Arturo Vargas Bustamante

On January 20, 2025, President Trump issued an executive order to end birthright citizenship in the U.S., a constitutional right guaranteed by the 14th Amendment. This policy brief discusses the health and social costs of ending birthright citizenship for millions of families in the United States. 

President Trump's executive order would deny citizenship to children born in the U.S. to:

• An undocumented immigrant mother and a father who is not a U.S citizen or green card holder OR
• A mother with a temporary status, such as on a student, work, or tourist visa, and a father who is not a U.S. citizen or green card holder.

Findings:

1. Anti-immigrant policies discourage families from using essential services, worsening health outcomes.
2. Restricting birthright citizenship will worsen barriers to prenatal care, driving up costs and harming infant health.
3. Immigrants contribute more to the U.S. health system than they receive in health care services.
4. Latino children would be disproportionately affected by changes to birthright citizenship.
5. Latino noncitizens, particularly the undocumented and temporary visa holders, would be the most affected racial and ethnic group if birthright citizenship ends.

The executive order ending birthright citizenship threatens the health and well-being of entire communities, including U.S. citizens. These policies generate fear and mistrust of government services and deter families from seeking necessary health care. Even if overturned, the order’s chilling effects will persist, worsening health outcomes, increasing health care costs, and heightening social and legal instability.

Policymakers and state governments must act swiftly to mitigate the harm by partnering with community-based organizations (CBOs) and trusted organizations to: 

1. Expand legal support: Increase legal orientation to help families navigate evolving immigration policies and protect their rights.
2. Combat misinformation: Disseminate clear, accessible information on the importance of preventive and prenatal care, ensuring immigrant and mixed-status families understand their health care options. 
3. Safeguard health care access: Strengthen protections that allow immigrant communities to seek essential health care services — especially prenatal and preventive services —  without fear of immigration enforcement or retaliation.
    

Black Americans experience the highest prevalence of heart failure (HF) and the worst clinical outcomes of any racial or ethnic group, but little is known about end-of-life care for this population. Researchers compare treatment intensity between Black and white older adults with HF near the end of life. They compared four common measures of treatment intensity at the end of life (number of hospital admissions, receipt of care in an intensive care unit (ICU), utilization of life support, and whether the decedent died in a hospital) between Black and white HF patients, controlling for demographic, social, and health characteristics.

Findings: Racial identity was not significantly associated with the number of hospital admissions or admission to an ICU in the last 24 months of life. However, Black HF patients were more likely to spend time on life support and more likely to die in a hospital than white HF patients. Thoughtful and consistent engagement with HF patients regarding treatment preferences is an important step in addressing inequities.
 

Summary: The Latino health paradox is the phenomenon whereby recent Latino immigrants have, on average, better health outcomes on some indicators than Latino immigrants who have lived in the United States longer and U.S.-born Latinos and non-Latino whites. This study examined whether the paradox holds after accounting for health care access and utilization.

Researchers used 2019–2020 National Health Interview Survey data. The main predictors included population groups of foreign-born and U.S.-born Latinos (Mexican or non-Mexican) versus U.S.-born non-Latino whites. 

Findings: After adjusting for health care access, utilization, and predisposing and enabling factors, foreign-born Latinos, including those living in the United States ≥15 years, had lower predicted probabilities for most health outcomes than U.S.-born non-Latino whites, except overweight/obesity and diabetes. U.S.-born Latinos had higher predicted probabilities of overweight/obesity and diabetes and a lower predicted probability of depression than U.S.-born non-Latino whites.

In this national survey, the Latino health paradox was observed after adjusting for health care access and utilization and predisposing and enabling factors, suggesting that, although these are important factors for good health, they do not necessarily explain the paradox.

Read the Publications:

• Journal Article: Health Care Access and Utilization and the Latino Health Paradox
   

Summary: This study examined the association between food insecurity and health insurance coverage, access to care, health care utilization, and financial hardships among U.S. adults.

Authors employed a retrospective longitudinal cohort study design using panel data from the 2016–2017 Medical Expenditure Panel Survey. Linear probability models were used to examine the association between food insecurity in one year and outcomes of interest (health insurance coverage, access to care, health care utilization, and financial hardships) in the subsequent year. 

Findings: Food insecurity was associated with higher uninsured rates and lower private coverage rates as well as lower access to care, including delay in receiving necessary medical care and delay in obtaining necessary prescription drugs. Those experiencing food insecurity also had a higher rate of emergency room visits, whereas associations with inpatient, outpatient, and prescription drug use were not significant. Food insecurity was linked to greater financial hardships, such as experiencing difficulties paying medical bills.

These findings highlight the adverse consequences of food insecurity on access to and affordability of care for U.S. adults and families. Food insecurity can have far-reaching implications for the well-being of individuals and families.

Read the Publication:

• Journal Article: Adverse Consequences of Food Insecurity Among U.S. Adults Beyond Health Outcomes