Changes in use of county public health services following implementation of Alabama’s immigration law

Kari White, Justin Blackburn, Bryn Manzella, Elisabeth Welty, Nir Menachemi

Research output: Contribution to journalArticle

15 Scopus citations


Several states have enacted legislation restricting undocumented immigrants’ access to publicly funded health benefits not protected by federal law. Using electronic health records from 140,856 county health department visits, we assessed the monthly change in Latino patients’ visits compared to non-Latinos 12 months before and after implementation of Alabama’s immigration law. We used ICD-9 diagnosis codes to determine whether visits included services exempt under the law: immunizations, testing and treatment for sexually transmitted infections (STIs) and communicable diseases, and family planning. Differences between groups in the mean percent change were assessed with t-tests. Among children younger than 18 years, there were no significant differences by ethnicity. Visits among Latino adults decreased by 28% for communicable diseases, 25% for STIs, and 13% for family planning; this was significantly different from changes among non-Latino adults (p <.05). State-level legislation may reduce immigrants’ access to protected benefits, which could adversely affect the broader public’s health.

Original languageEnglish (US)
Pages (from-to)1844-1852
Number of pages9
JournalJournal of Health Care for the Poor and Underserved
Issue number4
StatePublished - Jan 1 2014
Externally publishedYes


  • Access to care
  • Hispanic/Latino
  • Immigrants
  • Immigration policy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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