Between the lines: A mixed-methods study on the impacts of parental deportation on the health and well-being of U.S. citizen children.

Objective: To explore the impacts of parental deportation on the health and well-being of U.S. citizen children of Mexican immigrants. Methods: From 2019-2020, this ambi-directional cohort study recruited U.S.-based families with an undocumented Mexican immigrant parent and U.S.-citizen childrens (ages 13-17) recently exposed to parental deportation (N = 61), and similar families without a history of parental deportation (N = 51). Children health, behavioral, economic, and academic outcomes were measured via phone surveys upon enrollment and six months later. A subsample of "exposed" caregivers (N = 14) also completed in-depth semi-structured interviews. Data were analyzed using fixed-effects regression models and thematic analyses. Results: Childrens exposed to parental deportation had significantly worse health status, behavioral problems, material hardship, and academic outcomes than children in the control arm (p<.05). Caregivers' interviews illustrated these health, behavioral, academic and family impacts. Conclusions: Parental deportations have wide and potentially long-lasting health, behavioral, economic, and academic consequences for U.S. citizen youth. Changes in immigration policies and enforcement practices are urgently needed to protect the unity of mixed-legal status families in the U.S. and prevent the suffering of U.S. children in these families.

Immigration enforcement and the institutionalization of elderly Americans.

This paper examines the relationship between immigration enforcement and institutionalization rates of the elderly. Exploiting the staggered implementation of the Secure Communities (SC) immigration enforcement program across U.S. counties from 2008 through 2014, we show that SC led to a 0.26 percentage points (6.8 percent) increase in the likelihood that Americans aged 65 and above live in an institution. Supportive of supply shocks in the household services market as a central mechanism, we find that the elderly who are most likely to purchase domestic worker services are also the most likely to move into nursing homes following the implementation of SC. Additionally, we find suggestive evidence of significant reductions in the work hours of housekeepers, personal care aides, and home health workers hinting at the critical role of negative supply shocks in occupations that facilitate aging in community.

The next phases of the Migrante Project: Study protocol to expand an observatory of migrant health on the Mexico-U.S. border.

Background: Mexican migrants traveling across the Mexico-United States (U.S.) border region represent a large, highly mobile, and socially vulnerable subset of Mexican nationals. Population-level health data for this group is hard to obtain given their geographic dispersion, mobility, and largely unauthorized status in the U.S. Over the last 14 years, the Migrante Project has implemented a unique migration framework and novel methodological approach to generate population-level estimates of disease burden and healthcare access for migrants traversing the Mexico-U.S. border. This paper describes the rationale and history of the Migrante Project and the protocol for the next phases of the project. Methods/design: In the next phases, two probability, face-to-face surveys of Mexican migrant flows will be conducted at key crossing points in Tijuana, Ciudad Juarez, and Matamoros (N = 1,200 each). Both survey waves will obtain data on demographics, migration history, health status, health care access, COVID-19 history, and from biometric tests. In addition, the first survey will focus on non-communicable disease (NCD), while the second will dive deeper into mental health and substance use. The project will also pilot test the feasibility of a longitudinal dimension with 90 survey respondents that will be re-interviewed by phone 6 months after completing the face-to-face baseline survey. Discussion: Interview and biometric data from the Migrante project will help to characterize health care access and health status and identify variations in NCD-related outcomes, mental health, and substance use across migration phases. The results will also set the basis for a future longitudinal extension of this migrant health observatory. Analyses of previous Migrante data, paired with data from these upcoming phases, can shed light on the impact of health care and immigration policies on migrants' health and inform policy and programmatic responses to improve migrant health in sending, transit, and receiving communities.

Safe-zone schools and the academic performance of children in mixed-status households: Evidence from the 'between the lines' study.

In response to the intensification of immigration enforcement in the interior of the USA, some school districts have implemented 'safe-zone' policies to protect students' academic progression and well-being. Using primary data from a sample of US-born children of unauthorized migrants, we document the detrimental effect of stricter immigration enforcement on children's educational outcomes and the benefits of safe-zone policies. Our analyses show that restricting immigration authorities' access to schools and providing counseling on immigration-related issues are crucial policy components in strengthening children's focus, effort, expectations, parental involvement, and relationships. These findings highlight the damaging impact of immigration enforcement on US-citizen children in mixed-status households and advance our understanding of the role of local policies in mitigating these effects.

Schooling and Parental Labor Supply: Evidence from COVID-19 School Closures in the United States.

