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{
    "pk": 14627,
    "title": "Anti-immigrant Rhetoric and the Experiences of Latino Immigrants in the Emergency Department",
    "subtitle": null,
    "abstract": "Introduction:\n Anti-immigrant rhetoric and increased enforcement of immigration laws have induced worry and safety concerns among undocumented Latino immigrants (UDLI) and legal Latino residents/citizens (LLRC), with some delaying the time to care.1 In this study, we conducted a qualitative analysis of statements made by emergency department (ED) patients – a majority of whom were UDLI and LLRC – participating in a study to better understand their experiences and fears with regard to anti-immigrant rhetoric, immigration enforcement, and ED utilization.\nMethods: \nWe conducted a multi-site study, surveying patients in three California safety-net EDs serving large immigrant populations from June 2017–December 2018. Of 1684 patients approached, 1337 (79.4%) agreed to participate; when given the option to provide open-ended comments, 260 participants provided perspectives about their experiences during the years immediately following the 2016 United States presidential election. We analyzed these qualitative data using constructivist grounded theory.\nResults:\n We analyzed comments from 260 individuals. Among ED patients who provided qualitative data, 59% were women and their median age was 45 years (Interquartile range 33-57 years). Undocumented Latino immigrants comprised 49%, 31% were LLRC, and 20% were non-Latino legal residents. As their primary language, 68% spoke Spanish. We identified six themes: fear as a barrier to care (especially for UDLI); the negative impact of fear on health and wellness (physical and mental health, delays in care); factors influencing fear (eg, media coverage); and future solutions, including the need for increased communication about rights.\nConclusion:\n Anti-immigrant rhetoric during the 2016 US presidential campaign contributed to fear and safety concerns among UDLI and LLRC accessing healthcare. This is one of the few studies that captured firsthand experiences of UDLI in the ED. Our findings revealed fear-based barriers to accessing emergency care, protective and contributing factors to fear, and the negative impact of fear. There is a need for increased culturally informed patient communication about rights and resources, strategic media campaigns, and improved access to healthcare for undocumented individuals.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "immigrant health"
        },
        {
            "word": "social emergency medicine"
        },
        {
            "word": "health equity"
        },
        {
            "word": "Health Policy"
        }
    ],
    "section": "Health Equity",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/1cx2p26h",
    "frozenauthors": [
        {
            "first_name": "Carolina",
            "middle_name": "",
            "last_name": "Ornelas",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        },
        {
            "first_name": "Jacqueline",
            "middle_name": "M.",
            "last_name": "Torres",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, California",
            "department": "None"
        },
        {
            "first_name": "Jesus",
            "middle_name": "R.",
            "last_name": "Torres",
            "name_suffix": "",
            "institution": "Olive View - UCLA Medical Center, Department of Emergency Medicine, Sylmar, California",
            "department": "None"
        },
        {
            "first_name": "Harrison",
            "middle_name": "",
            "last_name": "Alter",
            "name_suffix": "",
            "institution": "Highland Hospital - Alameda Health System, Department of Emergency Medicine, Oakland, California",
            "department": "None"
        },
        {
            "first_name": "Breena",
            "middle_name": "R.",
            "last_name": "Taira",
            "name_suffix": "",
            "institution": "Olive View - UCLA Medical Center, Department of Emergency Medicine, Sylmar, California",
            "department": "None"
        },
        {
            "first_name": "Robert",
            "middle_name": "M.",
            "last_name": "Rodriguez",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        }
    ],
    "date_submitted": "2020-10-09T20:41:18Z",
    "date_accepted": "2020-10-09T20:41:18Z",
    "date_published": "2021-05-07T20:26:27Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14627/galley/7460/download/"
        }
    ]
}