Battling discrimination and social isolation: psychological distress among Latino day laborers

Perceived and Experienced Anti-Chinese Discrimination and Its Associated Psychological Impacts Among Chinese Canadians During the Wave 2 of the COVID-19 Pandemic

The current study examined the sociodemographic factors associated with perceived and experienced anti-Chinese discrimination and discrimination as a predictor of psychological distress and loneliness among Chinese Canadians. A cross-sectional online survey was conducted in early 2021 with a sample of 899 Chinese Canadians (i.e., immigrants, citizens, visitors, and international students) during the Wave 2 of the COVID-19 pandemic. Overall, anti-Chinese discrimination was generally associated with younger age and poor financial or health status. Christianity/Catholicism believers were less likely to report perceived discrimination, whereas being married/partnered and living with family reduced the incidences of experienced discrimination. Most importantly, hierarchical linear regression models showed that both perceived and experienced discrimination predicted higher psychological distress (βs = 4.90-7.57, ps ≤ .001) and loneliness (βs = .89-1.73, ps ≤ .003), before and after controlling for all related sociodemographic covariates. Additionally, older age, higher education, better financial or health status could all buffer psychological distress, whereas living with family or in a house and better financial or health status could mitigate feeling of loneliness. The results suggested that discrimination has a robust detrimental impact on mental health conditions among Chinese Canadians.

A systematic review of how social connectedness influences associations between racism and discrimination on health outcomes

Racial discrimination is a well-known risk factor of racial disparities in health. Although progress has been made in identifying multiple levels through which racism and racial discrimination influences health, less is known about social factors that may buffer racism's associations with health. We conducted a systematic review of the literature with a specific focus on social connectedness, racism, and health, retrieving studies conducted in the United States and published between January 1, 2012, and July 30, 2022, in peer-reviewed journals. Of the 787 articles screened, 32 were selected for full-text synthesis. Most studies (72%) were at the individual level, cross-sectional, and among community/neighborhood, school, or university samples. Studies had good methodological rigor and low risk of bias. Measures of racism and racial discrimination varied. Discrimination scales included unfair treatment because of race, schedule of racist events, experiences of lifetime discrimination, and everyday discrimination. Measures of social connectedness (or disconnectedness) varied. Social-connectedness constructs included social isolation, loneliness, and social support. Mental health was the most frequently examined outcome (75%). Effect modification was used in 56% of studies and mediation in 34% of studies. In 81% of studies, at least 1 aspect of social connectedness significantly buffered or mediated the associations between racism and health. Negative health associations were often weaker among people with higher social connectedness. Social connectedness is an important buffering mechanism to mitigate the associations between racial discrimination and health. In future studies, harmonizing metrics of social connectedness and racial discrimination can strengthen causal claims to inform interventions.

Mixed methods in community psychology: A values-forward synthesis

Mixed methods research (MMR) combines multiple traditions, methods, and worldviews to enrich research design and interpretation of data. In this virtual special issue, we highlight the use of MMR within the field of community psychology. The first MMR studies appeared in flagship community psychology journals over 30 years ago (in 1991). To explore the uses of MMR in the field, we first review existing literature by identifying all papers appearing in either Journal of Community Psychology or American Journal of Community Psychology in which the word "mixed" appeared. A total of 88 publications were identified. Many of these papers illustrate the pragmatic use of MMR to evaluate programs and to answer different research questions using different methods. We coded articles based on Green et al.'s classifications of the purpose of the mixing: triangulation, development, complementarity, expansion, and initiation. Complementarity was the most frequently used purpose (46.6% of articles), and nearly a quarter of articles mixed for multiple purposes (23.86%). We also coded for any community psychology values advanced by the use of mixed methods. We outline three themes here with corresponding exemplars. These articles illustrate how MMR can highlight ecological analysis and reconsider dominant, individual-level paradigms; center participant and community member experiences; and unpack paradoxes to increase the usefulness of research findings.

Development and refinement of a corner-based injury prevention programme for Latino day labourers

Objective

Latino day labourers (LDLs) in the USA are at increased risk for non-fatal and fatal occupational injuries, which are compounded by stressors that include wage theft, job insecurity and discrimination. This paper describes the development and refinement of Vales+Tú (You are Worthy of More), an injury prevention programme currently being evaluated as part of a cluster randomised trial in which health promotion is taken directly to the 'corners' (e.g. street corners, home improvement store parking lots, and public parks) where workers gather to seek employment.

Design

Vales+Tú comprises two corner-based intervention approaches, group problem-solving (small group discussions) and brief motivational interviewing (one-on-one dialogue), that aim to activate LDL agency to control their safety and that of their peers.

Setting

Corners in Houston, Texas, where LDLs seek employment.

Method

Intervention Mapping informed the refinement of Vales+Tú for the current trial. We provide a narrative review of the development process based on needs assessment and formative development activities (surveys, focus group discussions and pilot tests).

Results

In addition to documenting the need for LDL injury prevention, with 20.2%-41.6% of Houston-based LDLs surveyed between 2013-2014 and 2019 reporting a severe work-related injury in the past year, we describe key facets of the Vales+Tú corner-based intervention approaches - including their theoretical basis and LDL-centred activities, as well as enhancements made informed by formative evaluation.

Conclusion

The community-engaged development process of Vales+Tú resulted in two practical intervention approaches that can be adopted by worker centres and other organisations to promote LDL worker safety.

