Exposures to acute and chronic stressors

Exposures to acute and chronic stressors that may have lasting effects on health later along the life-course are often differentially distributed by immigrant legal status. In particular, undocumented tryptophan hydroxylase might entail traumatic physical and psychological experiences (Holmes, 2013) that have lasting health effects. Furthermore, chronic and acute work-related exposures with potentially long-term impacts on health may also be disproportionately distributed across legal status strata. Undocumented workers have limited power to change occupational exposures (Holmes, 2007) that increase risk for injuries or illness that may have lasting, irreversible impacts on their physical and mental health (Negi, 2011; Walter, Bourgois, & Loinaz, 2003). The long-term impact of poor working conditions may not be apparent until late-life. Moreover, there may be lasting health consequences of trauma, injury, or stress earlier in life even if political or individual-level changes lead to a change in legal status. Some exposures may be particularly salient for child health as they undergo critical periods of development. For example, early childhood exposure to pesticides used for farming in the U.S. have in turn been linked to adverse health and neurodevelopmental outcomes for the children of farmworkers (Raanan et al., 2014), who may be disproportionately undocumented (Mehta et al., 2000). Moreover, the broader social, economic, and health inequities experienced by parents who face barriers to healthcare (Ortega et al., 2007; Vargas Bustamante et al., 2012) and low wages (Hall et al., 2010) as the result of their legal status may, in turn, result in early and long-term disadvantages for their children, including barriers to early childhood education (Yoshikawa, 2011), greater developmental risk (Ortega et al., 2009), and lower educational attainment (Bean et al., 2011). Fewer opportunities for cognitive and social development during early and critical developmental stages may contribute to poor health later in life, regardless of intervening experiences. The life-course construct of critical periods is therefore closely tied to concepts of linked lives and intergenerational effects.
Linked lives and intergenerational effects Immigrants׳ individual-level exposure to inequitable structural factors can have an impact on families and broader communities. The construct of linked lives provides a theoretical basis for examining how conditions related to an individual׳s legal status may influence or be influenced by the conditions of others, with potential consequences for health (Elder Jr., 1998; Gee et al., 2012). Intergenerational effects points to the ways in which an individual׳s life-course is shaped by individuals from previous generations and shapes the exposures of those in future generations (Kane, 2015; Serbin & Karp, 2004). Most often, linked lives and intergenerational effects refer to connections between family members, given evidence linking the health exposures of those in previous generations to the health outcomes of children and grandchildren (e.g. Lê-Sherban, Diez Roux, Li, & Morgenstern, 2014). An estimated nine million individuals in the U.S. live in mixed legal status families, and family members who are authorized to be in the U.S. can experience the consequences of policies that are meant to limit access to services for their undocumented relatives (Castañeda & Melo, 2014; Chavez, Lopez, Englebrecht, & Viramontez Anguiano, 2012). Lives may also linked across neighborhoods, communities, and institutions: enforcement or service exclusions aimed at undocumented immigrants may affect the wellbeing of community members, regardless of legal status (Hacker et al., 2011; Rhodes et al., 2015). One example of the intergenerational impact of legal status stratification on health relates to the separation of foreign- and U.S.-born family members, including parents and children, due to immigrant detention and deportation (Chaudry et al., 2010; Dreby, 2015). Parental separation due to deportation has been associated with reduced child well-being (Brabeck & Xu, 2010; Chaudry et al., 2010; Koball et al., 2015). In findings from a longitudinal birth cohort study, Yoshikawa (2011) reports that mothers׳ fear of deportation, even without its actual occurrence, was associated with higher levels of maternal depression, which was in turn associated with fewer cognitive skills among pre-school age children.