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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 health care system.

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.

"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.

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