Worry and fear about personal consequences resulting from the current immigration policy and rhetoric in the United States appear to be associated with higher levels of anxiety, sleep difficulties, and blood pressure among US-born adolescents, according to study results published in JAMA Pediatrics. Furthermore, significant increases in anxiety were observed in the first year after the 2016 presidential election.

This cohort study analyzed data on US-born adolescents with ≥1 immigrant parent (N=397) from the Center for the Health Assessment of Mothers and Children of Salinas, a long-term study of Mexican farmworker families in the Salinas Valley region of California, to determine whether immigration policy concerns are associated with worse physical and mental health in this population. The adolescents self-reported concerns about immigration policy using 2 subscales of the Perceived Immigration Policy Effects Scale (PIPES) instrument: Children’s Vulnerability and Threat to Family. Main outcome measures assessed at ages 14 years and 16 years included maternal rating of child’s overall health; body mass index; self-reported quality of sleep (using the Pittsburgh Sleep Quality Index [PSQI]); self- and maternal-reported anxiety and depression problems (using the Behavior Assessment System for Children, 2nd edition); and systolic, diastolic, and mean arterial blood pressure. Researchers examined health outcomes at age 16 years and changes in outcomes between ages 14 and 16 years among participants reporting low or moderate PIPES scores compared with high PIPES scores. Data analyses took place between March 2018 and February 2019.

Among the 397 US-born Latino adolescents (52.1% female adolescents), 98.2% (n=385) had either a mother or father born in Mexico and 86% (n=337) had both parents born in Mexico. Nearly half of all participants reported worrying at least sometimes about personal consequences resulting from US immigration policy (44.8%; n=178), being reported to the immigration office (41.3%; n=164), and family separation because of deportation (44.6%; n=177). Participants with high PIPES scores compared with low or moderate scores had worse PSQI scores (0.98; 95% CI, 0.36-1.59), higher maternally reported anxiety T scores (2.98; 95% CI, 0.53-5.44), and higher self-reported mean anxiety T scores (5.43; 95% CI, 2.64-8.23). Significantly increased anxiety levels over the 2 visits were reported by participants with high PIPES scores (adjusted mean difference-in-differences 2.91; 95% CI, 0.2-5.61) as were increased levels of depression that were not statistically significant (adjusted mean difference-in-differences 2.63; 95% CI, −0.28 to 5.54).

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Limitations of the study include not knowing the immigration status of the participants’ parents and not having the self-reported sleep quality or immigration stress at 14 years. Furthermore, the fact that many participants lived in an immigrant-friendly community could have served as a buffer, thereby underestimating the implications for adolescents living in communities less receptive to immigration.

Study investigators emphasized the importance of interventions to alleviate these detrimental effects to children’s development. They further concluded that “future research should track these potentially lasting implications as adolescents exposed to anti-immigrant policy and rhetoric become young adults.”


Eskenazi B, Fahey CA, Kogut K, et al. Association of perceived immigration policy vulnerability with mental and physical health among US-born Latino adolescents in California [published online June 24, 2019]. JAMA Pediatr. doi:10.1001/jamapediatrics.2019.1475