Immigrant-Inclusive Policies Promote Child and Family Health

In this issue of AJPH, findings by Miller et al. (p. 1738) suggest that anti-immigrant rhetoric and proposed changes to public charge during the early years of the Trump administration significantly reduced federal nutrition assistance program participation among mixed-status immigrant households. Mixed-status households in states with the most, compared with the least, generous eligibility provisions for noncitizens had greater declines in Supplemental Nutrition Assistance Program (SNAP) participation, and those in moderately generous states saw declines across SNAP and school meals programs. Public charge is a determination made when some potentially eligible noncitizens seek legal permanent residency. Trump-era changes to public charge included an expansion of assistance programs considered indicative of whether the applicant is deemed likely to be dependent on long-term government assistance in the future (i.e., a “public charge”). Prior to final rule issuance in August 2019, the proposed rule and several leaked drafts, as well as speculation about the scope, time frame, and contents of the rule change, perpetuated fear in immigrant communities. Miller et al.’s results indicating significant participation reductions in SNAP, the National School Lunch Program (NSLP), and the School Breakfast Program (SBP) are concerning, given robust evidence demonstrating these programs’ health and educational benefits. These findings suggest potentially harmful long-term consequences of anti-immigrant rhetoric and regulatory changes, underscoring the urgent necessity of implementing policy solutions that promote equitable assistance program access without fear.