This article examines changes in parental labor supply in response to the unanticipated closure of schools following the onset of the COVID-19 pandemic in the United States. The authors collect detailed daily information on school closures at the school-district level, which they merge to individual-level data on labor supply and sociodemographic characteristics from the monthly Current Population Survey spanning from January 2019 through May 2020. Using a difference-in-differences estimation approach, the authors find evidence of non-negligible labor supply reductions. Having a partner at home helped offset the negative effect of school closures, particularly for maternal employment, although respondents' job traits played a more significant role in shaping labor supply responses to school closures. Overall, the labor supply impacts of school closures prove robust to identification checks and to controlling for other coexistent social distancing measures. In addition, these early school closures seem to have had a long-lasting negative impact on parental labor supply.

Health Care and Education Access of Transnational Children in Mexico.

Between 2001 and 2018, more than 5.5 million Mexican migrants were removed from the United States or returned to Mexico with their families as immigration enforcement escalated. Learning how this transition affected their children-also referred to as "the invisibles"-is a policy-relevant topic for both the United States and Mexico. Using representative data on 7.6 million Mexican- and U.S.-born children from the 2015 Mexican Intercensal Survey, we provide evidence of the gaps in access to education and health care between these two groups and of the factors potentially responsible for the existing barriers. Relative to children born in Mexico, U.S.-born children are at a considerable disadvantage in terms of health care access, but less so in terms of education. Lack of a Mexican-issued birth certificate is among the persistent factors responsible for the gaps in services. Policies aimed at changing the approach to immigration enforcement in the United States, lessening paperwork requirements in Mexico, and easing access to documentation in both countries could improve transnational children's access to basic services, as well as their present and long-term well-being.

Reforming the provision of cross-border medical care: Evidence from Spain.

Cross-border medical care, defined as care facilitated by a local health provider under pre-established regional agreements, as in the case of European Union (EU) citizens accessing care within EU countries, has been on the rise. Unlike medical tourism, typically sought by patients through their own volition and paid for out-of-pocket, cross-border medical care is often reimbursable or paid for directly by the responsible government. Yet, because nations vary in the extent of health coverage offered to their residents, these expenditures are often only partially reimbursed. The resulting financial burden for some countries can be large and not reciprocal, straining regional and country-level finances. We analyze the effectiveness of a legislative measure adopted by a Spanish region in January 2012 with the purpose of curbing cross-border medical care. Using a comprehensive administrative dataset of all medical procedures performed in the country between 2008 and 2015, we find that the measure led to a drastic drop in the number of foreigners' hospitalizations and a reduction of 4.8 million euros/trimester in costs. Finally, the decrease in hospitalizations did not disproportionally affect patients based on their gender, age, or origin, although it fostered a reduction in readmissions.

Timing of social distancing policies and COVID-19 mortality: county-level evidence from the U.S.

Using county-level data on COVID-19 mortality and infections, along with county-level information on the adoption of non-pharmaceutical interventions (NPIs), we examine how the speed of NPI adoption affected COVID-19 mortality in the United States. Our estimates suggest that adopting safer-at-home orders or non-essential business closures 1 day before infections double can curtail the COVID-19 death rate by 1.9%. This finding proves robust to alternative measures of NPI adoption speed, model specifications that control for testing, other NPIs, and mobility and across various samples (national, the Northeast, excluding New York, and excluding the Northeast). We also find that the adoption speed of NPIs is associated with lower infections and is unrelated to non-COVID deaths, suggesting these measures slowed contagion. Finally, NPI adoption speed appears to have been less effective in Republican counties, suggesting that political ideology might have compromised their efficacy.

Early adoption of non-pharmaceutical interventions and COVID-19 mortality.

To contain the spread of the COVID-19 pandemic, many countries around the globe have adopted social distancing measures. Yet, establishing the causal effect of non-pharmaceutical interventions (NPIs) is difficult because they do not occur arbitrarily. We exploit a quasi-random source of variation for identification purposes -namely, regional differences in the placement on the pandemic curve following an unexpected and nationwide lockdown. Our results reveal that regions where the outbreak had just started when the lockdown was implemented had 1.62 fewer daily deaths per 100,000 inhabitants when compared to regions for which the lockdown arrived 10+ days after the pandemic's outbreak. As a result, a total of 4,642 total deaths (232 deaths/daily) could have been avoided by the end of our period of study -a figure representing 23% of registered deaths in Spain at the time. We rule out differential pre-COVID mortality trends and self-distancing behaviors across the compared regions prior to the swift lockdown, which was also uniformly observed nationwide. In addition, we provide supporting evidence for contagion deceleration as the main mechanism behind the effectiveness of the early adoption of NPIs in lowering the death rate, rather than an increased healthcare capacity.

