Order Keepers or Immigration Agents? Latine Immigrant Views of Law Enforcement in Healthcare Settings

Sara A Snyder; Krystal E Kuan; Margarita G Velasco; Altaf Saadi

doi:10.1007/s11606-024-08767-x

Order Keepers or Immigration Agents? Latine Immigrant Views of Law Enforcement in Healthcare Settings

J Gen Intern Med. 2024 May 2. doi: 10.1007/s11606-024-08767-x. Online ahead of print.

Authors

Sara A Snyder^{1

2}, Krystal E Kuan³, Margarita G Velasco¹, Altaf Saadi⁴

Affiliations

¹ Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.
³ Departments of Biostatistics, Epidemiology, and Global Health, Boston University School of Public Health, Boston, MA, USA.
⁴ Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. asaadi@mgh.harvard.edu.

PMID: 38698296
DOI: 10.1007/s11606-024-08767-x

Abstract

Background: Police and security presence in healthcare settings have grown. There are few studies exploring perceptions of these law enforcement agents among US Latine immigrants, who can be vulnerable to immigration enforcement actions due to past and ongoing criminalization and anti-immigrant policies.

Objective: To explore Latine immigrants' perceptions of law enforcement in healthcare settings.

Design: Exploratory, semi-structured qualitative interviews asked participants about their perspectives of law enforcement in healthcare settings.

Participants: English- and Spanish-speaking adult patients (n = 19) from a Federally Qualified Health Center (FQHC) in Los Angeles, CA, serving predominantly low-income Latine immigrants.

Approach: We used the framework method for analysis to establish a codebook and inform our thematic interpretation.

Key results: We identified three themes: (1) perceptions of safety offered by police officers are separated from the role of immigration officers; (2) perceptions of police officers are integrated into broader perceptions of the healthcare system; and (3) lived experiences, including immigration status, influenced valence response to officer uniforms and perceptions of officers. Most participants viewed police officers positively as maintaining order and safety, separating them from federal immigration enforcement actions, and reflecting on local, state, and organizational "sanctuary" or immigrant-friendly policies. Individuals with precarious immigration status more often saw officers as intimidating. Immigration enforcement remained a key concern.

Conclusions: Differentiating police and security roles from immigration enforcement in healthcare could improve Latine immigrant trust and access. Future studies should explore perspectives of Latine immigrants in localities without sanctuary laws or organizational immigrant-friendly policies.

Keywords: healthcare; immigrant health; law enforcement; perceptions.

Grants and funding

K23NS128164/NS/NINDS NIH HHS/United States