The Effect of U.S. Health Care Safety Net Clinics on Immigrant Mortality, 1990-2019

• In Event: Immigrant Health - Changing Contexts, Heterogeneity, Resilience, and Selectivity

Abstract

Immigrant health outcomes vary widely across the U.S., in large part due to our historically fragmented and exclusionary social safety net. This study examines the mortality impact of one uniquely immigrant-inclusive federal safety net policy—the Community Health Center (CHC) program—which serves patients regardless of income, insurance, or immigration status. I combine restricted access county-level mortality records with administrative data on the location of CHCs from 1990-2019, along with Census, IPUMS, ACS, and other data sources. Using a staggered difference-in-differences event study design, I find that the CHC program induced sizable reductions in the foreign-born adult mortality rate. Specifically, new CHCs reduced immigrant mortality by an average of 65 per 100,000 immigrant adults, which equates to a two-percent average annual reduction in immigrant mortality in treated counties since 1990. In a broader context of exclusion and medical legal violence toward immigrants, this study highlights the potential for inclusive safety net policy to improve immigrant health.

Author

• Emily Parker, Rutgers University-New Brunswick