In this chapter, contributors review the impact of structural inequity and fear on immigrant health. Experts from the University of California, Irvine; Wake Forest University; the University of Texas Rio Grande Valley; RWJF; and Family Focus discuss how the health of immigrants and the health of their communities are impacted by racism, inequities, and fear of participating in civic life—especially when people risk being deported and separated from their families. Along with research and data, the contributors offer poignant stories of what it means to live with increased surveillance in Texas, how immigration policies keep people from essential health programs in Illinois, and what the fear of being observed in ordinary activities does to health in North Carolina. The contributors also consider the disproportionate impact of COVID-19 on immigrant communities.