May Sudhinaraset, PhD, is an affiliate at the UCLA Center for Health Policy Research and an associate professor in the Department of Community Health Sciences in the UCLA Fielding School of Public Health. She is also a member of the California Center for Population Research and faculty advisory committee in the UCLA Asian American Studies Center.

Sudhinaraset focuses on health equities across race/ethnicity, immigration status, gender, and socioeconomic status globally and in the US. Her specific areas of research include sexual and reproductive health care, quality of care, and broader social determinants of health.

Sudhinaraset has led a number of global and U.S.-based research projects. Globally, she has led the development of validated measures for person-centered sexual and reproductive health care; implemented and evaluated quality improvement interventions in India, Kenya, and Myanmar; and examined inequities related to maternal and child health. In the U.S., she has examined the role of reproductive rights policies and immigrant policies on preterm birth and low birth weight. She also leads a study to assess access to care for Asian and Latinx undocumented immigrants in California.

Sudhinaraset received her undergraduate degree in biology from UC Berkeley and her doctorate from Johns Hopkins Bloomberg School of Public Health.

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The "Disproportionate Costs" of Immigrant Policy on the Health of Latinx and Asian Immigrants
Journal Article
Journal Article

The "Disproportionate Costs" of Immigrant Policy on the Health of Latinx and Asian Immigrants

There is growing evidence that Asian and Latinx immigrants' health and health care access is shaped by immigrant policies that determine their rights, protections, and access to resources and the extent to which they are targeted by policing or deportation based on citizenship/legal status and other immigration-related social categories. However, there is limited population-based evidence of how immigrants experience the direct consequences of policies, nor of the impact of such consequences on their health.

Between 2018 and 2020, researchers conducted the Research on Immigrant Health and State Policy (RIGHTS) Study, developing a population-based survey of Asian and Latinx immigrants in California that measured 23 exclusionary experiences under health care and social services, education, labor/employment, and immigration enforcement policies. Applying Ruth Wilson Gilmore's concept of "disproportionate costs," authors conducted a latent class analysis (LCA) and regression models of the RIGHTS data to 1) describe patterns of immigrant policy exclusion experienced by Asian and Latinx immigrants and 2) test relationships between patterns of policy exclusion and health care access and health status.

LCA analyses identified six classes of distinct combinations of policy exclusions. In regression analyses, respondents in the class with cumulative exclusions across all policy sectors had the worst health care access and highest level of psychological distress, but the best self-rated health, while those in the class with employment and enforcement exclusions also had poor health care access. Respondents in the other three classes experienced combinations of health and social services exclusions, but these alone were not associated with worse outcomes.

Findings: Results show that the consequences of immigrant policies harm health through both cumulative exposure to and intersections of exclusions across policy sectors. Labor/employment and immigration enforcement policies, specifically, likely drive health inequities within immigrant populations. The RIGHTS study highlights the need to measure the cumulative and intersecting "disproportionate costs" of immigrant policy within diverse immigrant populations.
 

Persistent Effects of Legal Status on Healthcare Access and Outcomes: Findings from a State-Wide Representative Cross-Sectional Survey in California (BMJ Public Health)
Journal Article
Journal Article

Persistent Effects of Legal Status on Healthcare Access and Outcomes: Findings from a State-Wide Representative Cross-Sectional Survey in California (BMJ Public Health)

Summary: This study examines how legal status and past undocumented status are associated with health care access and health outcomes. Data were collected between 2018 and 2020 as a follow-on, cross-sectional survey to the California Health Interview Survey (CHIS). Researchers assess associations between past and current legal status and usual source of care, delayed medical care and psychological distress.

Findings: Overall, 26.2% of the sample had ever been undocumented. Compared with citizens who have always held lawful status (CLS), noncitizens who were previously undocumented and noncitizens who have always held lawful status (NLS) were less likely to have a usual source of care. Citizens who were previously undocumented were more likely to delay medical care compared with CLS. NLS were more likely to have moderate and above distress compared with CLS.

Public health efforts are needed to address the burden of trauma and disadvantage among those experiencing persistent effects of undocumented status.

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Barriers to Breastfeeding cover pages
Policy Note
Policy Note

Reducing Breast Cancer Risk Through Better Family Leave Policies

In 2023, an estimated 32,000 women in California will be diagnosed with breast cancer, and approximately 4,680 will die from it. For birthing women, both the initiation of breastfeeding and the duration of it can reduce the risk of breast cancer. Therefore, it is important to understand the barriers to a woman’s decision to start breastfeeding and to continuing its practice for as long as desired.

Through the study of mothers of newborns, maternal care providers (including physicians, nurses, lactation consultants, and doulas), and community advocates for child and maternal health, authors of this policy note gained insights into the barriers to initiating and continuing to breastfeed, particularly among working women.

Based on interviews, as well as on literature and policy reviews, this policy note presents authors’ findings on the perceived benefits of comprehensive family leave, lack of family leave policies as a barrier to breastfeeding, and recommendations for improving family leave policies.

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Barriers to Breastfeeding cover pages
Policy Note
Policy Note

Reducing Breast Cancer Risk Through Improved Workplace Accommodation

In 2023, an estimated 32,000 women in California will be diagnosed with breast cancer, and approximately 4,680 will die from it. For birthing women, both the initiation of breastfeeding and the duration of it can reduce the risk of breast cancer. Therefore, it is important to understand the barriers to a woman’s decision to start breastfeeding and to continuing its practice for as long as desired.