"I Use Sunglasses . . . the Sun Can Ruin the Eyes": Latino Day Laborers' Lay Strategies to Reduce Dangers at Work

Latino day laborers (LDLs) are at a high risk for injury and accidents at work and have limited socioeconomic resources to deal with their consequences. While little is known about LDLs' perceptions of their own vulnerability at the workplace, less is known about the strategies they adopt to confront these risks. The purpose of this qualitative study was to assess LDLs' perceptions of their workplace dangers and to document the strategies they adopt and endorse to confront them. Guided by a participatory research approach, four focus groups stratified by age were conducted with 34 LDLs in Houston, Texas. Main focus group themes were identified using a combination of qualitative analysis methods involving a thematic analysis conducted by the interview team, LDL advisors, and bilingual Latino researchers. All participants were Latino males (mean age = 40), the majority reported having completed sixth grade or less (64.2%) and having lived in the United States for an average of 12.7 years. We described three categories of strategies to reduce risk for workplace injury generated by local LDLs (practical knowledge and job experience, interpersonal, and personal). These strategies should be explored and encouraged to assist in planning risk-reduction programs, presented in the voice and language of Latino "inside experts" with firsthand experience. The findings of the focus group suggest that LDLs already possess a broad repertoire of strategies to cope with risks at work that can be incorporated in safety programs for LDLs and other immigrant Latino workers.

Vales+Tú: a cluster-randomized pilot study to reduce workplace injuries among US Latino day laborers

Latino day laborers (LDL) are a vulnerable population of workers facing considerable risk for occupational injury. Under the guidance of our Community Advisory Board, we developed and tested the feasibility, acceptability and preliminary effects of Vales+Tú (You Are Worth More), a workplace injury risk-reduction program implemented by promotores on street-corners where LDL seek employment. The program was informed by theoretical perspectives emphasizing individual and group agency and self-determination. A pilot three-arm cluster-randomized community trial was conducted among 75 LDL. The intervention arms consisted of an individualized Brief Motivational Interview, a Group Problem Solving activity and a standard of care control (OSHA safety cards). We met our study goal of 25 LDL per intervention arm, and contacted 88% of participants post intervention. Participants evaluated the interventions favorably. At post-test, the Brief Motivational Interview group reported significant reductions in exposure to workplace hazards and increases in risk-reduction practices. The Group Problem Solving participants showed significant reductions in exposure to hazards (t-test −4.16, p < 0.001). Both intervention groups increased their reliance on corner peers, a measure of social support. Standard of care participants increased in self-efficacy to work safely. Overall, the only significant different between the three study conditions was in self-efficacy. These findings provide evidence of the feasibility and acceptability of Vales+Tú and show preliminary program efficacy. A large-scale replication trial will permit a more formal modeling of the study findings. Clinical Trial Registration (ClinicalTrials.gov): NCT04378348.

"Who is our real enemy?" internalized racism in the Puerto Rican diaspora and the role of political education within community health intervention

RATIONALE

Puerto Ricans experience disproportionately high levels of emotional distress and co-occurring adverse health outcomes. Our study sought to elicit Puerto Rican men's perceptions of health disparities while centering dialogue on stressors, coping mechanisms, and general well-being. This paper focuses on one pronounced finding in our study, that of internalized racism and the effect it has on both individual well-being and intra-group cohesion. A significant gap within racial health disparity work is the role of internalized racism and its connection to psychological distress, ruptures in social unity, and resulting ill-health of racial and ethnic populations. Based on this, we probed this particular finding to further understand internalized racism within this Puerto Rican population.

METHODS

Using a hybrid thematic analysis approach, this study presents qualitative findings from in-depth interviews with Latino (92.5% Puerto Rican) men living in Springfield, Massachusetts and conducted between October 2019 and January 2020.

RESULTS

Our findings reveal a duality throughout: The acceptance and propagation of negative Latinx stereotypes and consequent intragroup division exists alongside expressions of community pride and desire for Latinx unity. This duality is analyzed by using W.E.B. Du Bois's theory of double consciousness. Double consciousness not only explains the self-disparagement toward oneself and one's own racial and ethnic group, but also elucidates a liberatory pathway toward political consciousness and well-being. The concept of "second sight" within double consciousness is particularly germane, speaking to one's awakening to the learned self-subjugation imposed by White supremacy.

CONCLUSIONS

Internalized racism contributes to the persistent propagation of disparate health burdens in minoritized communities. Remediation can and should include community-led frameworks for the development of efficacious multilevel health interventions. The Young Lords community health activism provides such a model. These findings provide viable evidence-based examples of how the academy can synergize with community-led efforts to achieve collective agency.

A healthy migrant effect? Estimating health outcomes of the undocumented immigrant population in the United States using machine learning

This paper investigated whether the commonly observed immigrant health advantage persists among undocumented immigrants in the U.S. and provides nationally representative evidence on the health of this vulnerable population. Data were derived from pooled cross-sections of the National Health Interview Survey (NHIS, 2000-2018). The legal status of foreign-born NHIS respondents is imputed using a non-parametric machine learning model built based on information from the 2004, 2008 and 2014 cohorts of the Survey of Income and Program Participation (SIPP). Multivariate logistic regression analysis indicated that, despite exposure to numerous additional risk factors, the undocumented population experienced a more pronounced Healthy Migrant Effect, with lower odds of reporting fair or poor self-rated health, any physician-diagnosed chronic conditions or being obese. The observed patterns in undocumented health outcomes may be related to the additional challenges and exclusionary policies associated with undocumented migration that could in turn lead to a more pronounced selection of healthy and resilient individuals.

Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care

The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults (M_age = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population.

