Online Poster Portal

Background: Anti-immigrant rhetoric and enforcement actions in the United States have contributed to a pervasive climate of fear that discourages all immigrants, regardless of lawful status, from seeking healthcare services. This climate has been further compounded by structural policy changes, including California DHCS's freeze on Medi-Cal enrollment for certain undocumented adults effective January 1, 2026, and the elimination of protected status for schools, hospitals, and churches as safe havens from immigration enforcement. Historically, emergency departments and urgent care centers have been critical safety-net access points for undocumented and legal immigrants who delay care for chronic conditions for fear of direct or indirect immigration-related consequences or lack stable primary care. We expect that their utilization by these populations has likely sky-rocketed due to the current political climate. 

Objective: To examine the association between immigration-related experiences and stress, insurance status, delayed care-seeking behavior, and comorbidities among patients presenting to various clinics and urgent care centers across Los Angeles County.

Methods: This cross-sectional survey study uses REDCap for data collection. Survey questions were collected and adapted from the California Health Interview Survey (CHIS), the Person-Centered Primary Care Measure, the KFF/New York Times 2025 Survey of Immigrants, and UCSF SOIS. The study will be conducted at multiple clinics across Los Angeles County such as Mid-Valley Comprehensive Clinic (MVCC) urgent care, Clinica Romero Primary Care Clinic, Mission Community Hospital Family Medicine Residency Program Teaching Clinics, and Venice Family Clinic. Participants will be randomly sampled from the waiting room. Participants will be compensated with a gift card. The survey includes 30+ questions inquiring about comorbidities, healthcare access and utilization, patient-provider trust, and immigration-related stress. Exposure measures include self-reported immigration status and related stressors, primary language, and current insurance status. Outcomes analyzed include the number and severity of co-morbidites and increase in urgent care utilization. 

Results: We expect a majority of non-citizen participants will report delayed care-seeking behaviors​. Most participants with a high number of urgent care visits will have a high burden of disease in terms of number of comorbidities and severity of disease.

Conclusions: Findings from this study will raise awareness of the direct impact of immigration raids and Medi-Cal coverage changes affecting immigrant communities in Los Angeles County.​ Survey findings may inform policy and advocacy initiatives to reduce healthcare utilization costs by improving access to care and reducing barriers to timely care-seeking..

Acknowledgements: The authors acknowledge our various clinic partners and the patients contributing to this research. The authors are supported by the UCLA HRSA Center of Excellence. The authors report no conflicts of interest.