Juan Pedroza on Immigrant Health, Place, and the Pandemic

Dave Chancellor: Hello, and thanks for joining us for the Poverty Research and Policy podcast from the Institute for Research on Poverty at the University of Wisconsin–Madison. I’m Dave Chancellor and for this episode. I had the privilege of speaking with Juan Pedroza about immigration in the U.S., the COVID pandemic and how place matters when it comes to thinking about immigrant health. Pedroza is assistant professor of demography, migration inequality in the sociology department at the University of California, Santa Cruz, and he was a fellow in IRP’s Emerging Poverty Scholar program for this past academic year and we’re so delighted to be able to share this conversation with you. So let’s turn to the interview.

Chancellor: Professor Pedroza, thank you for being here. So, broadly, I think we can characterize your work as looking at health and socioeconomic inequalities within the context of immigration in the United States and particularly how we sometimes see different outcomes that develop based on place differences. Is that about right? Or would you maybe characterize this in a different way?

Juan Pedroza: Yeah, that’s right. I I’ve been looking at immigration policy and immigrant communities for about 15 years. And the important role of local communities and how place constructs opportunity has always stood out. And it’s been in field work that I’ve done, to work that I’ve done in my dissertation, and my ongoing work today. It just seems like if we place a lot of emphasis on the policy context, people’s networks, what the history of the community is, whether or not that community has deep immigrant roots going back a long time or whether it’s more recent, that really makes a huge difference for all sorts of things. Now, it doesn’t mean that place is destiny, or if there isn’t a really robust, rich set of institutions that we can’t do something. But if we pay attention to the role of what’s going on and what’s been happening in local communities, I think it can help us account for quite a bit of the gaps and health gaps and poverty, and the solutions are going to be a little different, right? So if you’re thinking about a large immigrant destination that’s in an urban center. Other solutions there might be really different than a new destination that might be more rural and on the eastern seaboard. So being really, really mindful of the communities that we’re talking about and what kind of context that they live in, I think can make a big difference for meeting people where they’re at and meeting their needs based on what’s possible, what’s doable and what we think can make a difference.

Chancellor: So I want to talk about some of the factors that have impacted immigrant health during the COVID-19 pandemic. But, you know, it feels like it’s important that we sort of understand a picture of what was happening before March of 2020, to really understand this context. And I’m wondering if you can give me a picture of that. What are some of the themes that we need to understand as we think about what happened after March of 2020?

Pedroza: Yes, that’s such a great question. I really like the way that you frame that because if we want to understand what happened starting in March 2020 and we start with March 1st, 2020, we’re just going to miss a lot of what had been happening, the momentum that our already built into these streams of immigration. And I think the temptation is to read into what’s happening to migration from Central America and from the Caribbean. All the logics that we have used to understand migration in general and biologics. I mean, Mexican unauthorized migration, for example. I come from Mexico and I’ve been reading that research for a very long time for personal interest. And it’s also part of my research and it’s really clear the evidence from the border militarization that we did in the 1990s that that essentially backfired. That if the intent there was to lock up the border to lower and authorized immigration, the exact opposite happened and it happened with me and my family. Once that border gets more difficult, the more expensive to cross. You know, we decided let’s we’re going to stay in the U.S. instead of what had been happening for decades, which was more circular migration. So that’s the established we’ve known that for a long time. And if we then try to import that logic in that deterrence approach of controlling the border to new populations who are presenting themselves to Border Patrol as asylum seekers, it just shows a lack of imagination on our part. These are different circumstances. Someone who is coming into the United States, entering without inspection, with the intention to work and wants to not come in contact with Border Patrol is really, really different than unaccompanied minor or someone fleeing climate change who wants to file an application for political asylum and can’t return to their country for really different reasons. So I think that that we need to understand where we’ve been coming from, that these things are really distinct. And once we do that, I think we can really appreciate that for many people, it’s a mix of both. There’s an economic motivation for wanting to come to the U.S., but there might also be other fear for your life or your where you grew up is now under water or under political instability. So really, having a good sense of where that’s coming from is so, so, so important. And when COVID hit in March 2020, I think it gave some of the leadership that was in place at the time a little bit of a reason to kick the can down the road a little bit, saying, Oh, we have to lock up the border because of COVID. But now that very recently we saw that we’re opening travel back up to international travelers. Now we have to come back to that difficult conversation again and again and have a real debate about what do we do with people who are presenting themselves at our border seeking asylum. And I’ve been doing some research on this. And one of the consequences of how much more difficult we made it to come to the U.S. How much more costly and treacherous that journey is, if you feel like you’re not going to get a fair shake is people are spending a lot more money. People are getting hurt. People are paying for the price of crossing the border with their health. And this is the research that I’ve been doing on the rate of non-citizens who’ve been coming in and in the more recent time period, once these immigrants settle in our local communities, they’re reporting multiple disabilities at higher rates of other populations, and they’re unique in one having a really great immigrant health advantage, but also losing that advantage because of policies we put in place. So I think all of that taken together, right? What are the different migrant strains? What are the obstacles we’re putting in place? And what do those obstacles then mean for migration flows and the health of the community?