Discrimination, acculturative stress, alcohol use and their associations with alcohol-related consequences among Latino immigrant men

Latino immigrant men are at increased risk for unhealthy alcohol use and related consequences due to social stressors associated with immigration. We assessed the associations of, and examined whether social stressors moderated associations between, alcohol use and alcohol-related consequences in a community-based sample of Latino immigrant men in Washington (N = 187). The mean Alcohol Use Disorders Identification Test Consumption (AUDIT-C) score was 6.3 (scores ≥ 4 indicate unhealthy alcohol use). More than half of the men (61.5%) reported experiencing discrimination in at least one setting and mean acculturative stress score was 18.3 indicating moderate levels of acculturative stress. Linear regression models were fit to assess main effects (associations between both alcohol use and social stressors and alcohol-related consequences) and moderation (whether the association between alcohol use and consequences varied based on experience of social stressors using multiplicative interaction) after adjustment for potential confounders. Alcohol use (β = 0.47, 95% CI = 0.20-0.73; p = .001), discrimination (β = 0.85, 95% CI = 0.27-1.43; p = .004), and acculturative stress (β = 0.13, 95% CI = 0.02-0.24; p = .025) were all associated with increased experience of alcohol-related consequences. The association between alcohol use and alcohol-related consequences was stronger for those with high levels of acculturative stress (p = .025) but not experience of discrimination (p = .587). Findings underscore the importance of social and cultural context in alcohol use and related consequences. Efforts to reduce negative consequences of drinking may include focus on reducing exposure to discrimination and acculturative stress.

COVID-19 Racism, Internalized Racism, and Psychological Outcomes among East Asians/East Asian Americans

The present study investigated the psychological effects of racism on East Asians and East Asian Americans (EAEAAs) living in the United States during the COVID-19 pandemic using a mixed-methods approach. First, using an autoregressive cross-lagged panel analysis, we investigated the relations between COVID-19 racism, internalized racism, psychological distress, and social isolation among EAEAAs. We then examined the impact of the COVID-19 pandemic on EAEAAs using consensual qualitative research-modified. Quantitative findings showed that COVID-19 racism at Time 1 was associated with greater subsequent psychological distress, and COVID-19 racism at Time 2 was associated with greater levels of subsequent psychological distress and social isolation at Time 3, suggesting that COVID-19 racism predicted psychological distress and social isolation over time. Qualitative findings highlighted the prevalence of racism towards EAEAAs and the associated negative consequences. Findings demonstrate that EAEAAs living in the United States are at great risk due to the detrimental effects of racism during COVID-19.

Competence in Daily Activities and Mental Well-Being among Technical Intern Trainees in Japan: A Cross-Sectional Study

Migrant workers are at a greater risk of having low mental well-being compared to their local counterparts. The Japanese government accepts migrants through its Technical Intern Training programs, but the factors associated with their mental well-being remain unclear. This study aimed to (1) assess trainees' competence and importance in daily activities and (2) examine the association between their competence and mental well-being. We conducted a cross-sectional study using self-administered questionnaires. We recruited trainees through their supervising organizations and social media. We used the Occupational Self-Assessment tool to measure competence and importance in daily activities and the World Health Organization-5 Well-being Index to measure mental well-being. Hierarchical regression analysis was used to examine the association between competence and mental well-being. Among 383 trainees, 30.6% felt difficulty expressing themselves, and 27.4% felt difficulty accomplishing goals. Almost 50% valued self-care, working towards their goals, and managing their finances. Higher competence scores were associated with higher mental well-being scores (B = 0.76; 95% CI = 0.52, 1.00). Competence may be a key to having higher mental well-being among migrant trainees in Japan. A supportive and enabling environment, as well as mental health promotion at the community level, may improve trainees' competence in daily activities.

“Lots of Time They Don’t Pay”: Understanding Wage-Theft and Resistance in Bryan, Texas through Critical Community-Engaged Research

This critical community-engaged mixed methods study quantifies worker mistreatment on day labor corners in Bryan, Texas, and examines how day laborers resist labor exploitation. Day laborers seek work in open air spot markets. The work is precarious, with temporary and unregulated employment relations, weak enforcement, and poor working conditions. In this weak penalty and labor enforcement regime, labor violations are not surprising. Contrary to dominant theories, however, we argue that demand-side (industry) characteristics are more important for explaining the prevalence of labor violation than supply-side (worker characteristics). We use the Central Texas Day Labor Survey (2012–2021), 210 ethnosurveys consisting of 55% unauthorized workers, 24% authorized workers, and 20% Latinx, Black, and White citizens. We find that higher indices of labor violations and work abuse are not associated with lower-status workers; all workers, irrespective of legal status or citizenship, experienced abuse by employers. Demand-side characteristics were partially associated with higher levels of wage theft and mistreatment. In terms of wages, we found a gradation of wages with the lowest for unauthorized immigrants, then authorized immigrants, Latinx citizens, Black citizens, and lastly White citizens. Finally, workers collectively fight back against injustice by warning each other about unscrupulous employers.

Perceived Discrimination and Injury at Work: A Cross-Sectional Study Among Latino Day Laborers

BACKGROUND

Given the stigma of their undocumented status and their high prevalence of workplace injury, understanding the impact of discrimination on Latino day laborers (LDLs) is a critical public health issue.

METHODS

We surveyed LDLs (N = 149) and assessed their sociodemographics, experiences of and perceived reasons for discrimination, and work-related injury. A logistic regression examined the association between discrimination and injury, adjusting for sociodemographics. Next, Chi-square tests identified perceived reasons for discrimination associated with injury which were then included in a second logistic regression to test their association with injury, adjusting for discrimination and sociodemographics.

RESULTS

Participants reported a work-related injury (42%) and experiences of discrimination (81%). Discrimination was associated with injury in the first model (aOR = 2.25, p = 0.049), and discrimination attributed to immigration status was associated with injury in the second model (aOR = 5.04, p = 0.019).

DISCUSSION

Injury prevention programs should account for perceived mistreatment to reduce LDL risk for injury at work.

