ABSTRACT

            Statements about building walls, deportation and denying services to undocumented immigrants made by the US president may induce fear in Latino populations and create barriers to their health care access. To assess the impact of these statements on undocumented Latino immigrants’ (UDLI) and Latino legal residents/citizens’ (LLRC) perceptions of safety and their presentations for emergency care, we conducted surveys of adult patients at three county emergency departments (EDs) in California from June 2017 to December 2018. Of 1,684 patients approached, 1,337 (79.4%) agreed to participate: 34.3% UDLI, 36.9% LLRC, and 29.8% non-Latino legal residents/citizens (NLRC). The vast majority of UDLI (95%), LLRC (94%), and NLRC (85%) had heard statements about immigrants by President Trump. Most UDLI (89%), LLRC (88%), and NLRC (87%) either thought that these measures were being enacted now or will be enacted in the future. Most UDLI and LLRC reported that these statements made them feel unsafe living in the US, 75% (95% CI 70 to 80%) and 51% (95% CI 47 to 56%), respectively. More UDLI reported that these statements made them afraid to come to the ED (24% 95% CI 20 to 28%) vs LLRC (4.4% [95% CI 3 to 7%]) and NLRC (3.5% [95% CI 2 to 6%]); 55% of UDLI with this fear stated it caused them to delay coming to the ED (median delay 2-3 days). The vast majority of patients in our California EDs have heard statements about immigrants by the US president, which have induced worry and safety concerns in both UDLI and LLRC patients. These statements may also act as a barrier to some UDLI’s access of emergency care. Given California’s sanctuary state status, these safety concerns and ED access fears may be greater in a nationwide population of Latinos.