State-level immigration and immigrant-focused policies as drivers of Latino health disparities in the United States

There has been a great deal of state-level legislative activity focused on immigration and immigrants over the past decade in the United States. Some policies aim to improve access to education, transportation, benefits, and additional services while others constrain such access. From a social determinants of health perspective, social and economic policies are intrinsically health policies, but research on the relationship between state-level immigration-related policies and Latino health remains scarce. This paper summarizes the existing evidence about the range of state-level immigration policies that affect Latino health, indicates conceptually plausible but under-explored relationships between policy domains and Latino health, traces the mechanisms through which immigration policies might shape Latino health, and points to key areas for future research. We examined peer-reviewed publications from 1986 to 2016 and assessed 838 based on inclusion criteria; 40 were included for final review. These 40 articles identified four pathways through which state-level immigration policies may influence Latino health: through stress related to structural racism; by affecting access to beneficial social institutions, particularly education; by affecting access to healthcare and related services; and through constraining access to material conditions such as food, wages, working conditions, and housing. Our review demonstrates that the field of immigration policy and health is currently dominated by a “one-policy, one-level, one-outcome” approach. We argue that pursuing multi-sectoral, multi-level, and multi-outcome research will strengthen and advance the existing evidence base on immigration policy and Latino health.