The Work Environment of Immigrant Employees in Sweden—a Systematic Review

The aim of this systematic review was to summarize and synthesize research results focusing on the work environment of employees with an immigrant background in Sweden. We focus on the main conditions identified in the working environment of immigrant employees and how these conditions may affect their health and well-being. The concept of “minority stress” and the attachment theory are used to understand and interpret the findings. We systematically searched for literature published between the years of 1990 and 2020 in four databases, Web of Science, PubMed, SocIndex, and Academic Search Elite. We started the selection process by reading title and abstracts, then proceeded to read a selection of full-text studies and eliminated those that did not fulfil the inclusion criteria. We did a quality assessment on the full-text studies based on the MMAT-tool, and then performed a narrative synthesis of the results. The results show that immigrants experience several stressors in their work environment, including physical, psychological, and social risks. These risks are, among other things, associated with the nature of the jobs that immigrants are overrepresented in, with minority-related stressors such as discrimination, harassment, and threats on the basis of ethnic background, and with the lack of social support from managers and colleagues. Results also highlight beneficial factors in the immigrants’ working environment and show the importance of a supportive, inclusive, and empowering management. Our main conclusion is that Swedish workplaces need to introduce more active measures to raise awareness of and combat workplace discrimination, work harder to promote inclusion at the workplace, and eliminate physical, psychological, and social health hazards specific to immigrant employees. The leadership and management have an important role to play here, as does the employees’ trade unions and its special functions.

Uncovering Historical Legacies to Contextualize Health Inequities in Puerto Rican Men: An Expansion of the Minority Stress Model

BACKGROUND

Low/no-income Latino men are disproportionately burdened by chronic disease morbidity and mortality, which is often compounded by persistent exposure to stress. Chronic stress is a key mediating factor in pathways linking macro-level socio-structural forces to micro-level behavioral factors with negative health outcomes. Being that Latinxs continue to be one of the fastest growing populations in the U.S., it is imperative to better understand the roots of stress pathways and explore multi-level interventions.

METHODS

This study presents qualitative findings from in-depth interviews with Puerto Rican men (95%) living in Springfield, Massachusetts. We utilized the Minority Stress Model (MSM) first posited by Ilan Meyers, as a framework to understand stress and stress processes amongst Puerto Rican men. We mapped our data onto Meyers' MSM, which allowed us to find diverging themes and identify areas for expansion.

RESULTS

As expected, participants reported stress rooted in experiences of racism and prejudice, expectations of rejection, English-language acquisition, family relationships, insecure housing, precarious employment, and lack of resources. Nevertheless, the MSM did not account for the historical contexts that, as our findings indicate, are used to filter and understand their experiences with everyday stressors. Participants described and linked histories of colonial violence and movement and migration to their stress and community wellbeing.

DISCUSSION

Findings suggest the need to expand the current MSM and our conceptualization of the stress process to include historical understandings when contextualizing present-day stress and future interventions. We propose an expanded heuristic model that delineates the impact of distinctive historical trajectories that aid in interpreting racial health disparities amongst minoritized populations. Future multi-level interventions should give weight to highlighting history and how this impacts the present, in this case including the culpability of U.S. policy regarding Puerto Rico and the adverse health effects for Puerto Rican men on the mainland.

A Qualitative View of Migration-Related Stressors on the Mental Health of Latinx Americans in the Current Sociopolitical Climate of Hostility Towards Migrants

This qualitative study aimed to elucidate and contextualize which and how migration-related stressors may influence Latinx Americans' (i.e., US-born; US-citizens) mental health status, including substance misuse. In 2019, a community sample of 22 Latinx Americans were recruited for an in-depth qualitative interview. Eligibility criteria included: being an adult, self-identify as Latinx, report a migration-related stressor, and report at least one symptom of a mental health or substance use problem. Open-ended questions focused on the migrant experience, perceptions and impacts of immigration enforcement, and how these experiences related to their mental health. Using a migration as a social determinant framework, we identified several migration-related stressors at the structural- and social-level of environmental influence that were related to participants' mental health. Findings highlight how migration-related stressors at the structural- and social-level of influence create systematic uncertainty by inducing fear into the daily lives of Latinx Americans.

Immigration Policy Vulnerability Linked to Adverse Mental Health Among Latino Day Laborers

Latino day laborers in the United States are socially and economically vulnerable due to exclusionary immigration policies. Using data from a multi-mode survey, we examine the relationship between immigration policy legal vulnerability and mental health outcomes among 138 Latino, male day laborers (mean age = 45.65, SD = 12.05). Multivariable linear and logistic regression models separately estimated the effect of legal vulnerability, as measured by the Perceived Immigration Policy Effects Scale, on anxiety and depression symptoms and a positive depression and anxiety screening, respectively. Approximately 26.1% and 27.9% of day laborers reported depression and anxiety symptoms, respectively. In each adjusted model, we find a positive relationship between legal vulnerability and adverse mental health. Immigration policy legal vulnerability is associated with more depression and anxiety symptoms among Latino day laborers. Policies to reduce legal vulnerability, such as pathways to citizenship and employment authorization, may support Latino day laborers' mental health outcomes.

Contextual influences on Latino men's sexual and substance use behaviors following immigration to the Midwestern United States

Objectives: Latinos in the United States experience a disproportionate number of HIV and other sexually transmitted infections (STIs) and higher use of alcohol and illegal drugs, which has been attributed to increases in risk behaviors following immigration. Whereas substantial research documents these behavioral changes, little is known about how immigrants increase their risk or why some immigrants increase their risk and other immigrants do not. This study explored how the social and normative context affects sexual and substance use behaviors among Latino immigrant men in a midsized Midwestern city of the United States.Methods: We interviewed 64 Latino immigrant men recruited from community sites in Milwaukee, Wisconsin (mean age = 32.6 years). Participants reported the social and normative contexts preceding and following immigration, including social networks and support, perceptions of the law, and familiar and peer normative influences.Results: Immigrants attributed changes in their sexual and substance use behaviors to their immigration goals, social support, peer and familial normative influences, and restrictions related to their immigrant status. Immigration for economic and personal advancement was generally protective from behaviors that would interfere with those goals as were extended familial networks that could provide support, resources, and normative control. The need to stay under the radar of authorities, the proportion of Latinos in the community, the social and normative changes associated with immigrants' age, and the higher perceptions of risk for HIV in the United States compared with their home countries also influenced immigrants' sexual and substance use behaviors.Conclusions: Changes in risk behavior after immigration to the United States reflect a combination of social and normative factors and personal goals. Interventions and policies aiming to prevent HIV and substance use among Latino immigrants should understand the contextual conditions that decrease or increase their risk behaviors in the United States.