Through this study of mothers of newborns, maternal care providers (including physicians, nurses, lactation consultants, and doulas), and community advocates for child and maternal health, authors gained insights into the barriers to initiating and continuing to breastfeed, particularly among women who enter or return to the workforce.

In this policy note, authors present findings — based on interviews, literature, and policy reviews — on the challenges women face in achieving their breastfeeding goals due to workplace barriers, as well as recommendations for improving workplace accommodations for breastfeeding mothers.

This is one key finding in a larger study of 33 participants who represent or work with Black, Asian American, or Native Hawaiian or Pacific Islander communities. In conducting the study, the authors learned about the barriers to initiating and maintaining breastfeeding in accordance with a mother’s breastfeeding plan.

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The "Disproportionate Costs" of Immigrant Policy on the Health of Latinx and Asian Immigrants
Journal Article
Journal Article

The "Disproportionate Costs" of Immigrant Policy on the Health of Latinx and Asian Immigrants

There is growing evidence that Asian and Latinx immigrants' health and health care access is shaped by immigrant policies that determine their rights, protections, and access to resources and the extent to which they are targeted by policing or deportation based on citizenship/legal status and other immigration-related social categories. However, there is limited population-based evidence of how immigrants experience the direct consequences of policies, nor of the impact of such consequences on their health.

Between 2018 and 2020, researchers conducted the Research on Immigrant Health and State Policy (RIGHTS) Study, developing a population-based survey of Asian and Latinx immigrants in California that measured 23 exclusionary experiences under health care and social services, education, labor/employment, and immigration enforcement policies. Applying Ruth Wilson Gilmore's concept of "disproportionate costs," authors conducted a latent class analysis (LCA) and regression models of the RIGHTS data to 1) describe patterns of immigrant policy exclusion experienced by Asian and Latinx immigrants and 2) test relationships between patterns of policy exclusion and health care access and health status.

LCA analyses identified six classes of distinct combinations of policy exclusions. In regression analyses, respondents in the class with cumulative exclusions across all policy sectors had the worst health care access and highest level of psychological distress, but the best self-rated health, while those in the class with employment and enforcement exclusions also had poor health care access. Respondents in the other three classes experienced combinations of health and social services exclusions, but these alone were not associated with worse outcomes.

Findings: Results show that the consequences of immigrant policies harm health through both cumulative exposure to and intersections of exclusions across policy sectors. Labor/employment and immigration enforcement policies, specifically, likely drive health inequities within immigrant populations. The RIGHTS study highlights the need to measure the cumulative and intersecting "disproportionate costs" of immigrant policy within diverse immigrant populations.
 

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Persistent Effects of Legal Status on Healthcare Access and Outcomes: Findings from a State-Wide Representative Cross-Sectional Survey in California (BMJ Public Health)
Journal Article
Journal Article

Persistent Effects of Legal Status on Healthcare Access and Outcomes: Findings from a State-Wide Representative Cross-Sectional Survey in California (BMJ Public Health)

Summary: This study examines how legal status and past undocumented status are associated with health care access and health outcomes. Data were collected between 2018 and 2020 as a follow-on, cross-sectional survey to the California Health Interview Survey (CHIS). Researchers assess associations between past and current legal status and usual source of care, delayed medical care and psychological distress.

Findings: Overall, 26.2% of the sample had ever been undocumented. Compared with citizens who have always held lawful status (CLS), noncitizens who were previously undocumented and noncitizens who have always held lawful status (NLS) were less likely to have a usual source of care. Citizens who were previously undocumented were more likely to delay medical care compared with CLS. NLS were more likely to have moderate and above distress compared with CLS.

Public health efforts are needed to address the burden of trauma and disadvantage among those experiencing persistent effects of undocumented status.

Read the Publication:

Barriers to Breastfeeding cover pages
Policy Note
Policy Note

Reducing Breast Cancer Risk Through Better Family Leave Policies

In 2023, an estimated 32,000 women in California will be diagnosed with breast cancer, and approximately 4,680 will die from it. For birthing women, both the initiation of breastfeeding and the duration of it can reduce the risk of breast cancer. Therefore, it is important to understand the barriers to a woman’s decision to start breastfeeding and to continuing its practice for as long as desired.

Through the study of mothers of newborns, maternal care providers (including physicians, nurses, lactation consultants, and doulas), and community advocates for child and maternal health, authors of this policy note gained insights into the barriers to initiating and continuing to breastfeed, particularly among working women.

Based on interviews, as well as on literature and policy reviews, this policy note presents authors’ findings on the perceived benefits of comprehensive family leave, lack of family leave policies as a barrier to breastfeeding, and recommendations for improving family leave policies.

Read the Publications

Center in the News

Amplifying Asian Immigrant Women Voices through a Study on Sexual and Reproductive Health Experiences

This story which appeared on the University of California Newsroom highlights the work of Dr. May Sudhinaraset, associate professor of community health sciences and UCLA CHPR faculty associate. Sudhinaraset and her colleagues launched the first study to collect national data on the sexual and reproductive health care experiences of Asian immigrant women. News https://ucghi.universityofcalifornia.edu/news/amplifying-asian-immigrant-women-voices-through-study-sexual-and-reproductive-health

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Online

Experiences of Exclusion: How Policy Shapes the Lives of Latinx and Asian Immigrants

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