard | Duncan Lawrence | Laura Gottlieb | Jacqueline Torres
JAMA Network Open

Prior research has documented an association between decreased health care utilization and immigration enforcement in Alabama and Arizona. We did not find systematic evidence of an association between enforcement events and changes in utilization among patients with potentially undocumented immigration status in San Francisco. This suggests that a local environment with inclusive health care policies may mitigate the consequences of immigration enforcement actions. Study limitations include selection bias due to the clinical sample, the use of proxies for immigration status, and lack of power to evaluate specific reasons for clinical presentation (eg, acute stress). Future research should examine this question in a broader set of communities with varying degrees of health care policy inclusiveness and could more deeply explore the racialized nature of immigration enforcement and health consequences for Hispanic patients.