Dairy is Different: Latino Dairy Worker Stress in Vermont

Latino immigrant dairy workers face significant challenges. Dairy's employment of immigrants is recent compared to other sectors, though today immigrants account for over half of US dairy workers. This study applies the Migrant Farmworker Stress Inventory to dairy for the first time. Interviews of 173 workers were conducted using the MFWSI, augmented with dairy specific indictors. Bivariate analysis identified associations between dairy worker characteristics and stress. Findings were compared to other studies using the MFWSI. Average stress was 74.6/156 points, with 36.5% at risk for clinically significant stress. Vermont ranked eighth among 11 MFWSI studies, and fourth of seven studies for significant stress. Primary stressors differed from studies of fruit and crop workers. Over a third of Vermont immigrant dairy workers risk debilitating stress. The MFWSI underestimates dairy farmworker stress and should be modified for this sector. Identified stressors indicate Spanish-language, dairy safety training may be beneficial.

Structural Racism and Immigrant Health: Exploring the Association Between Wage Theft, Mental Health, and Injury among Latino Day Laborers

Background

Although wage theft has been discussed primarily as a labor and human rights issue, it can be conceptualized as an issue of structural racism with important consequences for immigrant health.

Objectives

The objectives of this study were to: 1) identify sociodemographic, employment, and stress-related characteristics that increase Latino day laborers' odds of experiencing wage theft; 2) assess the association between wage theft and serious work-related injury; 3) assess the association between wage theft and three indicators of mental health-depression, social isolation, and alcohol use-as a function of wage theft; and 4) assess serious work-related injury as a function of wage theft controlling for mental health.

Methods

Secondary data analyses were based on survey data collected from 331 Latino day laborers between November 2013 and July 2014. Regression analyses were conducted to test the relationships described above.

Results

Approximately 25% of participants reported experiencing wage theft and 20% reported serious work-related injury. Wage theft was associated with working in construction and was initially associated with work-related injury. Wage theft was not significantly associated with mental health indicators. The association between wage theft and injury became non-significant when controlling for the mental health variables.

Conclusions

The hardship and stress associated with wage theft incidents may ultimately lead to more frequent injury. Although we expected an association of wage theft with mental health, we found vulnerability to physical health as indicated by injury incidents. Thus, our basic premise was partially supported: wage theft may act as a stressor that stems from conditions, in part, reflecting structural racism, making workers vulnerable to poorer health.

"The solitude absorbs and it oppresses": 'Illegality' and its implications on Latino immigrant day laborers' social isolation, loneliness and health

Despite a well-documented relationship between social isolation and health among men, this link has been understudied among marginalized populations such as undocumented immigrant men whose structural social exclusion may impede the cultivation and maintenance of social connections in the United States. This may be particularly so in new immigrant settlement cities that may lack an established Latina/o community or the social infrastructure often needed to ease the process of social integration. Studies that have examined social disconnectedness, social isolation, and/or loneliness have largely focused on individual level factors (i.e., older age) that may precipitate or contextualize experiences of social isolation, social support and social networks. Missing from such conceptualizations is a consideration of the role of structural factors, such as "illegality" among undocumented immigrant men, on experiences of social disconnection, social exclusion, social isolation and loneliness and resultant adverse health behaviors. This study, through in-depth qualitative participant narratives, explores the social condition of one group of "illegal" immigrant men, Latino immigrant day laborers (LIDL), and their experiences of social exclusion, social isolation, loneliness and health in the new immigrant settlement city of Baltimore. Using an ethnographic methodological approach, eight focus groups (N = 37) were conducted with participants recruited from two day labor sites from 2016 to 2019. Thematic analysis revealed a structural process of social exclusion and disconnection that exposed LIDLs to experiences of racism, structural vulnerability, and dehumanization which in turn may have heightened social isolation and loneliness and patterned substance use and sexual risk taking. Findings further emphasize the potential conceptual significance of structurally induced social disconnection, as distinct from lack of social support, in the study of LIDLs' social isolation, loneliness and health.

The Gendered Effects of Local Immigration Enforcement: Latinas' Social Isolation in Chicago, Houston, Los Angeles, and Phoenix

The 2017 revitalization of the controversial Security Communities program, which requires local law enforcement to cooperate with federal immigration officials in the United States, has made it urgent to better understand such enforcement programs' effects on the well-being of Latinas/os, especially the foreign-born. Social isolation from increased immigration enforcement can have significant impacts on economic, social, and health outcomes among Latina/o immigrants and non-immigrants. This article analyzes the gendered impacts of different levels of increased local involvement in immigration enforcement on social isolation, using a survey of over 2000 Latinas/os in four large US cities, all considered to be traditional destinations. Unsurprisingly, respondents reported increased social isolation resulting from local law enforcement's involvement in immigration enforcement. In contrast to results from previous research, our analysis found that women and men were equally likely to feel socially isolated and that having children led to more social isolation for both women and men. Personal and vicarious experiences with immigration enforcement, as well as living in Phoenix and Houston - two urban areas with the strictest enforcement regimes - were strongly related to social isolation. Our results indicate that local authorities' increased involvement in immigration enforcement can lead to more social isolation for Latina immigrants, particularly those who have children, aligning their experiences with men's and, thus, undermining Latinas' previously recognized role as bridges between their families and social institutions and as community builders.

