Concerns about COVID-19 among undocumented women in justice-involved families

• DOI: https://doi.org/10.1108/IJMHSC-09-2021-0082
• Published date: 22 December 2022
• Date: 22 December 2022
• Pages: 42-57
• Subject Matter: Health & social care,Vulnerable groups,Inequalities & diverse/minority groups,Sociology,Race & ethnic studies,Minorities,Multiculturalism,Racial identity,Work,economy & organizations,Labour movements
• Author: Caitlin Cavanagh,Amanda Osuna,Roberta Liggett-O'Malley,Marina Henke,Elizabeth Cauffman

Concerns about COVID-19

among undocumented women

in justice-involved families

Caitlin Cavanagh, Amanda Osuna, Roberta Liggett-O’Malley, Marina Henke and

Elizabeth Cauffman

Abstract

Purpose –The COVID-19 pandemic has exacerbated chronic disparities in in come, employment and health-

care access. Yet, little is known about how various sources of eco nomic and emotional strain (i.e. caregiving,

justice system involvement and documentation status) intersect during the pandemic. The purpose of this

study is to understand how undocumented women in justice -involved families experienced the pandemic.

Design/methodology/approach –Surveys of 221 mothers of justice-involved youth examined

differences between documented and undocumented parents in COVID-19 testing, health and

economicconcerns related to the pandemic andgeneralized anxiety.

Findings –The resultsrevealed undocumented women were less likely to receiveCOVID-19 testing than

documented women, despite no difference between the two groups in suspicion that they may have

contractedthe virus. Also, undocumented women were more concernedthan documented women about

losing a job, not having enough food, not havingenough non-food supplies, not having access to basic

utilitiesor internet, losing their usual childcareservices and losing a loved one toCOVID-19.

Originality/value –The findings highlight the vulnerability of justice-involved families who have an

undocumented member and implications for long-term solutions to address these disparitiesare dis cussed.

Keywords Immigration, Disparities, Juvenile justice, COVID-19, Documentation status

Paper type Research paper

The coronavirus (COVID-19) pandemic has bro ught widespread economic and health-

related hardships across the USA. In some vulnerable communities, t hese hardships

have exacerbated chronic disparities in income, employment and health care access.

Of particular concern is the unique impact of COVID-19 on undocumente d citizens living in the

USA. Undocumented citizens are those living in a country without legal documen tation. As of

2017, an estimated 10 million undocumented immigrants are living i n the USA (Budiman,

2020;Passel and Cohen, 2019). Although disparities between docu mented and

undocumented citizens are well established, the COVID-19 pandemic has li kely exacerbated

these disparities. However, few studies explore how documentation status intersects with other

sources of economic and emotional strains, such as caregiving and justice system

involvement. In the present study, we examine differences between documented and

undocumented women who have a child involved in the juvenile justice system in COVID-19

testing, health and economic concerns related to the pandemic and gene ralized anxiety.

Increased health vulnerabilities for undocumented families during COVID-19

Prior to the onset of COVID-19, undocumented immigrants were already disadvantaged

when it came to health care access. Noncitizens in the USA often do not have access to

(Informationabout the

authorscan be found at the

end of this article.)

Received 24 September 2021

Revised 3 October 2022

Accepted 17 November 2022

MSU College of Social Science.

Author’s Note: The Crossroads

Mothers Study is supported by

funding from the American

Psychology-Law Society and

Michigan State University

College of Social Science. All

study participants provided

informed consent, via

processes approved by the

IRB. The authors are grateful

to the many individuals

responsible for the data

collection and preparation. The

authors have no known

conflicts of interest to disclose.

This manuscript is based on

data from the Crossroads

Mothers Study, a longitudinal

study of the mothers of

justice-involved youth. The

findings reported in this

manuscript have not been

presented elsewhere and have

not been published previously.

CC conceptualized the study,

analyzed the data and wrote

the manuscript. RLO aided in

writing the manuscript. AO and

MH led data collection efforts

and aided in writing the

manuscript. EC aided in study

conceptualization and writing

the manuscript.