The determinants of immigrant health insurance in the United States: Understanding the role of health care in origin societies.

We examine how immigrants' health insurance in the United States is shaped by institutional traits of the health care systems in their origin societies. Conditional on a wide range of individual, country-of-origin, state-level, and temporal controls, we find the affordability of health care back home helps explain immigrants' US health coverage. Specifically, low- and middle-income migrants from countries with less affordable health care are more likely to get private insurance once in the United States and, correspondingly, less likely to have public coverage, relative to migrants from countries with more affordable care. The relationship conforms to multiple hypotheses. As predicted by the institutional beliefs hypothesis, migrants from countries with less affordable care might anticipate equally expensive health services in the United States and, in turn, insure themselves against high medical bills. Likewise, as predicted by the endogenous preferences hypothesis, migrants from countries with less affordable care might be accustomed to paying more for health care and, in turn, be less reluctant to pay for private health insurance. Overall, the findings underscore the relevance of migrants' past health care experiences in their origin societies in informing their health insurance in the United States even years after migration.

Health Profile and Health Care Access of Mexican Migration Flows Traversing the Northern Border of Mexico.

BACKGROUND: The health of Latino migrants is most often studied with samples of immigrants settled in the United States or returned migrants in Mexico. We examine health outcomes and health care access of Mexican migrants traversing the Mexican border region to gain a better understanding of migrant health needs as they transition between migration phases. METHODS: We used data from a 2013 probability survey of migrants from Northbound and Southbound migration flows in Tijuana, Mexico (N=2412). Respondents included Northbound migrants with and without US migration experience, Southbound migrants returning home from the United States or the Mexican border region, and migrants returning to Mexico via deportation. Descriptive statistics and regression models were estimated to characterize and compare their health status, behavioral health, and health care access across migration phases. RESULTS: Northbound migrants with US migration experience, Southbound migrants from the United States, and deported migrants had worse levels of health insurance, health care utilization, and diabetes than Northbound migrants without US migration experience. Southbound migrants returning from the border reported worse self-rated health and deportees had higher odds of reported substance use compared with Northbound migrants without US migration experience. CONCLUSIONS: Mexican migrants' health profile and health care access vary significantly across migration flows and generally are worse for migrants with US migration experience. The results add to our understanding of Mexican migrant health along the migration continuum and can inform services in sending, receiving, and intermediate communities.

Deporting "Bad Hombres"? The Profile of Deportees under Widespread versus Prioritized Enforcement.

U.S. President Trump's administration has vowed to boost immigration enforcement to get rid of "bad hombres," or undocumented immigrants with criminal records. Using past data on the alleged detention motives for a representative sample of Mexican deportees, we evaluate how prior widespread and prioritized enforcement has fared in that regard. We find that while the early sweeping approach to enforcement raised deportees' propensity of being detained for minor offenses, the trend reversed with prioritized enforcement. These findings inform policy tactics that, aside from proving effective in prioritizing serious criminal offenses, can also lead to significant savings to taxpayers.

Correction to: Interior Immigration Enforcement and Political Participation of U.S. Citizens in Mixed-Status Households.

Ruggles, S., Genadek, K., Goeken, R., Grover, J., & and Sobek, M. (2017). Integrated Public Use Microdata Series: Version 7.0 [Data set]. Minneapolis: University of Minnesota. https://doi.org/10.18128/D010.V7.0.

Interior Immigration Enforcement and Political Participation of U.S. Citizens in Mixed-Status Households.

The 2000s have witnessed an expansion of interior immigration enforcement in the United States. At the same time, the country has experienced a major demographic transformation, with the number of U.S. citizens living in mixed-status households-that is, households where at least one family member is an unauthorized migrant-reaching 16 million. U.S. citizens living in mixed-status households are personally connected to the struggles experienced by their unauthorized family members. For them, immigration policy is likely to shape their current and future voting behavior. Using data from the 2002-2014 Current Population Survey Voting and Registration Supplements, we examine whether intensified immigration enforcement has affected the political engagement of U.S. citizens living in mixed-status households. We find that immigration enforcement has chilled their electoral participation by lowering their propensity to register by 5 %; however, it has not visibly affected their voting propensity among those registered. Importantly, their lower voting registration likelihood does not seem to reflect indifference for community and public matters, given that it has been accompanied by greater involvement in civic forms of political participation, such as volunteering. Understanding how immigration policy affects the political participation of a fast-growing segment of the electorate is imperative because they will inevitably constitute a rapidly rising political force in future elections.

