Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
A U-Visa, while I am not exactly sure if it qualifies as “policy”, is a way for an undocumented immigrant to obtain citizenship. An individual must have endured a substantial amount of physical or mental abuse. It provides protection and allows the both the individual without citizenship to stay in the U.S. for a period of three-years along with their family members.
Describe why an evaluation of that policy is informative (e.g., determining effect of the policy, or primarily a test of hypothesized mediators).
In our current political climate, much has been said regarding immigrants, particularly those from Latin America. A U-visa is a common mechanism for immigrants that have been abused either in Latin America or in the U.S. to begin citenzship process, individuals whom otherwise would never had a chance to have legal status. This allows the individual access to resources once they become documented, allowing them to work and receive healthcare and benefits. It would help give us positive feedback to understand how obtaining a U-visa has a positive impact on the individual and their larger social network.
Specify the outcomes and populations you think most affected by the policy
Physical health. People’s stress levels would be reduced once they received citizenship status. Not only would they not have to be fearful of constant deportation, they would be able to receive healthcare and work related benefits. It would not only have a positive impact on the individual, but on the family system and neighborhood as a whole.
Propose a study design to evaluate the policy.
What are the individual-level and familial benefits, as well as community-level benefits to receiving legal citizenship?
First, we would have to determine how the stress is impacting the individual and family. I imagine we could understand the stress levels of the individual by assessing their cortisol levels. We could assess family as well, such as increase in educational opportunities, ability to secure a home, and socioeconomic impact. At the community level, we may assess for a decrease in poverty level, increase in employment, and given that crime is 90% poverty based, a decrease in crime.
Describe the biggest challenge to implementing and drawing inference about the impact of the policy on health.
One would be accessing this particular population. Seems like fear of deportation would be high and the participants wouldn’t trust the study officials. Drawing inference at the community level may be difficult because only a small number of individuals are actually allowed to receive a U-visa each year. Having a big enough sample to conduct a study would be difficult.