KFF/New York Times 2025 Survey of Immigrants: Health and Health Care Experiences During the Second Trump Administration – KFF

Report on the Impact of U.S. Immigration Policies on Sustainable Development Goals

Introduction: An SDG Perspective on Immigrant Health and Well-being

Recent policy actions in the United States present significant challenges to the achievement of several Sustainable Development Goals (SDGs), particularly concerning the nation’s 51.9 million immigrants and their families. This report analyzes data from a Fall 2025 survey to assess the impacts of the current policy environment on immigrant health, access to care, and overall well-being, framed within the context of SDG 3 (Good Health and Well-being), SDG 10 (Reduced Inequalities), and SDG 16 (Peace, Justice and Strong Institutions).

Challenges to SDG 3: Good Health and Well-being

The fundamental goal of ensuring healthy lives and promoting well-being for all is being undermined for immigrant communities due to policy-induced fear and stress. The data reveals direct negative consequences on both mental and physical health.

Direct Health Impacts of Policy-Related Stress

• Since January 2025, 40% of immigrant adults have reported negative health impacts stemming from immigration-related worries. This figure rises to 77% among likely undocumented immigrants.
• Reported health impacts include increased stress, anxiety, sadness, sleep or eating problems, and the exacerbation of chronic conditions such as diabetes and high blood pressure.
• The well-being of children, a key demographic for SDG 3, is also compromised. Approximately 18% of immigrant parents report that their child has experienced negative impacts, including behavioral problems and disruptions to eating, sleeping, or school performance.

Barriers to Accessing Healthcare Services

Access to essential health services is a cornerstone of SDG 3. However, a growing number of immigrants are forgoing necessary medical attention.

1. The proportion of immigrant adults skipping or postponing healthcare in the past year increased from 22% in 2023 to 29% in 2025.
2. Among those who went without care, 19% cited immigration-related concerns as a reason.
3. For immigrant parents, 30% reported their children missed or delayed healthcare, with 14% citing immigration fears as a direct cause.

Exacerbating Disparities: A Setback for SDG 10 (Reduced Inequalities)

Current policies are widening health and social inequalities based on immigration status, race, and income, directly contravening the objective of SDG 10 to reduce inequality within and among countries.

Disparities in Health Coverage

Access to health coverage, a key determinant of health equity, varies dramatically across immigrant subgroups.

• As of 2025, 15% of all immigrant adults are uninsured. This rate masks severe inequalities:
  • Likely Undocumented Immigrants: 46% uninsured
  • Lawfully Present Immigrants: 21% uninsured
  • Naturalized Citizens: 7% uninsured
• Uninsured rates are disproportionately high among specific demographic groups, further deepening inequalities:
  • Hispanic Immigrants: 27%
  • Lower-Income Immigrants: 23%
  • Immigrants with Limited English Proficiency (LEP): 23%

Unequal Impact on Social and Economic Stability

The fear generated by the policy environment disproportionately affects the most vulnerable, hindering their access to essential social protection systems, a key target under both SDG 1 and SDG 10.

• The share of immigrants avoiding government assistance programs for food, housing, or healthcare due to fear rose from 8% in 2023 to 12% in 2025.
• This chilling effect is most pronounced among likely undocumented immigrants, where the rate of avoidance surged from 27% to 46%.
• Furthermore, 11% of immigrant adults, including 42% of the likely undocumented, have stopped participating in such programs since January 2025.

Erosion of Trust and Institutional Integrity: Implications for SDG 16

SDG 16 calls for effective, accountable, and inclusive institutions. The current climate has eroded trust in public institutions, including the healthcare system, creating an environment of fear that prevents individuals from seeking essential services.

Fear of Institutional Data Sharing

• A significant barrier to care is the fear that healthcare providers will not maintain patient confidentiality. 51% of immigrant adults are concerned that providers might share their information with immigration enforcement officials.
• This concern is nearly universal among likely undocumented immigrants, with 78% expressing fear, thereby undermining the healthcare system’s role as a safe and trusted institution for all residents.

Economic Barriers and Institutional Failures

The failure of institutions to ensure affordable care contributes to negative health outcomes and economic instability, undermining the principles of SDG 16.

1. Problems paying for healthcare have increased, affecting 36% of immigrant adults in 2025, up from 20% in 2023.
2. Cost and lack of coverage were cited by 63% of those who skipped care as a primary reason, highlighting systemic barriers to achieving universal health coverage (a target of SDG 3) and demonstrating an institutional failure to protect vulnerable populations.
3. While Community Health Centers (CHCs) serve as a crucial safety net, particularly for 45% of likely undocumented immigrants, policy changes threaten their capacity to serve these communities, further weakening institutional support systems.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article’s primary focus is on the health and well-being of immigrant families in the U.S. It details negative health impacts such as increased stress, anxiety, and worsening chronic conditions, as well as significant barriers to accessing health coverage and care. This directly relates to ensuring healthy lives and promoting well-being for all.