The Citizenship Advantage in Psychological Well-being: An Examination of the Hukou System in China

Given that Chinese migrants with rural hukou status are not considered full citizens in their urban destinations, rural-urban hukou conversion signifies full citizenship attainment in urban China. We assess causal effects of three major types of urban hukou attainment-merit-, policy-, and family-based hukou conversion-on migrants' psychological well-being in middle- and later-life. We further examine how hukou matters-how periods and hukou destinations alter the values of specific urban hukou and their psychological health implications for individuals. We use the China Health and Retirement Longitudinal Study (2015 data) and life history data (for 2014) for analysis. To assess the extent to which the salmon effect contributes to estimation bias for migrants, we compare results from a sample with current migrants and one with current and returned migrants. To address for selection into hukou conversion, we adopt inverse probability-weighted regression adjustment methods. We show that the salmon bias significantly dampened causal estimates. Merit- and policy-based hukou conversion has protective effects on psychological well-being. Policy-based converters have better psychological health than other types of converters. Hukou conversion in the pre-1978 period conveys greater psychological benefits than that in the post-1998 period, when economic and social values of urban hukou have decreased. Hukou converters in the cities with the most resources enjoy better psychological well-being than their counterparts in other cities. Our study joins the emerging literature in investigating how citizenship conveys advantage in health and well-being. We discuss these results in the global context as well as the context of China's decades of evolution of hukou policy and the urbanization process.

Protective Factors to the Wellbeing of Undocumented Latinx Immigrants in the United States: A Socio-Ecological Approach

Undocumented immigrants often experience multiple chronic stressors that over time can increase health risk. This qualitative study used data from 7 focus groups and 15 key informant interviews to identify relevant protective factors to the heath of undocumented immigrants in the U.S. Findings showed that at the individual level, undocumented immigrants rely primarily on motivation to cope with adversity, while also relying on family support and community cohesion at the interpersonal level. At the policy level, safe neighborhoods and non-stigmatizing environments, protection from abuse/exploitation, and activism were identified as protective factors. English proficiency was also identified as important.

A Structural-Environmental Model of Alcohol and Substance-Related Sexual HIV Risk in Latino Migrant Day Laborers

A structural-environmental model of alcohol and substance-related sexual HIV risk in 344 Latino migrant day laborers, participants in a cross-sectional survey, is tested using structural equation modeling. Hypothesized pathways include: (1) direct paths between environmental conditions and both distress related risk factors, and cultural and community protective factors; (2) indirect paths between environmental conditions and distress through cultural and community protective factors; and (3) indirect paths between environmental conditions and sexual risk through both distress risk factors and cultural and community protective factors. As hypothesized, the environmental factors, discrimination and working conditions, were indirectly related to sexual risk through the distress related factor, problem drinking, and through the protective factor, contact with family in country of origin. More specifically, as discrimination and working conditions worsen, contact with family decreases, problem drinking increases, and sexual risk increases. Implications for multi-level interventions are discussed.

"My own corner of loneliness:" Social isolation and place among Mexican immigrants in Arizona and Turkana pastoralists of Kenya

This article explores the intersection of two growing health concerns: the rising incidence of loneliness and the negative health impacts of migration and displacement. To better evaluate loneliness across diverse populations, we emphasize the cultural shaping of expectations for social lives and the ways in which structural vulnerability and violence can undermine these expectations. We draw on ethnographic research with two groups of migrants: Mexican immigrants living in southern Arizona and Turkana pastoralists of Kenya who experience displacement and unpredictable mobility as a result of low intensity violence. For Mexican immigrants, feelings of loneliness intertwine with the emotions of fear, trauma, and sadness, all closely associated with social isolation. The Turkana describe loneliness associated with the loss of their animals, or the shifting social landscapes they must traverse to keep their families safe. The culturally salient experiences described by these two communities highlight the complexity of defining loneliness. Given the pace of global migration and the number of refugees and displaced persons, closer scrutiny of how cultural expectations and structural violence interact to produce feelings of loneliness seems overdue.

Beyond Occupational Hazards: Abuse of Day Laborers and Health

With the increase in labor market flexibility and worksite immigration enforcement, day labor is a common type of informal employment arrangement among immigrants. Our study contextualized day laborers' physical and mental health within work- and community-level factors. We use a nationally representative sample of 2015 day laborers from the National Day Labor Survey. Multivariable logistic regression models estimated the association of occupational and socioenvironmental abuses with self-rated health (SRH), a positive PHQ-2 screening, morbidities, and workplace injuries. Employer abuse was associated with fair/poor SRH, workplace injuries, morbidity, and PHQ-2; business owner abuse was associated with PHQ-2 and workplace injuries; and crime and having a dangerous job are both associated with workplace injuries. Health disadvantages stem from unsafe occupational conditions and an overlapping array of adverse social experiences. These findings highlight the need to develop and evaluate policies that protect all workers regardless of socioeconomic position and immigration status.

Undocuqueer Stress: How Safe are "Safe" Spaces, and for Whom?

Exploring the intersection of race/ethnicity, gender, sexuality, and immigration status, this study explored the concept of minority stress among 31 Latinx undocuqueer immigrants within the context of LGBTQ "safe" spaces. For participants, LGBTQ nightclubs and relationships represented important physical and symbolic spaces where they were able to understand what it meant to be undocuqueer. Participants described experiences of fear, anxiety, and rejection as they attempted to enter and exist within spaces presumably "safe" for LGBTQ people. The cumulative effect of feeling unsafe led participants to avoid certain spaces and inhibited their capacity to engage in relationships authentically. This study raises implications for research and policy related to serving LGBTQ and immigrant communities.

