UCLA

This dissertation investigates how interpersonal experiences of discrimination influence the health and healthcare behaviors of Asian and Latino immigrants living in California. This study is grounded in a structural determinant of health framework, drawing from Sewell’s theory of structure and Bronfenbrenner’s socioecological model. These theories inform the study’s hypotheses and guide the operationalization of key variables. Specifically, this research addresses three central questions: (1) How do specific forms of discrimination, such as wage theft, dangerous workplace conditions, and law enforcement encounters relate to self-rated health, psychological distress, and healthcare access? (2) Do these relationships differ between Asian and Latino immigrants? (3) Does documentation status further shape these associations?

To answer these questions, this dissertation draws on quantitative data from the Research on Immigrant Health and State Policy (RIGHTS) study, a cross-sectional population-based survey. Multivariable regression models were used to estimate the associations between discrete experiences of discrimination and four key outcomes: self-rated health, psychological distress, delayed medical care, and the number of doctor visits. Interaction terms were included to assess differences by race/ethnicity and documentation status.

Findings reveal that while not all individual forms of discrimination are universally predictive of negative health outcomes, several experiences, particularly being asked to perform dangerous work, wage theft, and law enforcement surveillance were consistently associated with poorer health and delayed care. These effects were more pronounced among Latino immigrants, suggesting that racialized enforcement practices and labor exploitation contribute to health inequities between immigrant groups. Furthermore, law enforcement surveillance was uniquely associated with poorer self-rated health among undocumented immigrants, suggesting the psychological toll of structural exclusion. Certain forms of discrimination were linked to increased doctor visits, suggesting that mental health distress may drive fragmented or crisis-oriented healthcare-seeking behavior.

This study contributes to public health and immigration scholarship by disaggregating the types of discrimination that impact health, incorporating intersectional analysis by race/ethnicity and documentation status, and framing these dynamics as public health issues rooted in broader social structural environments. It highlights the importance of healthcare systems that are trauma-informed and structurally competent, alongside inclusive policies for immigrants, to improve public health. Ultimately, the findings emphasize that achieving health equity for immigrants requires addressing the legal, economic, and enforcement structures that influence their everyday lives.