rapid response survey -...
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RapidResponseSurvey:HealthImpactsofFederalImmigrationPolicy
InitialFindings,May2017
Meileen Acosta,Epidemiologist.SolanoCountyPublicHealth.Mdacosta@solanocounty.comWillDominie,PolicyManager.BARHIIandthePublicHealthAllianceofSouthernCalifornia.WDominie@PHASoCal.org
• RapidlyChangingNationalConversation• IncreasedUncertainty• SteppedupICEEnforcement• ReportsofICEatHealth/SocialServiceLocations
• ProposalsforBorderWall• ThreatstoSanctuaryCityFunding• Muslim/RefugeeBan• Xenophobic/RacistViolence
PolicyContext
• ProgramParticipationDataAnalysis(WIC,etc.)
• InterviewswithImmigrantServingOrganizations
• RapidResponseSurvey
BARHII/AllianceActions
• Rapid,Policy-DrivenDataCollection• BuildonStaffKnowledgeandExperiencewiththeCommunity
• ShareBARHII/AllianceEfforts• ResultsInform:• InternalPractice• PolicyAdvocacy
SurveyGoals
• Meantasainitial,rapid,qualitativeassessment
• Notascientificrepresentativesample• Conveniencesurveywithself-selectedparticipation
• Willbeaccompanied/followedbyquantitativeanalysis
Limitations
ProgramTypesClinical
• Clinics/FQHCs• Pediatrics• Medi-Cal
PublicHealth• MentalHealth• Lead• DrugandAlcohol• Epidemiology• FamilyHealth/Maternal
Health• Immunizations• NeedleExchange• STD/HIV• RapeCrises
SocialServices• WIC• CALWorks and
Employment• CALFresh• CPS• Homelessness
CommunityPartners
N=50
Responses
N=50
N=157
Results:Combined“Have you witnessed or heard from clients that they have been impacted by the new immigration and refugee policy, enforcement and public discussion since November 2016 in the following ways:”
58%
55%
43%
33%
31%
30%
26%
19%
14%
12%
0% 10% 20% 30% 40% 50% 60% 70%
Afraidtocontinueorsignupforpublicprograms,services,and/or…
Increasedfear,stress,orothermentalandemotionalhealthimpacts
Familymembersatriskofdetentionanddeportation
Afraidtoleavethehouseorneighborhood
Afraidtotravel(bycar,transit,orplane)
Dropsinprogramutilizationorparticipation
Atriskoflosinghealthcare
Atriskoflosingjobs/wages
Atriskoflosinghousing
Atriskoflosingothernecessities
ResultsbyRegion“Have you witnessed or heard from clients that they have been impacted by the new immigration and refugee policy, enforcement and public discussion since November 2016 in the following ways:”
56%
52%
41%
26%
26%
25%
26%
18%
12%
11%
66%
62%
46%
56%
48%
44%
24%
24%
20%
12%
0% 10% 20% 30% 40% 50% 60% 70%
Afraidtocontinueorsignupforpublicprograms,services,and/or…
Increasedfear,stress,orothermentalandemotionalhealthimpacts
Familymembersatriskofdetentionanddeportation
Afraidtoleavethehouseorneighborhood
Afraidtotravel(bycar,transit,orplane)
Dropsinprogramutilizationorparticipation
Atriskoflosinghealthcare
Atriskoflosingjobs/wages
Atriskoflosinghousing
Atriskoflosingothernecessities
SouthernCalifornia NorthernCalifornia
WhatAreWeHearing- AccessingServices
“Apatienttoldmeshewasafraidofgoingbacktocountyclinic.Shefeelsfearfulthatbecauseweareagovernmententitywewillturninherinformationandillegalstatustoimmigrationauthorities.Notonlyhasshestoppedseeingourclinic,herspecialist,butalsosheisreluctanttotakeherdaughtertothePediatricsdepartmentforthesamereason.Herdaughterwhoisonly3hashadahistoryofabnormalbloodwork,wassetuptoseeaspecialistforpossibleleukemiaandisrecentlyfainting.”
“Ireceivedacallfromaclientwhomisasinglemotherwith2children.TheclientcalledtorequestcancellationofCalFreshbenefitsforherchildren,statingshefearedreceivingbenefitswouldcreatelegalissuesforherinthefuturewhichcouldresultinherdeportation.Iinformedtheclientherinformationisnotshared,howeverclientinsistedwecancelherCalFreshbenefits.”