Vaya Con Dios: The Influence of Religious Constructs on Stressors around the Migration Process and U.S. Lived Experiences among Latina/o Immigrants

This qualitative study explores the role of religious practices on the migration process and the U.S. lived experiences of Latina/o immigrants. We conducted semi-structured interviews with 20 Latino/a immigrant adults living in a southern state of the United States. Interviews focused on participants’ migration experiences, religious constructs, and stress responses. Results revealed that religious practices provided strength, well-being, and positive life outlook during the migration process. After migration, religious practices also assisted participants in creating a sense of community/family, as well as provided financial and social support during difficult times. Recommendations for future interdisciplinary research and for practitioners are discussed for individuals working with Latinx and immigrant populations.

"They Dumped Me Like Trash": The Social and Psychological Toll of Victimization on Latino Day Laborers' Lives

Although recent rhetoric links undocumented immigrants to criminality, reports indicate undocumented immigrants commit less crime than their native-born counterparts and that this vulnerable group may be at increased risk for criminal victimization. Immigrants living in new immigrant settlement cities may be particularly at risk for exposure to criminal victimization due to the vulnerabilities associated with a lack of an established Latino community and limited availability of culturally appropriate social services to provide support. This ethnographic study examines the experiences of victimization and its social and psychological toll of a street-recruited sample of Latino day laborers (LDLs) (N = 25) living and working in Baltimore, a new immigrant settlement city. Findings elucidate and describe the specific types of victimization experienced by LDLs, including workplace victimization (wage theft, abandonment at the jobsite, poor working conditions, verbal abuse) and street-level victimization (assault and robbery), as well as reveal the social and psychological toll of victimization (sociocultural alienation, despair or desesperación, and problem drinking) on their lives. Findings have implications for community psychology, through research and practice, as they provide insights for prevention and intervention within the intersection of structural vulnerability (i.e., undocumented immigration status), violence, and mental health.

Migrant Workers and Psychological Health: A Systematic Review

Migrant workers show an increase in the incidence of serious, psychotic, anxiety, and post-traumatic disorders due to a series of socio-environmental variables, such as loss of social status, discrimination, and separations from the family. The purpose is to elaborate a systematic review and highlight the prevailing psychological pathologies of these workers and categories most at risk. Our research included articles published from 2009 to 2019 on the major databases (Pub Med, Cochrane Library, and Scopus) using a combination of some keywords. The online search indicated 1.228 references. Using inclusion and exclusion criteria, we analyzed 127 articles, in particular 12 reviews and 115 original articles. Principal emerging disorders from the research are depressive syndrome (poor concentration at work, feeling down, or anger and somatization), anxiety, alcohol or substance abuse, and poor sleep quality. This causes low life conditions, which is also due to marginalization from the social context and strenuous work; in fact, migrant workers may suffer verbal or physical abuse, and they are often employed in dangerous, unhealthy jobs. It is therefore essential to increase the role of occupational medicine and promote wellbeing for this vulnerable job category.

Vida PURA: results from a pilot randomized trial of a culturally adapted screening and brief intervention to reduce unhealthy alcohol use among Latino day laborers

Latino immigrant men are at increased risk for unhealthy alcohol use. Vida PURA is a culturally adapted evidence-based intervention that consists of promotores providing screening and brief intervention to reduce unhealthy alcohol use among Latino immigrant men. The purpose was to assess the efficacy of Vida PURA in a pilot randomized control trial. Participants were screened for eligibility at a day labor worker center using the Alcohol Use Disorders Identification Test (AUDIT). Those with an AUDIT score ≥ 6 (N = 121) were randomized into an intervention (N = 77) or control group (N = 44). Participants in the intervention group received a brief intervention from a promotor including personalized feedback, motivational interviewing to assess their readiness to change, and referral to services. Participants in the control group received information about local substance use treatment services. We assessed changes in AUDIT scores, drinks per drinking day, drinking days, and frequency of heavy episodic drinking at 2 and 8 weeks following the baseline survey using a mixed-effects regression model. Many men had high AUDIT scores, indicating dependence. Both the intervention and control groups reduced their alcohol-related behaviors over time, but there were no significant differences between the groups. A culturally adapted brief intervention may not be enough to significantly reduce alcohol use among Latino day laborers, especially among those that are dependent. We discuss lessons learned from this trial, including the value of community-based approaches to reaching high-risk and underserved populations.

Perceived Racial Discrimination and Pain Intensity/Disability Among Economically Disadvantaged Latinos in a Federally Qualified Health Center: The Role of Anxiety Sensitivity

The present study examined the role of anxiety sensitivity (AS; fear of the negative consequences of anxiety) in the relation between perceived racial discrimination and pain-related problems among Latinos seeking health services at a Federally Qualified Health Center. Participants included 145 adult Latinos (87.80% female, M_age = 38.07 years, SD = 11.98, and 96.2% reported Spanish as their first language). Results indicated that perceived racial discrimination was indirectly related to the pain intensity and pain disability through AS. These effects were evident above and beyond the variance accounted for by gender, age, marital status, educational status, employment status, years living in the United States, and number of axis I diagnoses. Overall, the present findings highlight the merit in focusing further scientific attention on the interplay between perceived racial discrimination and AS to better understand and inform interventions to reduce pain problems among Latinos in primary care.

Working and Living Conditions and Psychological Distress in Latino Migrant Day Laborers

Background. Little research has been conducted on relations between challenging working and living conditions and psychological distress in Latino migrant day laborers (LMDLs), a particularly marginalized Latino population in the United States. Aims. Consistent with a structural-environmental framework of LMDL vulnerability to health and mental health problems, this study tests a model of hypothesized pathways between working and living conditions and multiple forms of psychological distress. Method. Structural equation modeling was used to test the conceptual model with 344 LMDLs who participated in a cross-sectional survey in the San Francisco Bay Area. Results. As hypothesized, results reveal pathways between (1) working and living conditions; (2) working and living conditions and depression, as well as desesperación (desperation), the latter a Latino cultural idiom of distress frequently expressed by LMDLs; and (3) between living conditions and alcohol use. Discussion. Findings increase understanding regarding how challenging working and living conditions contribute to the same, as well as different, forms of psychological distress in LMDLs. Conclusions. Implications for mitigating structural vulnerability to psychological distress can be addressed at multiple social-ecological levels ranging from community-based support for enhancing LMDL employment (e.g., via day labor centers) to expanding the availability of work authorization for undocumented workers.

