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How anti-immigrant rhetoric affects health care utilization

The 2016 presidential campaign saw a dramatic rise in anti-immigrant rhetoric. The sudden, herbal testosterone cream high-profile change was associated with a substantial decline in utilization of health care services by undocumented adults and their children. That’s the takeaway message from a new study in JAMA Network Open by former LDI associate fellow Joseph Nwadiuko and colleagues.

The authors compared primary care visits, emergency department use, and inpatient discharges from 2014 through 2017 for more than 20,000 patients in the Johns Hopkins Health System (JHHS), drawing from The Access Partnership (TAP) program. TAP cares for low-income patients who are ineligible for Medicaid, in large part due to immigration status—92% of TAP participants are undocumented. The authors compared utilization and outcomes to Medicaid patients in eight Medicaid plans in Maryland.

From the announcement of Donald Trump’s candidacy in June 2015 through May 2018, there was a 43.3% relative decrease in primary care visits for undocumented children and a 34.5% relative decline in undocumented adult primary care visits. Emergency department use increased for undocumented children, and there was a relative decrease in hospitalizations among undocumented adults.

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