WhatAreWeHearing- PreparingforICE“Isawapatientrecentlyataneveningclinicatalocalschoolwhowassufferingfromheadaches.Aninterviewandexamledmetobelievethesewererelatedtostress.Asweexploredsourcesofstressforher,sherevealedthatneithershenorherhusbandaredocumentedbuttheironlychildwasborninthiscountryandis,therefore,acitizen.Shouldtheybedeported,shehasnoideahowshewilldealwithfindingcareforherchildwhois8yearsold.”.
“ThechildrenatourschoolsarrivecryingbecausetheyareafraidthattheirparentsmaybepickedupbyICEagentsandtheywillnotbereturningtoschooltopickthemup.Parentswhoaredroppingorpickinguptheirkidsfromourschoolshavereportedthattheywon'twalktowardstheschooliftheyseeapatrolcarinthevicinityoftheschool.”
WhatAreWeHearing- MentalHealth
“OneoutreachclientthatwasactivelyinterestedinengaginginMentalHeathServicespriortotheelection,whoisnowsoafraidtoleavetheirhousethattheyhavecutoffallcontactwithgovernmentagenciesforfearofbeingthoughtofasillegal(sic)becausetheyare"brown,"andaremarriedtosomeonewhoisinfactillegal. Theyareworriedaboutdrawingattentiontotheirspouseasillegal,sotheywon'tengageinanythingthatcouldrequirepersonalinformationtobeshared/registered.”
“We'vebeenseeingmorechildrenaffectedemotionallybythefearthattheirparentsorthemselveswillgetdeported.We'veseeninincreaseinpsychosomaticsymptoms(i.e.sleepdisturbances,headaches,stomachaches,tiredness,nausea)andanxiety/fearsincrease.”
WhatAreWeHearing- IsolationandFear“I’vehadseveralclientswhodonotwanttocomeoutoftheirhomestodosimplelivingroutines.Ithasbecomedifficulttogoshoppingforfoodsthattheyneedduetobeingscaredthattheywillbesubjectedtoracialprofilingthatmayleadthemtobeingheldup.”
“Ihaveanundocumentedpatientwhohasadiagnosisthat'shighrisktopublichealth.He'sadaylaborerand,sometimes,duetofearhe'llbecaughtanddeported,he'llforgogoingtowork.Lostwagesrenderhimunabletosupporthimselfandhisspouse.”
DataIntoAction:NextSteps
Suggestions?
• PublicHealthAwakenedhaspreparedthisguideforpublichealthdepartmentswishingtosupportimmigrantcommunities:http://publichealthawakened.com/guide-for-public-health-to-protect-immigrant-rights/
• TheNationalImmigrationLawCenterjustputtogetheranexcellentguideforhealthcareproviderswhichwasaccompaniedbyarecordedwebinarandslides.
• Guide:https://www.nilc.org/wp-content/uploads/2017/04/Protecting-Access-to-Health-Care-2017-04-17.pdf
• Recording:https://attendee.gotowebinar.com/recording/viewRecording/516256275702666498/4325227337731450370/sara@humanimpact.org
• Slides:https://www.nilc.org/wp-content/uploads/2017/04/NILC-Health-KYR-Webinar-20170424.pdf
• CaliforniaHealthAdvocateshasputtogetherthesefrequentlyaskedquestions:https://d3n8a8pro7vhmx.cloudfront.net/capca/pages/62/attachments/original/1494018311/2017_05_04_CPCA_Immigrant_Patient_FAQs.pdf?1494018311
• SanFranciscoandSanMateohavemadepublictheir detailedinstructionstostaffininteractionswithICE:• https://www.sfdph.org/dph/files/PoliciesProcedures/COM10-
ImmigrationStatusInteractionsWithICE_Agents_Policy.pdf• http://barhii.org/wp-content/uploads/2017/03/SanMateoMessagetoStaff.pdf
Resources
• Meileen Acosta,Epidemiologist.SolanoCountyPublicHealth.Mdacosta@solanocounty.com
• WillDominie,PolicyManager.BARHIIandthePublicHealthAllianceofSouthernCalifornia.WDominie@PHASoCal.org
Contact
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