Title: The effect of anti-immigrant climate on cardiovascular disease risk profiles of immigrant and US-born Latinos
Description: Sociopolitical and economic factors shape the lived experience of immigrants and subsequent US-born generations. Often marked by immigrant-related federal and subfederal (i.e., state, county, and city) government policies, but also inclusive of public sentiment toward immigrants, an anti-immigrant climate limits Latino immigrants’ and US-born Latinos’ access to pro-health resources and services, keeps them in a lower socioeconomic position, increases their exposure to interpersonal and structural discrimination, and directly and indirectly exposes them to acute and chronic stressors that can take a toll on their cardiovascular health. The objective of this dissertation is to examine the association between anti-immigrant climate, first defined using policies and then defined using anti-Latino immigrant sentiment, and a panel of traditional and non-traditional cardiovascular disease risk factors among immigrant and US-born Latino adults living in the United States. This dissertation is organized into five sections: 1) an introduction, 2) a systematic review and critical analysis of the literature on US federal and subfederal policies and physical and mental health outcomes among Latino adults, 3) an empirical study of subfederal immigrant-related policies enacted in 2007 and their association with a panel of cardiovascular disease risk factors among Latino adult participants in the National Health Interview Survey, 4) an empirical study of anti-Latino immigrant sentiment during the 2016 Presidential campaign and election and a panel of incident cardiovascular disease risk factors in a cohort of Latino participants of the Hispanic Community Health Survey/Study of Latinos, and 5) a discussion of findings and implications for future research.

The systematic review did not identify any studies of immigrant-related policies and traditional cardiovascular disease health condition risk factors of obesity, hypertension, high cholesterol, or diabetes. Exclusionary policies were associated with poor mental health and poor self-rated health and no relationship between policies and adverse birth outcomes was observed. In the empirical study of subfederal immigrant-related policies, I did not observe a statistically significant association between exposure to exclusionary policy climates in 2007 and a greater increase in the prevalence of cardiovascular disease risk factors relative to exposure to neutral/inclusive policy climates. Although no statistically significant difference-in-differences were observed, Latinos living in exclusionary states had a statistically significant increase in the prevalence of high alcohol consumption one year after exposure, while the prevalence remained unchanged among Latinos living in neutral/inclusive states.

This increase was reflective of increases among foreign-born Latinos, not US-born Latinos. In the empirical study of anti-Latino immigrant sentiment during the 2016 Presidential campaign and election, findings from models of high depressive symptoms suggested that among Latinos of Mexican and Central American background, the exposed were more likely to have incident high depressive symptoms than the unexposed. Findings also suggested an association between exposure status and incident current alcohol use, particularly among the foreign-born. An inverse association between exposure and risk of hypertension was observed, with further differences by duration of US residence. Patterns for alcohol consumption across both empirical studies suggest that future studies should continue to explore the effect of anti-immigrant climate on acute changes in alcohol consumption among Latinos in the US. Additionally, findings from the systematic review and the second empirical study also support the continued study of the relationship between anti-immigrant climate and mental health outcomes.

As the sociopolitical climate of the US becomes increasingly harsh toward Latino immigrants and their families, studies should examine other health outcomes in order to understand which dimensions of health are affected by exposure to an anti-immigrant climate among one of the largest ethnic populations in the US.