Rapid Response Survey -...
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RapidResponseSurvey:HealthImpactsofFederalImmigrationPolicy
InitialFindings,May2017
Meileen Acosta,Epidemiologist.SolanoCountyPublicHealth.Mdacosta@solanocounty.comWillDominie,PolicyManager.BARHIIandthePublicHealthAllianceofSouthernCalifornia.WDominie@PHASoCal.org
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• RapidlyChangingNationalConversation• IncreasedUncertainty• SteppedupICEEnforcement• ReportsofICEatHealth/SocialServiceLocations
• ProposalsforBorderWall• ThreatstoSanctuaryCityFunding• Muslim/RefugeeBan• Xenophobic/RacistViolence
PolicyContext
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• ProgramParticipationDataAnalysis(WIC,etc.)
• InterviewswithImmigrantServingOrganizations
• RapidResponseSurvey
BARHII/AllianceActions
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• Rapid,Policy-DrivenDataCollection• BuildonStaffKnowledgeandExperiencewiththeCommunity
• ShareBARHII/AllianceEfforts• ResultsInform:• InternalPractice• PolicyAdvocacy
SurveyGoals
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• Meantasainitial,rapid,qualitativeassessment
• Notascientificrepresentativesample• Conveniencesurveywithself-selectedparticipation
• Willbeaccompanied/followedbyquantitativeanalysis
Limitations
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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
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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
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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
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WhatAreWeHearing- AccessingServices
“Apatienttoldmeshewasafraidofgoingbacktocountyclinic.Shefeelsfearfulthatbecauseweareagovernmententitywewillturninherinformationandillegalstatustoimmigrationauthorities.Notonlyhasshestoppedseeingourclinic,herspecialist,butalsosheisreluctanttotakeherdaughtertothePediatricsdepartmentforthesamereason.Herdaughterwhoisonly3hashadahistoryofabnormalbloodwork,wassetuptoseeaspecialistforpossibleleukemiaandisrecentlyfainting.”
“Ireceivedacallfromaclientwhomisasinglemotherwith2children.TheclientcalledtorequestcancellationofCalFreshbenefitsforherchildren,statingshefearedreceivingbenefitswouldcreatelegalissuesforherinthefuturewhichcouldresultinherdeportation.Iinformedtheclientherinformationisnotshared,howeverclientinsistedwecancelherCalFreshbenefits.”
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WhatAreWeHearing- PreparingforICE“Isawapatientrecentlyataneveningclinicatalocalschoolwhowassufferingfromheadaches.Aninterviewandexamledmetobelievethesewererelatedtostress.Asweexploredsourcesofstressforher,sherevealedthatneithershenorherhusbandaredocumentedbuttheironlychildwasborninthiscountryandis,therefore,acitizen.Shouldtheybedeported,shehasnoideahowshewilldealwithfindingcareforherchildwhois8yearsold.”.
“ThechildrenatourschoolsarrivecryingbecausetheyareafraidthattheirparentsmaybepickedupbyICEagentsandtheywillnotbereturningtoschooltopickthemup.Parentswhoaredroppingorpickinguptheirkidsfromourschoolshavereportedthattheywon'twalktowardstheschooliftheyseeapatrolcarinthevicinityoftheschool.”
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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.”
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WhatAreWeHearing- IsolationandFear“I’vehadseveralclientswhodonotwanttocomeoutoftheirhomestodosimplelivingroutines.Ithasbecomedifficulttogoshoppingforfoodsthattheyneedduetobeingscaredthattheywillbesubjectedtoracialprofilingthatmayleadthemtobeingheldup.”
“Ihaveanundocumentedpatientwhohasadiagnosisthat'shighrisktopublichealth.He'sadaylaborerand,sometimes,duetofearhe'llbecaughtanddeported,he'llforgogoingtowork.Lostwagesrenderhimunabletosupporthimselfandhisspouse.”
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DataIntoAction:NextSteps
Suggestions?
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• 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/[email protected]
• 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
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• Meileen Acosta,Epidemiologist.SolanoCountyPublicHealth.Mdacosta@solanocounty.com
• WillDominie,PolicyManager.BARHIIandthePublicHealthAllianceofSouthernCalifornia.WDominie@PHASoCal.org
Contact