Geographic variation in COVID-19 vulnerability by legal immigration status in California: a prepandemic cross-sectional study

• Type of Material: Article
• Authors: Heeju Sohn, Emory University; Jasmine K Aqua, Emory University
• Language: English
• Date: 2022-05-23
• Publisher: BMJ Journals
• Publication Version: Final Published Version
• Copyright Statement: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bmjopen-2021-054331
• Title of Journal or Parent Work: BMJ Open
• Volume: 12
• Issue: 5
• Grant/Funding Information: This project was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD, grant number R00HD096322).
• Keywords: COVID-19; public health; epidemiology
• Research Categories: Sociology, Public and Social Welfare; Health Sciences, Epidemiology

Abstract

Objective To quantify COVID-19 vulnerabilities for Californian residents by their legal immigration status and place of residence. Design Secondary data analysis of cross-sectional population-representative survey data. Data All adult respondents in the restricted version of the California Health Interview Survey (2015–2020, n=128 528). Outcome measure Relative Social Vulnerability Indices for COVID-19 by legal immigration status and census region across six domains: socioeconomic vulnerability; demography and disability; minority status and language barriers; high housing density; epidemiological risk; and access to care. Results Undocumented immigrants living in Southern California’s urban areas (Los Angeles, Orange, San Diego-Imperial) have exceptionally high vulnerabilities due to low socioeconomic status, high language barriers, high housing density and low access to care. San Joaquin Valley is home to vulnerable immigrant groups and a US-born population with the highest demographic and epidemiological risk for severe COVID-19. Conclusion Interventions to mitigate public health crises must explicitly consider immigrants’ dual disadvantage from social vulnerability and exclusionary state and federal safety-net policies.