The Deferred Action for Childhood Arrivals program and birth outcomes in California: a quasi-experimental study

Jacqueline M Torres; Emanuel Alcala; Amber Shaver; Daniel F Collin; Linda S Franck; Anu Manchikanti Gomez; Deborah Karasek; Nichole Nidey; Michael Hotard; Rita Hamad; Tania Pacheco-Werner

doi:10.1186/s12889-022-13846-x

The Deferred Action for Childhood Arrivals program and birth outcomes in California: a quasi-experimental study

BMC Public Health. 2022 Jul 29;22(1):1449. doi: 10.1186/s12889-022-13846-x.

Authors

Jacqueline M Torres¹, Emanuel Alcala^{2

3}, Amber Shaver², Daniel F Collin^{4

5}, Linda S Franck⁶, Anu Manchikanti Gomez⁷, Deborah Karasek⁸, Nichole Nidey⁹, Michael Hotard¹⁰, Rita Hamad^{4

11}, Tania Pacheco-Werner²

Affiliations

¹ Department of Epidemiology and Biostatistics, UC San Francisco, 550 16th Street, 94143, San Francisco, CA, USA. Jacqueline.Torres@ucsf.edu.
² Central Valley Health Policy Institute, California State University, Fresno, Fresno, San Francisco, CA, USA.
³ Department of Public Health, UC Merced, Merced, CA, USA.
⁴ Department of Family and Community Medicine, UC San Francisco, San Francisco, CA, USA.
⁵ Preterm Birth Initiative, UC San Francisco, San Francisco, CA, USA.
⁶ Department of Family Health Care Nursing, University of California, San Francisco, CA, USA.
⁷ Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, CA, USA.
⁸ Department of Obstetrics, Gynecology and Reproductive Sciences, UC San Francisco, San Francisco, CA, USA.
⁹ Cincinnati Children's Hospital, Cincinnati, OH, USA.
¹⁰ Immigration Policy Lab, Stanford University, Stanford, CA, USA.
¹¹ Philip R. Lee Institute for Health Policy Studies, UC San Francisco, San Francisco, CA, USA.

Abstract

Background: The Deferred Action for Childhood Arrivals (DACA) program provides temporary relief from deportation and work permits for previously undocumented immigrants who arrived as children. DACA faced direct threats under the Trump administration. There is select evidence of the short-term impacts of DACA on population health, including on birth outcomes, but limited understanding of the long-term impacts.

Methods: We evaluated the association between DACA program and birth outcomes using California birth certificate data (2009-2018) and a difference-in-differences approach to compare post-DACA birth outcomes for likely DACA-eligible mothers to birth outcomes for demographically similar DACA-ineligible mothers. We also separately compared birth outcomes by DACA eligibility status in the first 3 years after DACA passage (2012-2015) and in the subsequent 3 years (2015-2018) - a period characterized by direct threats to the DACA program - as compared to outcomes in the years prior to DACA passage.

Results: In the 7 years after its passage, DACA was associated with a lower risk of small-for-gestational age (- 0.018, 95% CI: - 0.035, - 0.002) and greater birthweight (45.8 g, 95% CI: 11.9, 79.7) for births to Mexican-origin individuals that were billed to Medicaid. Estimates were consistent but of smaller magnitude for other subgroups. Associations between DACA and birth outcomes were attenuated to the null in the period that began with the announcement of the Trump U.S. Presidential campaign (2015-2018), although confidence intervals overlapped with estimates from the immediate post-DACA period.

Conclusions: These findings suggest weak to modest initial benefits of DACA for select birthweight outcomes during the period immediately following DACA passage for Mexican-born individuals whose births were billed to Medicaid; any benefits were subsequently attenuated to the null. The benefits of DACA for population health may not have been sufficient to counteract the impacts of threats to the program's future and heightened immigration enforcement occurring in parallel over time.

Keywords: Birth Outcomes; DACA; Population Health; Quasi-Experimental.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Birth Weight
California
Child
Emigration and Immigration
Female
Humans
Mothers
Undocumented Immigrants*
United States

Grants and funding

K12 HD052163/HD/NICHD NIH HHS/United States