Week 6 Homework

Week 6 Homework

by Leticia -
Number of replies: 1

The Deferred Action for Childhood (DACA) policy is not intended to be a health policy, but it likely has important health implications for DACA recipients and their family members who remain undocumented. Evaluation of the DACA policy is important because since it’s implementation in June 2012 over 500,000 individuals who crossed the border without documents as children, and millions of their family members have experienced life-altering outcomes. This large number of affected individuals, and the continued controversy that challenges ongoing implementation of DACA, demands evaluation of its social, economic, and health outcomes to bolster support for this humanitarian policy.

While preliminary studies have documented increased social incorporation, greater educational attainment, and improved economic opportunities for DACA recipients, changes in health outcomes for DACA recipients and their undocumented family members have not been rigorously studied. Nonetheless, I predict that health outcomes for DACA recipients and their families have improved due to significant decreases in chronic stress experienced by both. DACA recipients surely experience decrease in their day-to-day stress due to the knowledge that they cannot be deported. However, they still experience the stress associated with the knowledge that other family members can still be deported. In turn, these family members experience the chronic stress of possible deportation on a daily basis that is mitigated by the relief they must experience knowing that their children (i.e., the DACA recipients) cannot be deported.

To study the change in health outcomes for DACA recipients and their families I propose to analyze key indicators of mental and physical health before and after award of DACA status. However, I do not know what population-level data is available and suspect that because undocumented immigrants are a “hidden population” it may be unavailable. Nonetheless, it may be possible to collect in-depth information about/from families who regularly visit Clínica Martn-Baró in San Francisco. This community-based clinic was founded in 2007 and is staffed by SF State and UCSF health professionals and students who maintain trusted relationships with the clients who seek services at this site. Because services have been delivered since 2007 (i.e., before establishment of DACA policy) it may be possible to access records for families touched by DACA, and to interview members of the family who continue to visit the clinic. This mixed-method approach may yield informative information about how the DACA policy affects the health of both DACA recipients and their family members. 

In reply to Leticia

Re: Week 6 Homework

by Maria Glymour -

Leti This is such an interesting example.  I agree it's really hard to study rigorously, for all the reasons you note.  Sometimes in this type of setting people find a regression discontinuity strategy for a rigorous design.  For example, if there is an arbitrary age cutoff or year of entry cutoff in the eligibility rules, you would expect that children right above and right below the age threshold would have different outcomes: this type of "discontinuity" can be used to estimate the effect of eligibility.  The design really depends on identifying arbitrary features of the policy  - features that do not correspond with human biology or the values of other confounders - and using those things as a discontinuity. This design is pretty popular in econometrics because it is more convincing than most observational approaches.  Do you know if there is any such discontinuity in DACA that might be used for such an approach?

Maria