Chancellor: You talked about how the leadership in many ways to kick the can down the road, you know, with U.S. Use the pandemic to sort of do that. When these lockdown orders, the stay at home orders came out. How did that quickly change some of the processes that were happening within the immigration system? I guess how those impact the people that were sort of existing within that system.

Pedroza: Yeah, yes. So much of my work looks at prosecutorial discretion. So law enforcement, including immigration, has a lot of discretion when deciding whether or not they’re going to detain you, whether or not you’re going to be deported. There’s just a lot of leeway there. And right now we’re seeing from the Biden administration debates around where I should be focusing their attention, who we should be focusing enforcement attention to. These are debates that go back to the Obama administration and under Trump, the idea and they put this on their website was that everyone is a priority for removal. So we’re now back at a time when we’re having more of a conversation around what kinds of priorities do we want in the March 2020 lockdown orders and everything that we all went through was a reminder that discretion is really, really important and that the level of enforcement that we have, the number of people we have in detention is a choice. These are man-made policy made outcomes. And you saw, especially in those early summer months of 2020, a huge slowdown in detainers. So requests from Immigration and Customs Enforcement to local counties to hold immigrants. Those detainers went down. The number of removals or deportations from the United States also went down, and the population, the prison population and immigrant detention centers also went down right at the same time period when we all realized that this massive experiment that we’ve all been investing in, which is the criminal justice system but also the civil immigration enforcement detention system, were some of the most poorly constructed experiments in terms of what COVID could really do to our to our nation’s health. So we know that we can slow down enforcement and by the way, look when we release people from detention centers and when they get a lot of immigrants then had court dates. Most of those individuals showed up to their court date, so I think it really showed that we don’t have to keep someone in custody at the levels that we’ve been doing for the last decade. The other bad news here, if we learned that discretion is really powerful and we should be rethinking how many people we have in detention that that was, I think, a revisiting of some lessons that we should have already known. The bad news were the backlogs. The backlogs in our immigration courts really, really skyrocketed as COVID made day to day work really, really difficult, as well as some pressures from the last administration. The other thing that, of course, made news from day one was the actual conditions of confinement that were tailor made for disaster in terms of COVID. We’re talking about detention centers for families and children detention centers across the country holding adult immigrants. These were and the Government Accountability Office looked into this and they found there just were not adequate measures in place in many. Many of the detention centers some were doing were making more of an effort than others. But social distancing, mask wearing the things that we know slow down COVID were not in place, the level that we would hope to make sure that everyone is healthy and safe. So the solution there, I think, is clear we need to rethink the level of commitment that we have and detention per.

Chancellor: So, you know, you talked so much about what we kind of see kind of a long term stalemate in immigration reform and this kind of is like coincided with potentially unsafe working conditions for a lot of essential workers. We’ve seen school shutdowns and just sort of like a mixed bag of relief policies. What did you see kind of going on here and how did that sort of affect the conditions that especially when it comes to the health of immigrants in the US? How do you think about that?