Access to Health Care among Mexican Migrants and Immigrants: A Comparison across Migration Phases.

OBJECTIVES: We examined differences in, and factors associated with, access to health services among Mexican im/migrants to the U.S. across migration phases, including pre-departure, destination, interception, and return. METHODS: Using data from a cross-sectional survey conducted in Tijuana, Mexico (N = 1,541), we computed descriptive statistics and staged logistic regressions to estimate health care access indicators and factors associated with access to services. RESULTS: Im/migrants at post-migration phases had lower likelihood of receiving health care and having a usual source of care, and higher rates of forgone care, than their counterparts at pre-departure. These differences were partly explained by length of migration phase, health insurance status, transportation barriers, and detention or imprisonment. CONCLUSIONS: Mexican im/migrants face challenges in accessing health services across the migration continuum, especially at post-migration phases. Binational efforts to provide affordable insurance coverage and reduce transportation limitations and incarceration could contribute to improving health care access among Mexican im/migrants.

Schooling and Labor Market Effects of Temporary Authorization: Evidence from DACA.

This paper explores the labor market and schooling effects of the Deferred Action for Childhood Arrivals (DACA) initiative, which provides work authorization to eligible immigrants along with a temporary reprieve from deportation. The analysis relies on a difference-in-differences approach that exploits the discontinuity in program rules to compare eligible individuals to ineligible, likely undocumented immigrants before and after the program went into effect. To address potential endogeneity concerns, we focus on youths that likely met DACA's schooling requirement when the program was announced. We find that DACA reduced the probability of school enrollment of eligible higher-educated individuals, as well as some evidence that it increased the employment likelihood of men, in particular. Together, these findings suggest that a lack of authorization may lead individuals to enroll in school when working is not a viable option. Thus, once employment restrictions are relaxed and the opportunity costs of higher-education rise, eligible individuals may reduce investments in schooling.

Immigration Enforcement, Parent-Child Separations, and Intent to Remigrate by Central American Deportees.

Given the unprecedented increase in the flow of migrants from El Salvador, Guatemala, and Honduras to the United States, this article analyzes the impact of U.S. interior enforcement on parent-child separations among Central American deportees, along with its implications for deportees' intentions to remigrate to the United States. Using the EMIF sur survey data, we find that interior enforcement raises the likelihood of parent-child separations as well as the likelihood that parents forcedly separated from their young children report the intention to return to the United States, presumably without documents. By increasing parent-child separations, interior enforcement could prove counterproductive in deterring repetitive unauthorized crossings among Central American deportees.

Healthcare access among circular and undocumented Mexican migrants: results from a pilot survey on the Mexico-US border.

BACKGROUND: Temporary and unauthorized migrants may face unique obstacles to access health care services in the U.S. OBJECTIVE: This study estimated levels of health care access among Mexican migrants returning to Mexico from the U.S. and factors associated with access to health care, with emphasis on the role of modifiable, enabling factors. METHODS: We conducted a pilot probability health care survey of migrants in the border city of Tijuana, Mexico (N=186). RESULTS: Approximately 42% of migrants reported having used health care services in the U.S. during the past year. Only 38% had a usual source of care and approximately 11% went without needed medical care in the U.S. About 71% of migrants did not have health insurance in the U.S. Lack of health insurance and transportation limitations were significantly related to various access indicators. CONCLUSION: These results have implications for future policies and programs aimed to address modifiable health care access barriers faced by these vulnerable and underserved segments of the Mexican migrant population.

On the intended and unintended consequences of enhanced U.S. Border and interior immigration enforcement: evidence from Mexican deportees.

Since about 2000, a number of federal and state policies have been implemented in the United States with the intention of stemming the flow of illegal immigration. In this article, we focus on two initiatives: (1) Operation Streamline, as an example of increased border enforcement by the federal government; and (2) state-level omnibus immigration laws, as an illustration of enhanced interior enforcement by state governments. We investigate whether these policies have reduced the intentions of deported Mexican immigrants to attempt a new unauthorized crossing. Although state-level omnibus immigration laws reduce the proportion of deportees intending to attempt a new crossing, increased border enforcement has proven to be far less effective. In addition, we ascertain the human costs associated with these policies. Our findings are mixed in this regard. Noteworthy is how the adoption of more stringent interior enforcement seems to result in a "herding" or "ganging-up" effect, whereby the incidence of verbal and physical abuse rises with the number of states enacting such measures. Additionally, our estimates suggest that deportees are more likely to respond that they have risked their lives to cross into the United States as a result of enhanced border enforcement.