Emergency room visits among people born outside the United States declined sharply at Los Angeles County safety-net hospitals after immigration enforcement intensified in the region last year, according to new USC research.
Despite making fewer ER visits, foreign-born patients were more likely to be hospitalized when they did seek care, according to the study , published Oct. 5 in JAMA Network Open.
The findings add to evidence that immigrant populations avoid or delay seeking medical care during periods of local immigration enforcement activity, which could lead to the development of more serious health conditions and higher costs for patients and the healthcare system.
Key findings
Immigration enforcement activity increased in L.A. County in early 2025 before expanding significantly in early June 2025 with high-profile operations in downtown Los Angeles and other communities.
Researchers analyzed patients' self-reported country of birth at three safety-net hospitals during the 12 months before June 2025 and the following four months. These hospitals—Los Angeles General Medical Center, Harbor-UCLA Medical Center and Olive View-UCLA Medical Center—are a key source of care for immigrant communities.
- In the first four weeks after heightened immigration operations began, emergency department visits by foreign-born patients decreased by more than 20% compared with U.S.-born patients. By October 2025, this gap had narrowed to 10%.
- Yet, foreign-born patients who did seek emergency care were more likely to be hospitalized. Compared with U.S.-born patients, admission rates increased by 4.8 percentage points among Mexican-born patients, 5.1 percentage points among patients born in Central or South America, and 2.5 percentage points among those born in Asia.
"Our findings suggest that immigration enforcement may discourage immigrant patients from seeking acute care when they need it, with potentially serious health consequences for patients and economic costs for the health systems that serve them," said lead author Sarah Axeen , a scholar at the USC Schaeffer Institute for Public Policy & Government Service and assistant professor at the Keck School of Medicine of USC.
About the study
Other authors are Cameron Kaplan, Daniel Cordova, Manuel Pastor and Todd Schneberk, all of USC; Annie Ro of the University of California, Irvine; and Anna Gorman of the Los Angeles County Department of Health Services.
Data for this work was made available by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001855. The content is solely the responsibility of the authors.
