196 - The effect of immigration policy on the health of Latinx mothers and their infants

Poster Number: 196
Publication Number: 196.413

Brittany J. Raffa, UNC Chapel Hill, Chapel Hill, NC, United States; Jonas Swartz, Duke University School of Medicine, Durham, NC, United States; Shabbar I. Ranapurwala, University of North Carolina, Chapel Hill, Chapel Hill, NC, United States; Congwen Zhao, Duke University School of Medicine, Durham, NC, United States; Rushina Cholera, Duke University School of Medicine, Durham, NC, United States

Background: Latinx children comprise 25% of the U.S pediatric population, and 1 in 4 live with an undocumented parent. Increasingly restrictive immigration policy since 2016 has been associated with negative outcomes for Latinx families, including decreased healthcare utilization and public program enrollment.  

Objective: To examine the impact of the 2016 presidential election on the health outcomes of Latinx women delivering with emergency Medicaid (a sensitive proxy measure for undocumented immigration status) and their infants over the first year of life.

Design/Methods: We used a controlled interrupted time series to estimate the effect of the election on preterm birth, low birth weight, and well child check (WCC) adherence among infants born to Latinx mothers with emergency Medicaid between January 1, 2014 and February 29, 2020. Control groups included infants of Latinx and non-Latinx mothers with traditional Medicaid.

Results: Among 13,507 infants observed in the study, 2,203 (16.3%) were born to Latinx mothers on emergency Medicaid and the remaining were born to mothers on traditional Medicaid including non-Latinx (n=9,100, 67.4%) and Latinx (n=2,204, 16.3%) recipients.
Low birthweight rates were lower in both the emergency Medicaid Latinx cohort (pre: 6.2%; post: 6.6%) and the traditional Medicaid Latinx cohort (pre: 8.9%; post: 7.0%) than for traditional Medicaid non-Latinx women (pre: 16.9%; post: 15.8%) both pre- and post-election (Table 1). Similarly, preterm birth rates were also lower in both Latinx cohorts than for non-Latinx women. Mean WCC adherence rates were not statistically different among the three groups (Table 1).
Relative to non-Latinx women (mean: 55.8%) or Latinx women (mean: 59.8%) on traditional Medicaid (controls), children of Latinx women on emergency Medicaid (mean: 60.9%) had similar WCC adherence post-2016 election. Relative to controls, we did not observe a post-election change in low birthweight or preterm birth rates among Latinx mothers on emergency Medicaid (Table 2).  Conclusion(s): We did not observe changes in preterm birth, low birthweight or well child visit adherence among families with births covered by emergency Medicaid associated with the 2016 presidential election. Latinx mothers were less likely to have a low birth weight or preterm births than non-Latinx mothers. We observed a non-significant decrease in WCC adherence in all groups which deserves further exploration.
TABLE 1 Study Population by Maternal Medicaid Status, Ethnicity and Time Period
TABLE 2: Outcomes Among Different Groups Pre- and Post-intervention