Pedroza: Yeah, and in really broad terms I think COVID has reminded us that we really do live in two different worlds. Those of us who are able to stay home and work over Zoom and get our work done had a really different experience than essential workers who had to go in-person to all of the kinds of work that we need to put food on the table to make sure that hospitals are up and running to make sure that everything that we know that is so essential that Americans have been doing usually for low wages, have we got reacquainted with the value of that work. At the same time, if you’re looking at meatpacking companies where early on in the pandemic, it was clear that there was pressure to keep those open, keep them up and running. There was not necessarily the same commitment to make sure that they were safe. So we have essential workers who got the message very clearly. You need to come into work at the same time that if we’re talking about immigrant populations or an authorized immigrant populations for the last 20 years, immigrants with children and those households mixed status households, the number of immigrants with kids has been growing. So we’re talking about not just workers, but workers with kids at home. And of course, we fear parent. You know that there was a lot of remote schooling and home schooling happening during the pandemic. So you have these two competing commitments. I have to go into work, but I have kids. I have to make sure that they’re showing up to class online and that can be really, really, really difficult. And these were already tough challenges. The balance between work and either child care or getting your kid to and from work was already really difficult. And I think the COVID made it even more challenging, just as a reminder of just how different experience and our experiences have been in the last year and a half. Those of us who were really happy to have our kids back in school and wearing masks, and we’re eager to get them back in those vibrant school environments. We know that in poor communities and immigrant communities, getting back into the classroom safely has been slow. So there are those challenges still remain the same time that we have the persistent need for essential work. So the kinds of relief efforts and the help that we’ve put in place at state and local and federal level has meant that a lot of these families that you’re talking about are unauthorized immigrants or mixed status. Families, unfortunately, are falling through the cracks, and they’re more likely to fall through the cracks. If you’re not living in a state like California, where thankfully we had some modest efforts from the state and from community based organizations to get relief to those households that need it. But we can do a lot more, and if we don’t, we know what the consequences are. People are going to be falling through the cracks and paying part of those consequences with housing instability, poverty, kids missing school. And the solutions are structural. So I’m hoping that in the coming years, we can really focus a lot more on how do we help people in the immediate moment, but also for long term planning and peace of mind?

Chancellor: So you mentioned some of the measures that California was taking, and I, you know, I want to go back to some of your earlier comments on the importance of place, and it seems like there’s been this confluence of wide variation in your state or local level. Health and Human Services policies. But I know you’ve studied quite a bit. And also, this is variation in state and local level, the response to the COVID pandemic. Tell me about that.

Pedroza: Yeah, I’m looking forward to the next wave of work by colleagues in sociology and public policy and economics as we wrap our heads around the existing set of policies before the pandemic. So think about states, states that were exclusionary for everyone. So there are some states in the US where it’s just really hard to get access to medical care. If you’re low income, it’s hard to get access to that schooling the kinds of things that we know can make a difference for your long term, long term self-sufficiency, long term well-being and mobility. And those are, we now know most of the same states that are also skeptical of the consequences of the pandemic and all of the mitigation efforts that we know can make a difference for getting the economy back up and running at full steam. That disconnect between contexts where people’s access to health, nutrition and adequate schooling was never that high of a priority. But it was more of an emphasis of you have. If you want something, you have to be willing to pay for it and you’re kind of on your own. No more person by person, case by case approach. That was a really difficult environment to be growing up in and raising kids and even before the pandemic. I think we’re really seeing that divergence get even stronger and it gets talked about in terms of polarization. And that’s of course, a huge part of it. But I think it’s a long standing rift that seems to be getting larger. And even if we don’t look at this from the lens of immigrants’ rights and immigrant well-being, there is still going to be this challenge for us. How do we make sure that everyone’s long term well-being is taken care of? And we know what some of those things, some of those factors are just happens that they have a lot of control over whether or not we’re going to make a difference and get people to people over the hurdle by investments in local communities. I worry that the states that are quick to open back up, they’re not taking mask mandates seriously, they’re not taking vaccinations seriously, purposely certain kinds of states that were struggling before the pandemic and whose local communities, white, black Latino communities were paying for those consequences with our health so that that rift is going to get, I believe, even stronger. In California, where I live, we have a lot of things in place, but even in California, it’s not uniform. So paying really close attention to what the state and local context is and what services are available, it’s going to make a big difference. And one outcome of that is just look at vaccination rates and map those on to other indicators of well-being. And I think that we have a lot to learn about how COVID may have been exposing existing inequalities and making challenges that we were ignoring even brighter for us. So I think the opportunity is that the urgency, I think, is now even more clear than it was before.

