Perceived general, mental, and physical health of Latinos in the United States following adoption of immigrant-inclusive state-level driver’s license policies: a time-series analysis

Background In the United States (U.S.), several states have laws that allow individuals to obtain driver's licenses regardless of their immigration status. Possession of a driver's license can improve an individual's access to social programs, healthcare services, and employment opportunities, which could lead to improvements in perceived mental and physical health among Latinos living in the U.S. Methods Using Behavioral Risk Factor Surveillance System data (2011-2019) for Latinos living in the U.S. overall (immigration status was not available), we compared the average number of self-reported perceived poor mental and physical health days/month, and general health status (single-item measures) before (January 2011-June 2013) and after implementation (July 2015-December 2019) of immigrant-inclusive license policies using interrupted time-series analyses and segmented linear regression, and a control group of states in which such policies were not implemented. We also compared the average number of adults reporting any perceived poor mental or physical health days ([greater than or equal to] 1 day/month) using a similar approach. Results One hundred twenty-three thousand eight hundred seven Latino adults were included; 66,805 lived in states that adopted immigrant-inclusive license policies. After implementation, average number of perceived poor physical health days significantly decreased from 4.30 to 3.80 days/month (immediate change = -0.64, 95% CI = -1.10 to -0.19). The proportion reporting [greater than or equal to] 1 perceived poor physical and mental health day significantly decreased from 41 to 34% (OR = 0.89, 95% CI = 0.80-1.00) and from 40 to 33% (OR = 0.84, 95% CI = 0.74-0.94), respectively. Conclusions Among all Latinos living in the U.S., immigrant-inclusive license policies were associated with fewer perceived poor physical health days per month and fewer adults experiencing poor physical and mental health. Because anti-immigrant policies can harm Latino communities regardless of immigration status and further widen health inequities, implementing state policies that do not restrict access to driver licenses based on immigrant status documentation could help address upstream drivers of such inequities. Keywords: Latino health, State policies, Immigrant health, Driver's license, Health disparities