The Public Health Implications of Aggressive Immigration Enforcement

• In Event: Immigration Enforcement as a Public Health Crisis: Spillover Effects Across Health Systems and Communities

Abstract

In late May 2025, the United States federal government (specifically, law enforcement agencies such as Immigration and Customs Enforcement (ICE), Customs and Border Patrol (CBP) and others) began an aggressive campaign of immigration raids and detentions in and around Los Angeles. Recent legal decisions (e.g., Noem v. Vasquez Perdomo, 2025) have authorized officers to stop individuals they suspect are in the United States illegally, including in instances where officer suspicion is based on physical appearance, speaking Spanish, or work in low-income employment – factors considered by many to be aspects of racial and ethnic profiling. Several of these encounters have led directly to hospitalizations and fatalities; however, research on the social determinants of health and legal socialization suggest that the effects of aggressive law enforcement activity extend beyond the individuals directly engaged by federal agents in ways that are challenging to measure. Anticipatory stress mechanisms may undermine the health not only of those whose immigration status places them at risk of detention or deportation, but others in targeted communities, as well as immigrants with legal authorization and US-born Latinos at risk of being profiled for their ethnic identity, use of Spanish, or accented English. Furthermore, theories of system avoidance suggest that individuals at risk of legal entanglements limit their involvement with record-keeping institutions, including doctors’ offices and other healthcare providers. If system-avoidant individuals forego routine primary and preventative care, health conditions that might have been easily addressed at early stages may advance to the point that they manifest as health emergencies. Although the net impacts of physical injury, anticipatory stress, and system avoidance on healthcare utilization are theoretically ambiguous, we hypothesize that emergency department (ED) visits, a particularly costly and precarious form of healthcare utilization, will ultimately increase in the communities most affected by aggressive immigration enforcement. We test this hypothesis using a novel dataset that combines monthly data on hospital-level ED admissions across greater Los Angeles (Los Angeles, Ventura, Orange, Riverside, and San Bernardino Counties) with crowd-sourced, incident-level reports of immigration enforcement activity curated from an independent local media source that has garnered national recognition for its coverage. We focus specifically on the period from June to December 2025, the period immediately following the onset of increased immigration enforcement activity, and adopt a Difference-in-Differences approach to test the association between local ICE activity and ED visits. Data curation is ongoing, and analyses to date identify 138 hospitals across the five-county area. By November we anticipate having estimates of the extent to which ED activity is impacted by ICE activity at both the Census tract and Hospital Service Area (HSA) levels.

Author

• Amanda Geller, University of California, Irvine
  Presenting Author