PAGE 42 jINTERNATIONAL JOURNAL OFM IGRATION,HEALTH AND SOCIAL CARE jVOL. 19 NO. 1 2023, pp. 42-57, ©Emerald Publishing Limited, ISSN 1747-9894 DOI 10.1108/IJMHSC-09-2021-0082

medical insurance or health care (Clark et al., 2020). For instance, undocumented

immigrants are ineligible for health coverage under The Affordable Care Act (Page et al.,

2020), and over seven million undocumented immigrants do not have health-care coverage

(Cheng et al.,2019). Those that do have access to health care receive significantly reduced

coverage compared to US citizens (Sommers, 2013). Financial concerns, discrimination

and fear of deportation serve as additional barriers that prevent undocumented immigrants

from accessing health care (Hacker, et al.,2015). Further, the stress of being

undocumented, including exposure to unique risks and traumatic experiences before,

during and after migrating (Bucay-Harari et al.,2020), puts individuals at risk for poor

mental health (Cervantes et al.,2010). This has only been exacerbated during the

pandemic (Gonzales et al.,2013;Sullivan and Rehm, 2005;Clark et al., 2020).

Due to lack of health-care coverage, undocumented immigrants have historically relied on

emergency departments for primary care services (Ortega et al.,2007). As emergency

departments become overwhelmed with COVID-19 patients, undocumented immigrants

may choose to stay home (Page et al.,2020). In addition, rapid COVID-19 testing occurs

after a referral from a primary care physician, which undocumented immigrants are less

likely to access (Ortega et al.,2007). Furthermore, due to financial strain, many

undocumented families share homes with various other people, which may hinder their

ability to properly social distance, and increases their risk of contracting COVID-19 (Clark

et al.,2020

;Hargreaves et al.,2020). As such, undocumented immigrants may display

more concern and anxiety about COVID-19infection than their citizen counterparts.

Increased economic vulnerabilities for undocumented families during COVID-19

Undocumented immigrants historically face several income and economic constraints

(Abrego and Gonzales, 2010;Chavez, 2012;Portes and Rumbaut, 2001). Many

undocumented families struggle financially and may find themselvesat or under the poverty

line (Gonzales, 2009). In fact, Cholera et al. (2020) found that children of undocumented

families are more likely than citizens to experience poverty, food insecurity, housing

instability and reduced educationalattainment.

Quarantine mandates have limited the operations of several businesses, placing

undocumented immigrants at increased risk for job loss. Borjas and Cassidy (2020) found

that while immigrant men make up an increasingly large fraction of the workforce in the

USA, they were also the most impacted by pay cuts and job loss during the pandemic.

Immigrant women also experienced substantial job loss due to COVID-19 (Borjas and

Cassidy, 2020;Gelatt, 2020;So

¨nmez et al., 2020). COVID-19 job loss is impacted by

several factors, such as a lack of remote work available to immigrants and high rates of job

insecurity due to the nature of work available to non-citizens (Borjas and Cassidy, 2020;

Gelatt, 2020;So

¨nmez et al.,2020).

Undocumented families have not been eligible for unemployment benefits or government

relief checks during the COVID-19 pandemic (Clark et al., 2020). Even if assistance were

more attainable, Clark et al. (2020) found that undocumented families would not seek

medical care for fear of legal penalties, such as deportation, for themselves or their

immediate families. This fear of legal repercussions is a daily concern for undocumented

and mixed-status families. These challenges may be reflected by increased financial

concerns and anxieties among undocumented citizens as compared to citizens.

Intersection between documentation status and the justice system during COVID

Undocumented individuals who are justice-involved face even more challenges during the

COVID-19 pandemic. Across federal and state prisons, incarcerated individuals are at high risk

for contracting COVID-19 (Saloner et al., 2020). The COVID-19 infection rate for prisoners was

5.5 times higher than the US population and is largely attributed to crowding and an inability to

VOL. 19 NO. 1 2023 jINTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE jPAGE 43