Project Summary/Abstract Over the past decade, up to 1,000,000 US citizen children have experienced the trauma of parental deportation and family separation, and an additional 4,000,000 children with undocumented parents face the risk of parental deportation. These children experience extreme adversity as a result of their parents’ undocumented status. This adversity will translate to worse health, educational, and economic outcomes across the life course. Immigration enforcement—the arrest, detention, and deportation of immigrants from the United States—exacerbates these health risks. Local policies that expand immigrants’ rights and access to services and material resources (immigrant integration policies) and that limit local government officials’ involvement in immigration enforcement (sanctuary policies) could be important tools for promoting health for these children. Little evidence exists for the effectiveness of these policies. The main goal of this study is to evaluate whether local sanctuary and integration policies improve health care access, physical health, and mental health for children with immigrant parents. A methodological innovation of this study is the use of a new comprehensive, longitudinal, nationwide database of state, county, and municipal sanctuary and integration policies, compiled by the research team. This database will be merged with a nationally-representative sample from the 2005–2019 National Health Interview Survey consisting of approximately 35,000 US-born children with likely-undocumented, noncitizen parents from Mexico, El Salvador, Guatemala, and Honduras. This study will use rigorous quasi-experimental methods to test the following hypotheses: 1) Passage of sanctuary and integration policies is associated with higher levels of health insurance coverage, better access to preventive medical and dental care, fewer emotional difficulties, better parent-rated health, and lower rates of disability for children with likely-undocumented parents [Specific Aim 1]. 2) Children living in jurisdictions with sanctuary and integration policies will not be as negatively impacted by immigration enforcement, compared to children living in jurisdictions without such policies [Specific Aim 2]. First, this study will use a difference-in-differences design to examine whether these outcomes improve when jurisdictions pass sanctuary and integration policies. Next, a moderation analysis will be conducted to examine whether the health impacts of immigration enforcement vary across jurisdictions with and without sanctuary and integration policies. This study will produce rigorous translational research that will help policymakers, practitioners, and immigrant-serving organizations choose effective policies to promote health equity for immigrant families. This will be the first study to examine the health impacts of county and municipal policies that expand immigrants’ rights and limit local involvement in immigration enforcement. Thi...