• SDG 10: Reduced Inequalities

  The article highlights significant disparities in health outcomes and access to care based on immigration status (naturalized citizen, lawfully present, likely undocumented), race/ethnicity, income, and English proficiency. It shows how specific policies create and exacerbate inequalities for the immigrant population compared to the U.S.-born population.

• SDG 1: No Poverty

  The article touches upon access to social protection systems. It notes that a growing share of immigrants are avoiding government programs for food, housing, and healthcare due to fear. This reluctance to access essential support systems can perpetuate poverty and hardship among vulnerable families.

• SDG 16: Peace, Justice and Strong Institutions

  The article discusses a lack of trust in institutions. It points out that immigrants fear their personal information will be shared by healthcare providers with immigration enforcement officials. This fear undermines the effectiveness and inclusivity of public institutions and services.

2. What specific targets under those SDGs can be identified based on the article’s content?

SDG 3: Good Health and Well-being

• Target 3.4: Reduce premature mortality from non-communicable diseases and promote mental health

  The article directly addresses this target by reporting that immigration-related worries lead to “increased stress, anxiety, or sadness” and “worsening health conditions like diabetes or high blood pressure.” This highlights the dual challenge of promoting mental well-being and managing non-communicable diseases within the immigrant community.

• Target 3.8: Achieve universal health coverage

  This target is central to the article, which extensively documents the lack of health coverage for immigrants. It details high uninsured rates, particularly among likely undocumented and lawfully present immigrants, and discusses how cost and lack of coverage are major reasons for skipping or postponing necessary health care, directly contradicting the goal of universal access and financial risk protection.

SDG 10: Reduced Inequalities

• Target 10.2: Empower and promote the social, economic and political inclusion of all, irrespective of origin or other status

  The article demonstrates the social exclusion of immigrants based on their immigration status. Policies and fears are shown to limit their access to fundamental services like healthcare and social assistance, preventing their full inclusion and participation in society.

• Target 10.3: Ensure equal opportunity and reduce inequalities of outcome

  The article provides clear evidence of unequal outcomes. It contrasts the high uninsured rates and negative health impacts experienced by immigrants with those of the U.S.-born population. It also details how specific policies, such as immigration enforcement and changes to tax and budget laws, directly contribute to these unequal health outcomes.

SDG 1: No Poverty

• Target 1.3: Implement nationally appropriate social protection systems for all

  The article shows how this target is undermined. It reports that a significant and increasing percentage of immigrants “avoided applying for a government program that helps pay for food, housing, or health care” due to fear related to their immigration status. This “chilling effect” prevents vulnerable populations from accessing the very social protection systems designed to support them.

SDG 16: Peace, Justice and Strong Institutions

• Target 16.6: Develop effective, accountable and transparent institutions

  The article implies a failure to meet this target. The widespread concern among immigrants that “health care providers sharing information about immigration status with immigration enforcement officials” points to a breakdown in trust and a perception that institutions are not accountable for protecting their private data, making these institutions ineffective for this segment of the population.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

For Target 3.4 (Mental Health and Well-being)

• Percentage of immigrant adults reporting negative health impacts (increased stress, anxiety, sadness) due to immigration-related worries: 40% overall, 77% among likely undocumented immigrants.
• Percentage of immigrant parents who say their child’s well-being has been negatively impacted (e.g., problems sleeping, changes in school performance): 18% overall, 46% among likely undocumented parents.

For Target 3.8 (Universal Health Coverage)

• Proportion of the population without health insurance: 15% of immigrant adults are uninsured (compared to 6% of U.S.-born adults). This rate is 46% for likely undocumented immigrants and 21% for lawfully present immigrants.
• Percentage of immigrant adults who skipped or postponed health care in the past 12 months: 29% (up from 22% in 2023).
• Proportion of those skipping care who cite cost or lack of insurance as a reason: 63%.

For Target 10.2 & 10.3 (Reduced Inequalities)

• Disparity in uninsured rates between immigrant adults (15%) and U.S.-born adults (6%).
• Disparity in uninsured rates among immigrant subgroups: Hispanic (27%), lower-income (23%), and those with Limited English Proficiency (23%) are more likely to be uninsured.

For Target 1.3 (Social Protection Systems)

• Percentage of immigrant adults who avoided applying for government assistance programs (food, housing, health care) due to immigration fears: 12% in 2025 (up from 8% in 2023).
• Percentage of likely undocumented immigrants who avoided applying for such programs: 46% in 2025 (up from 27% in 2023).

For Target 16.6 (Trust in Institutions)

• Percentage of immigrant adults concerned about health providers sharing patient information with immigration enforcement: 51% overall, 78% among likely undocumented immigrants.

4. Table of SDGs, Targets, and Indicators

Source: kff.org