Chancellor: I want to dwell a little bit on how COVID has kind of exposed these sort of existing inequalities. And it seems like this issue of immigrant health during the pandemic, it probably underlines some of the shortcomings in our labor situation, our health and human services policies, and in particular, broadly in our immigration system. And I hope you can kind of leave us with some thoughts about what are some of the things that we can do that are going to do better by this group of folks, or these groups of folks, because it’s not monolithic.

Pedroza: Yeah, I’ve been in my work shifting more to what sorts of policy solutions do we know work and mitigating or at least addressing harm. And I think we know a lot about what the negative outcomes of immigration enforcement are, negative outcomes of COVID, negative outcomes of poverty, segregation and inequality. And we’re learning more every day. We don’t know as much about what kind of solutions might have a chance of at least addressing some of these negative consequences. But I want to nominate a couple so organizations, community based organizations provide a lot of information, a lot of services and connections, and you can’t do all of that work without also investing in trusting relationships with local communities and immigrant households. So I think that’s even just as important of an outcome that individuals and families and children are getting services that we need, but also that we have a sense that we belong. And then we have a fair shake here in U.S. systems and community organizations are a big part of that and work that I’m doing on looking at access to food stamps, looking at access to justice and the safety net in general. It’s clear that different kinds of community organizations can make a difference. So that’s one thing that I’ll say and blood work by other scholars who are doing tremendous work on community health centers. Community health centers have been doing really, really impressive work for a long time and there in some parts of the country, some of the only sources of support. And if we’re talking about having access to a clinic that might make the difference between being hurt and being seriously injured. So the work of Emilie Parker, for example, is really, really great in this regard. There’s also work on the Deferred Action for Childhood Arrivals, which is this temporary policy that was intended to help young immigrants who came to the US as young people. And we know that that has all sorts of benefits for peace, of mind, for mental health, for earnings. And I would if we made that program more permanent or came up with more long term solutions, I think we could really reap the full benefits of Dhaka by making it one more permanent and to possibly expanding it to a broader category of immigrants. I think you could really make a difference. The work of Kevin Paller and other colleagues at UC Davis has been really clear on these kinds of outcomes early childhood interventions. And there is work here on how those can make a difference for low income communities in general, Low-Income working families. I think we could do more to understand how those might be specifically beneficial to immigrant households mixed status households. So the role of home nurse visitation programs, women, infant and children’s programs, access to nutrition, those sorts of things I think could be really, really promising, especially if we think about how those programs can be partnered with community organizations and the important role that the trusted intermediaries can really play. I think it’s really hard to think of that menu of options that I just mentioned without taking a step back and saying, Wait a minute, it kind of sounds like what we really need is stability and peace of mind here. And one really important way to achieve that would be to think through what our immigration laws are doing right now where we’ve been at a stalemate. It’s been thirty five years since we’ve really overhauled that system. And since then, we’ve come up with short term temporary, conditional specific policies targeted at either small populations or individual countries or a specific time period. And those are helpful. But if we came up with a broader solution, we might find that local communities have a lot of resources and a lot of resilience that we’re missing out on. Hoping that more work and more examples of what difference access to the safety, net access to justice and access and services could really make if we invested in everyone, all of our neighbors.

Chancellor: Professor Pedroza, I am just so grateful for your work and for you taking the time to share it with us today. Thanks for being here.

Pedroza: Thank you so much, thank you for having me. This was really great conversation, and I look forward to seeing what the next couple of years bring in terms of all of the investments that I hope that we make across the US.

Chancellor: Thanks again to Professor Juan Pedroza for taking the time to talk with us. You can follow his work on Twitter or find more on his website at www.SocialDemography. XYZ. The production of this podcast was supported in part by funding from the US Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation. But its contents don’t necessarily represent the opinions or policies of that office, any other agency of the federal government or the Institute for Research on Poverty. Music for the episode is by Martin de Boer. Thanks for listening.