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To Your Health: NLM update Transcript

DACA's impact on mental health: 10/02/2017

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health, a consumer health oriented podcast from NLM, that helps you use MedlinePlus to follow up on weekly topics.

The possible end of a program that provides freedom from deportation (and access to work permits) for undocumented immigrants, who were brought to the U.S. before age 16, has serious public health implications, finds an interesting perspective recently published in the New England Journal of Medicine.

Although the perspective's two authors note current deliberations about the Deferred Action for Childhood Arrivals program (DACA) often focus on its economic consequences, the authors counter the immigration program also has a significant impact on public health.

DACA began in June 2012 following an executive order from then-U.S. President Barack Obama; it is scheduled (by the executive order of current President Donald Trump) to be rescinded in March 2018. However, the U.S. Congress could decide to continue parts or all of the program.

Meanwhile, the perspective's two authors, who are physicians from the University of Pennsylvania School of Medicine and Massachusetts General Hospital, report recent research suggests moderate or severe psychological distress declined 40 percent in a DACA-eligible group compared to their non-eligible peers.

The perspective's authors report rates of adjustment and anxiety disorders fell by more than half after DACA was implemented among eligible, young adult recipients in the state of Oregon. The authors note other recent descriptive studies suggest significant improvements in psychological well-being occurred among DACA eligible persons after the program's implementation five years ago.

The authors write (and we quote): 'the evidence clearly indicates that rescinding DACA will have profound adverse population-level effects on mental health' (end of quote).

The perspective's authors add (and we quote): 'the potential mental health fallout from DACA's termination will be immensely challenging to address though our formal health care and public health systems because it is likely to be a silent and unseen problem' (end of quote).

The perspective's authors note that DACA eligible young adults (who often are called 'dreamers' by politicians and the news media) will seek assistance from physicians, other health care providers, social workers, and educators to counter fears of increased scrutiny from immigration authorities. In fact, the National Academy of Science, Engineering, and Medicine's Roundtable on Health Literacy heard vivid reports from health care providers about increased fears within U.S. immigrant populations in a March 2017 meeting in Oakland, CA.

The perspective's authors write (and we quote): 'such fears and isolation will make it difficult to deploy mental health treatment and public mental health resources where they will be needed most' (end of quote).

The perspective's authors add while (and we quote): 'DACA was never intended to be a public health program... its population-level consequences for mental health have been significant and rival those of any large-scale health or social policies in recent history' (end of quote).

To backup, the perspective's authors explain DACA provided freedom from deportation and access to work permits if undocumented immigrants (brought to the U.S. before age 16) completed high school, (or received a high school equivalence certificate or military service). The perspective's authors note the program currently covers about 800,000 young adults mostly from Mexico, Guatemala, El Salvador, South Korea, and Honduras. The authors explain DACA does not provide a pathway to U.S. citizenship.

The perspective's authors encourage the U.S. Congress to pass new legislation to continue the program, which they believe would be a well-timed preemptive strike that could prevent a significant public health challenge to the U.S. health care delivery system.

Otherwise, MedlinePlus.gov's health disparities health topic page reports immigrant populations are one of the demographic groups that currently experience significantly worse health outcomes compared to the U.S. general population.

A link to the U.S. Centers for Disease Control and Prevention's comprehensive report on health disparities and inequalities is available within the 'statistics and research' section of MedlinePlus.gov's health disparities health topic page.

MedlinePlus.gov's health disparities health topic page additionally provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. Clinical trials that may be occurring in your area can be found in the 'clinical trials' section. You can sign up to receive updates about health disparities as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's health disparities health topic page, please type 'health disparities' in the search box on MedlinePlus.gov's home page, then, click on 'health disparities (National Library of Medicine).'

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