Legal status is an important social determinant of health for immigrants and children of immigrant parents, which is typically not measured in public health surveys. The sensitivity of legal status and presumed response behavior to relevant questions are primary reasons why this topic goes unmeasured. Changes in immigration enforcement likely impact the sensitivity of the topic and may compromise data quality, however, this is also likely when legal status matters most for health outcomes. This dissertation evaluates the response behavior to questions of citizenship and immigration status in the California Health Interview Survey and applies these data to identify mental health risks for Latino adolescents with an unauthorized parent.
The first study, When we ask, do they answer? Item-nonresponse to questions of citizenship and immigration status in the California Health Interview Survey, examined foreign born survey participants who did not answer questions of citizenship and immigration status
between 2001 and 2015. Nonresponse was low overall, however, increased over time and was largely attributable to respondents who were born in Mexico. The second study, When they answer, should we listen? Examining the quality of self-reported citizenship and immigration status, evaluated potential misreporting of legal status among Mexican-born participants between 2003 and 2015. This study utilized indirect estimation strategies which have been developed to produce profiles of the unauthorized population from surveys which do not ask legal status. Nearly a quarter of all Mexican-born participants reported that they were a non-citizen without a
green card, and these participants were demographically similar to external profiles of the unauthorized population. Predicted probabilities of unauthorized status produced by the indirect estimation procedure indicated that the threat of extensive misreporting was low and consistent over time. These results, paired with the findings of low nonresponse, indicate that participants were willing to answer questions of citizenship and immigration status and that these data are fit for use. The third paper, Severe Psychological Distress Among Latino Adolescents with an Unauthorized Parent examined adolescent mental health using data from 2007 to 2016 disaggregated by parental nativity and legal status. Multivariate logistic models indicated that Latino adolescents with an immigrant mother were less likely to report severe psychological distress and that children with an unauthorized father were more likely to report severe psychological distress. These findings reveal important heterogeneity among children in immigrant households and demonstrates the value of measuring legal status in a population survey. It is critical that data used to monitor public health trends more fully incorporate immigrants and their children by measuring domains which are relevant to their health and wellbeing. In addition to measuring what needs to be measured, researchers should continue to critically evaluate quality and put data which are fit to use to meaningful and timely use.