Griselda Alonso remembers the home visit well. It was around 2008, a few years after she had started as a community health worker in Wake County.
On typical visits, she focused on children鈥檚 health, telling families how to get vaccines, outlining healthy eating habits for them and sharing information about diabetes or asthma medications.
During this visit to a family鈥檚 home in Fuquay Varina, something seemed off. The woman who welcomed her said she had not been able to sleep the previous night, and she had no interest in talking to Alonso about the health of her children.
The previous day, the woman鈥檚 husband had been driving home from work when a police officer stopped him. He was undocumented, had no criminal history and hadn鈥檛 committed a traffic violation other than driving without a license, Alonso recalled. In 2006, North Carolina legislators passed a law from obtaining driver鈥檚 licenses.
The next day, the woman learned her husband would be deported.
鈥淪he was absolutely devastated,鈥� Alonso said. That experience was not unique for the people Alonso and others saw when making home visits. 鈥淭he majority of community health workers found ourselves seeing the same stories,鈥� she told NC Health News.
Now a advocating for immigrant鈥檚 rights, Alonso fears these situations may become more common if the legislature passes , or HB10, a proposal that would require sheriffs across North Carolina to cooperate with Immigration and Customs Enforcement, or ICE.
鈥淯s community health workers are going to be the first who will notice the aftermath of HB10,鈥� Alonso said last week during a meeting of , a group founded by concerned Duke Health providers in 2020 to that affect North Carolina鈥檚 Latino community.
If passed, HB10 would create a statewide path for increasing the reach of federal immigration officials, putting North Carolina more in line with such states as , and , which immigration law experts have some of the harshest enforcement policies in the country. Experiences show that these policies have a negative impact on health outcomes and access to care. Fear of deportation in immigrant communities can lead to 鈥� including health care, studies show.
Immigration enforcement policies not only affect access to care for undocumented people, but their health implications also extend to loved ones and communities, shows. This has led many researchers to consider immigration enforcement to be a .
鈥淭he community has started to feel panic, and with panic comes a lot of health issues," Olivia Moreno, a community health worker with said on the LATIN-19 call last week.
Forgoing care and more
For families with undocumented members, immigration enforcement policies can affect access to health care, and providers often see these effects firsthand.
"Folks stop driving. Folks stop going to the hospital when they need to,鈥� Viviana Mart铆nez-Bianchi, a physician from Durham and co-founder of LATIN-19, said toward the end of last week鈥檚 meeting.
鈥淭hey don鈥檛 get out of the house,鈥� Edith Nieves Lopez, another primary care physician from Durham, told NC Health News.
Nieves Lopez explained that since undocumented immigrants cannot obtain driver鈥檚 licenses in North Carolina, they can鈥檛 always get to clinics and hospitals for care. Researchers in Michigan found that undocumented immigrants may instead of risking the drive to their appointment, especially in areas with high immigration enforcement or police activity.
Immigration enforcement also can have a negative impact on enrollment in public benefits programs, including and 鈥� a trend observed even for U.S.-born children of noncitizens who are eligible for these benefits. Researchers found deportation enforcement can have a on immigrant communities, reducing participation in public benefits and health care.
HB10 "adds another layer of fear and terror to community members to access basic needs," said Iliana Santillan, executive director of El Pueblo, an advocacy group for the N.C. Latino community, in an interview with NC Health News.
鈥淚 see patients every day who have delayed the health care they need because of fears related to anti-immigrant sentiments and unjust immigration enforcement,鈥� Narges Farahi, a family physician from Durham, said in an email to NC Health News.
Farahi highlighted a where, in the months after an immigration raid, Latina women were more likely to give birth to babies prematurely or with lower birth weight.
In 2014, researchers from Wake Forest University and El Pueblo found that Latina immigrants in areas with the 287(g) immigration enforcement program (see box below) were to seek prenatal care.
鈥淢any women stopped going to the hospital,鈥� Alonso, the community health worker, said about the 287(g) program.
