PCD. Identification of additional host effectors
and compounds (21) that induce A-PCD in conidia
and hyphae may inform new strategies for therapeutic intervention in vulnerable patient groups.
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We thank E. Pamer, M. Li, S. Kasahara, B. Zhai, and L. Heung for
discussions and critical reading of the manuscript; the Memorial Sloan
Kettering Cancer Center Cytology Facility, C. Franqui, and I. Leiner
for technical assistance; S. Knoblaugh (Ohio State University) for
histopathology; and D. Askew (University of Cincinnati) for expertise
on fungal strains. This research was supported by NIH grants RO1
AI093808 ( T.M.H.), R21 AI105617 (T.M.H.), RO1 AI081838 (R. A.C.),
T32 GM008704 (S.R.B.), P30 CA008748 (to MSKCC), and
P30GM106394 (B. Stanton, principal investigator; R.A.C., Pilot Project);
Burroughs Wellcome Fund Investigator in the Pathogenesis of
Infectious Disease Awards (T.M.H. and R. A.C.); Israel Science
Foundation grant 835/13 (A.S.); and Deutsche Forschungsgemeinschaft
grant BR1502/11-2 (G.H.B.). All data and code to understand and
address the conclusions of this research are available in the main
text and supplementary materials.
Materials and Methods
Figs. S1 to S10
Tables S1 and S2
3 March 2017; accepted 22 June 2017
Protecting unauthorized immigrant
mothers improves their children’s
Jens Hainmueller,1,2,3*† Duncan Lawrence,2† Linna Martén,2,4† Bernard Black,5
Lucila Figueroa,2,6 Michael Hotard,2 Tomás R. Jiménez,7 Fernando Mendoza,8
Maria I. Rodriguez,9 Jonas J. Swartz,9 David D. Laitin1,2
The United States is embroiled in a debate about whether to protect or deport its
estimated 11 million unauthorized immigrants, but the fact that these immigrants are
also parents to more than 4 million U.S.-born children is often overlooked. We provide
causal evidence of the impact of parents’ unauthorized immigration status on the health
of their U.S. citizen children. The Deferred Action for Childhood Arrivals (DACA) program
granted temporary protection from deportation to more than 780,000 unauthorized
immigrants. We used Medicaid claims data from Oregon and exploited the quasi-random
assignment of DACA eligibility among mothers with birthdates close to the DACA age
qualification cutoff. Mothers’ DACA eligibility significantly decreased adjustment and
anxiety disorder diagnoses among their children. Parents’ unauthorized status is thus a
substantial barrier to normal child development and perpetuates health inequalities
through the intergenerational transmission of disadvantage.
There is an ongoing, heated debate about he fate of the estimated 11 million un- authorizedimmigrantslivingin the United States. One important and often overlooked issue in these policy debates is that unauthorized immigrants are also parents to more
than 4 million children who are U.S. citizens by
birth (1, 2). How are these children affected by
the unauthorized status of their parents? Research has largely focused on the impacts of unauthorized status on the immigrants themselves
(3), but we know much less about the potential
intergenerational effects of this status on the
well-being of their offspring (4).
A growing body of research has demonstrated
links between parental immigration status and
child development (5–10) and generated insights
into how it might affect children’s health. Chil-
dren of unauthorized immigrant parents face
challenges beyond low socioeconomic status, in-
cluding parental anxiety, fear of separation, and
acculturative stress. Parent-child separations can
be harmful to children’s health, economic secu-
rity, and long-term development. Virtually all of
these studies have been qualitative or correla-
tional because of the difficulties in isolating the
causal effects of parents’ immigration status and
collecting systematic data on large samples of
Families with unauthorized immigrant parents
differ from families with authorized immigrant
parents in many confounding characteristics
(e.g., education, health care, and poverty) that
might generate differences in child outcomes
(11–13). This nonrandom selection implies that
typical observational studies cannot isolate the
causal effect of immigration status. Indeed, a
recent consensus statement of the Society for
Research on Adolescence (14) concludes that
“Nonexperimental or quasiexperimental research
with strong causal inference...has been lacking to
date in studies of policies and practices related to
The study of unauthorized status is further constrained by the difficulty of collecting systematic
samples, because unauthorized immigrants are
underrepresented in general population surveys
(15). Moreover, questions about the unauthorized
status of immigrants are typically avoided given
concerns about confidentiality and reporting
biases (16). Researchers therefore often have to
resort to noisy proxies for unauthorized status,
such as the identification of individuals as foreign-born, Hispanic, or Spanish-speaking (17, 18).
We provide causal evidence of the intergenerational impact of parental immigration status
on children’s health. We focus on the Deferred
Action for Childhood Arrivals (DACA) program,
which is one of the most extensive policies directed toward unauthorized immigrants in recent
decades. The DACA program, announced in 2012
by President Obama, protects recipients from
deportation by granting them a 2-year (
renewable) deferred action status, while also allowing them to obtain temporary work authorization.
More than 780,000 unauthorized immigrants so
far have received deferred action through this
program (19) (fig. S1). Although DACA recipients
arrived in the United States as children, many
are now adults and have become parents themselves. An estimated 200,000 children had parents
1Department of Political Science, Stanford University,
Stanford, CA 94305, USA. 2Immigration Policy Lab, Stanford
University, Stanford, CA 94305, USA. 3Graduate School of
Business, Stanford University, Stanford, CA 94305, USA.
4Uppsala Center for Labor Studies, Uppsala University,
Uppsala 75120, Sweden. 5Pritzker Law School and Kellogg
School of Management, Northwestern University, Chicago, IL
60611, USA. 6Department of Politics, University of Virginia,
Charlottesville, VA 22903, USA. 7Department of Sociology,
Stanford University, Stanford, CA 94305, USA. 8Department
of Pediatrics, Stanford University School of Medicine,
Stanford, CA 94305, USA. 9Department of Obstetrics and
Gynecology, Oregon Health & Science University, Portland,
OR 97239, USA.
*Corresponding author. Email: firstname.lastname@example.org
†These authors contributed equally to this work.