Measuring county-level immigration policy contexts that may influence Latino health in California

Studies have examined the impact of federal and state immigration policies on Latino immigrant health. Few studies have investigated the effects of local policies that shape access to services, resources, and opportunities among Latino and immigrant populations. This article presents a framework and measures to describe county-level immigration policy contexts. We developed multisectoral indicators of immigration policy contexts by linking policies and social conditions of inequity to immigration policy through mechanisms of structural racism. Using the indicators, we constructed measures of county-level immigration policy contexts in California. Two indices measured the extent of local 1) inclusive policymaking and 2) social inequity that is reinforced by immigration policy. We categorized counties into four typologies of local immigration policy contexts using the index scores. We used maps and Poisson regression analyses to examine geographic and demographic variations in the scores and typologies. We found that counties in metropolitan regions had the highest inclusive policymaking scores. Rural or agricultural counties had the highest social inequity scores. Inclusive policymaking and social inequity did not always align; some counties with many inclusive policies also had high social inequity. The counties represented in each typology of local immigration policy contexts shared unique geographic characteristics. Ultimately, our findings show that local immigration policy contexts are the product of two distinct mechanisms, and they vary across California, an inclusive state. Researchers must consider local contexts when investigating the social determinants of Latino health. State policymakers should address local conditions of inequity that are reinforced by immigration policy.