Deferred DREAMs: Health consequences of immigration policy

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Protesters hold up signs during a rally supporting Deferred Action for Childhood Arrivals outside the White House on September 5, 2017.

Less than a month ago at a Philadelphia commemoration of the five-year anniversary of the Deferred Action for Childhood Arrivals (DACA) program, some of the city’s 5,000 DACA recipients described the significant relief of coming out from under the constant threat of deportation.

That relief was short lived.

Just weeks later, on Sept. 5, President Trump returned to one of his most divisive campaign promises — to end the DACA program, bringing back feelings of anxiety and trepidation that had been at least temporarily shelved since they registered with DACA. Although Democratic leaders have met with President Trump to discuss potential legislation, it is not clear what, if anything, will come out of these meetings and the mixed messages from the President only inflame the uncertainty.

In response to the announcement, the media have focused on the extensive contributions of DACA recipients and the significant economic implications of ending the policy. However, another important area has received less attention in media reports —the consequences of immigration policy on the health of immigrants.

Studies have shown a strong link between immigration policies and the mental health and well-being of immigrants, and DACA recipients themselves have pointed to mental health and well-being as their “greatest health concern.”

In Pennsylvania and New Jersey, over 7,000 and 25,000 youth and young adults, respectively, have received DACA, which provides work permits, protection from deportation and — less tangibly — reduced stress and improved mental health.

Both regional and national studies have quantified this boost in mental health by comparing emotional well-being before and after DACA’s implementation, and these studies have shown significant reductions in psychological distress. DACA recipients report being able to move about the community (through access to driver licenses, for example) with less fear of deportation and access important resources for themselves and their families. Thus, it is not surprising that even the young children of DACA recipients have felt these positive effects in the form of large declines in anxiety and stress.

Although improvements in physical health are harder to capture in the short timeframe since the implementation of DACA, we know education and earnings are a predictor of health status. And given the large gains in employment and earnings for DACA recipients, one could expect long-term improvements in physical health to follow. Employment and college enrollment also mediate access to private health insurance coverage and, indeed, almost a third of participants in a United We Dream survey reported having gained coverage, and 21 percent of participants in the National UnDACAmented Research Project (NURP) reported improved access to health care.

While many DACA recipients report less stress and better mental health since the implementation of DACA, the temporary nature of the policy, the exclusions from public benefits and the wide-ranging structural barriers to opportunities mean many resources have remained out of reach. In addition, we must not forget that even with DACA, most recipients still live with the constant fear that their family members could be deported at any moment and nearly half have directly experienced the trauma of deportation within the family.

Rescinding DACA could result in a return to the limbo of no longer being protected from deportation, and those fears will unequivocally increase the toll on emotional and psychological well-being, beyond the distress stemming from the uncertainty of the program’s future.

Immigrant communities are incredibly resilient in the face of tremendous adversity. The very the fact that DACA was implemented is a testament to immigrant-led organizing and advocacy.

Many policymakers have shown their support for a clean Development, Relief, and Education for Alien Minors (DREAM) Act. If these policymakers are truly invested in the well-being of DACA recipients, then they must recognize that permanent, comprehensive solutions are needed — including a clear and attainable path to citizenship for DACA-eligible immigrants, but also for their undocumented family members and the larger undocumented immigrant community. Just as an overwhelming majority of the public supports DACA, 80 percent also support a path to citizenship for the 11-12 million undocumented immigrants in the U.S.

It is now on Congress to act on the will of the public and not defer dreams. But to do this, they need to hear from their constituents. See this helpful guide from the city of Philadelphia on concrete action steps you can take at the local, state, and federal levels.

Jessie Kemmick Pintor, PhD, is an assistant professor at the Dornsife School of Public Health at Drexel University. Alex Ortega, PhD, is a professor of health policy at Drexel.