In a 2018 study of Latino men in North Carolina on the health impacts of immigration enforcement, the fear of racial profiling and deportation were to poorer cardiovascular health, excessive use of alcohol, and higher rates of depression, anxiety and PTSD.
Young people on the front lines
Children and adolescents are especially vulnerable to feeling stress due to immigration policies, which can manifest as physical symptoms.
鈥淲e get children with headaches, with abdominal pain because they're absolutely terrified that their parents are going to get deported any day,鈥� Mart铆nez-Bianchi told listeners on the LATIN-19 call.
Nieves Lopez added that these symptoms can be 鈥渓ong term 鈥� because you're adding a significant amount of stress and trauma in a community.鈥�
Research into long-term effects of childhood stressors is growing and shows that long-term exposure to stressors puts kids at for developing heart disease and depression. Children whose family members are detained or deported experience such as diabetes, cancer and heart disease, studies show.
Stress can have an impact on education as well, a link that has been studied in the Latino community. In areas of the country experiencing high levels of deportation, are higher among Latino students. Another study found in Latino students compared with their white peers in school districts with large numbers of deportations.
'A tool for abusers'
Advocacy groups for domestic violence survivors are also opposed to HB10. According to Kathleen Lockwood, policy director at the , the bill would "create an additional force and tool for abusers."
Exploiting immigration status is a that abusers of undocumented victims use, she said. Many fear that HB10 would make it for people to seek justice, Lockwood added. Challenges also exist if the abuser is undocumented, as victims may not want to risk family members getting deported if they report to local law enforcement.
Lockwood calls it an "all-or-nothing approach," where victims cannot seek justice without potentially setting off a deportation proceeding.
Alonso highlighted another root of domestic violence in her community, which is that the majority of undocumented immigrants are . According to her, this has led women to enter into abusive relationships out of economic necessity. For many immigrant families, a deportation means losing a .
She and her fellow community health workers have already started preparing for what life could be like if HB10 becomes law. Alonso mentioned organizing workshops to prevent the spread of misinformation and teach individuals how to respond to law enforcement.
Given North Carolina鈥檚 history of patchwork immigration enforcement policies, community health workers like El Centro Hispano鈥檚 Moreno have learned to adapt to changing circumstances. Many are using the past adversity as a strength. 鈥淭he only advantage we have today compared to a few years ago is that we have a fantastic communication network. Information is reaching the communities faster,鈥� Moreno said.
Where immigration enforcement laws stand in N.C.
On May 15, HB10 hit a roadblock when members of the state House of Representatives rejected the measure 108-3 due in part to sheriffs鈥� objections to . Key lawmakers from the state House and Senate will now go to a conference committee to try to reach agreement on the bill.
North Carolina sheriffs are required to look into the immigration status of individuals accused of a felony or impaired driving offense. If that status cannot be determined, they are supposed to notify federal immigration officials who review the case and may issue a 48-hour .
鈥淭hey're not mandatory. They're not signed by a judge,鈥� said Rep. Marcia Morey, a Democrat from Durham and a former district court judge.
If HB10 becomes law, sheriffs in all 100 counties would be required to comply with carrying out detainer requests.
Some sheriffs 鈥� clustered in with immigration detainers and have signaled their opposition to HB10. In a statement from 2023 鈥� when the bill was originally introduced 鈥� Wake County Sheriff Willie Rowe that "HB10 will make us less safe by fomenting distrust in local law enforcement."
In an email to NC Health News, a representative from the NC Sheriffs鈥� Association said that the organization currently is not taking a position on the bill.
Fifteen North Carolina are part of the federal , partnering with federal immigration officials to give police officers powers to act in their stead.
While the 287(g) program was meant to identify those with serious criminal offenses, North Carolina researchers found that in five N.C. counties under the 287(g) program, detained were charged with misdemeanors, with the most common charge being a traffic violation.
There have been multiple accusations that the 287(g) program has empowered law enforcement offices to engage in. Sheriff鈥檚 departments have been subject to those allegations.
NC Health News editor Rose Hoban contributed reporting for this story.
This first appeared on and is republished here under a Creative Commons license.
North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at .