Help Wanted: Mental Health and Social Stressors Among Latino Day Laborers

Latino day laborers may be especially vulnerable to poor mental health due to stressful life experiences, yet few studies have described patterns of mental health outcomes and their correlates in this population. Patterns of depression (PHQ-9) and anxiety (GAD-7), and associations with demographic characteristics, social stressors, and substance use in a recruited sample of male Latino day laborers ( n = 101) are described. High rates of depression and anxiety were identified. Specifically, 39% screened positive for moderate or severe depression and 25% for moderate or severe anxiety. Higher levels of depression and anxiety symptoms were associated with being single, being homeless or in temporary housing, experiencing discrimination, acculturation stress, and marijuana use. While tobacco and unhealthy alcohol use were common in this sample (39% and 66%, respectively), they were not associated with depression and anxiety. These findings suggest that depression and anxiety are common among Latino day laborers and associated with stressful life experiences. Future research should further assess ways to ameliorate social stressors and reduce risk for poor mental health.

Migration and cognitive function: a conceptual framework for Global Health Research

BACKGROUND

Migration is a fundamental demographic process that has been observed globally. It is suggested that migration is an issue of global health importance that can have an immediate and lasting impact on an individual's health and well-being. There is now an increasing body of evidence linking migration with cognitive function in older adults. In this paper, we synthesized the current evidence to develop a general conceptual framework to understand the factors contributing to the association between migration and cognitive function.

METHODS

A comprehensive review of the literature was conducted on the associations between migration and cognition among middle-aged and older adults.

RESULTS

Five potential mechanisms were identified from the literature: 1) socioeconomic status-including education, occupation, and income; 2) psychosocial factors-including social networks, social support, social stressors, and discrimination; 3) behavioral factors-including smoking, drinking, and health service utilization; 4) physical and psychological health status-including chronic conditions, physical function, and depression; and 5) environmental factors-including both physical and social environment. Several underlying factors were also identified-including early-life conditions, gender, and genetic factors.

CONCLUSIONS

The factors linking migration and cognitive function are multidimensional and complex. This conceptual framework highlights potential implications for global health policies and planning on healthy aging and migrant health. Additional studies are needed to further examine these mechanisms to extend and refine our general conceptual framework.

Return-Migration to Mexico and the Gendered Transnational Migration Process

The Mexico-USA border is one of the most active borders in the world with many migrant men traveling to the United States to serve as "breadwinners" for their families. Yet knowledge within psychology is limited regarding how Latino migrants' masculine identities may be shaped within the migration context as a vast majority of studies are set within the United States. This gap in the literature continues to exist despite many Latino migrant men's engagement in transnational lifestyles involving multiple migrations between their country of origin and the United States. A more complete investigation of all phases of the migration journey, including return-migration, is then vital in the understanding of migrant men's experiences. Guided by gender strain theory and transnational conceptual frameworks, we used case study methodology to examine masculinity among return-migrants in Petlalcingo, Mexico to understand how migration-related life events relate to masculinity by identifying key moments and turning points within their migration process, such as: the decision to migrate, the migration journey, adjustment and acculturation in a new country and return-migration. Findings elucidate a gendered migration process as well as key variables that can be utilized in the development of larger binational studies examining masculinity and migration.

Stress of working abroad: a systematic review

Purpose

Many companies target international markets to expand their business. Companies need to manage international teams with a wide variety of skills, knowledge and values to run their business effectively; however, there are many issues of acculturation stress. Not only business travellers and expatriates, but also immigrant workers have issues adjusting to foreign culture. The aim of the present study is to identify the stress factors affecting foreign-born workers via a systematic review.

Methods

The systematic review was conducted using PubMed, PsycINFO, Embase and Cochrane Library databases. Articles on the subject of workers living abroad, such as immigrants, expatriates and business travellers, were included. The risk of bias in the included articles was assessed using the Cochrane Collaboration’s tool for assessing risk of bias for randomised controlled trials (RCTs), RoBANS for non-RCT studies, and CASP for qualitative studies.

Results

For the systematic review, 45 out of 14,994 articles were analysed. Six components, communication, cultural differences in the workplace, daily life, relationships with family and colleagues, financial problems and social inequality, were extracted.

Conclusion

Foreign-born workers are suffering from acculturation and occupational stress. The results of the present study can help greatly with understanding of the stress structure of working abroad.

Electronic supplementary material

The online version of this article (10.1007/s00420-018-1333-4) contains supplementary material, which is available to authorized users.

Exploring relationships among social integration, social isolation, self-rated health, and demographics among Latino day laborers

OBJECTIVES

Research indicates social integration and social isolation are related to health, and Latino day laborers (LDLs) tend to be socially isolated and, thus, at high risk for adverse health consequences. relationships among social isolation, social integration, self-rated health (SRH), and demographics were examined in a sample of LDLs to contribute to the literature on social networks and health in this and other migrant populations.

DESIGN

We analyzed data from 324 LDLs who participated in Proyecto SHILOS (Salud del Hombre Inmigrante Latino), a Houston-based survey of Latino immigrant men's health. Based on the literature, we hypothesized SRH would be (1) positively associated with social integration and (2) negatively associated with social isolation. All proposed measures were first entered into a correlation matrix to identify significant bivariate relationships (p ≤ .05, two-tailed). Associations between variables that were directly correlated with SRH and variables that were, in turn, proximally associated with these variables were then used to develop a structural equation path model of SRH. Individual paths in the model were measured for significance, and goodness of fit was assessed by the model chi-square, the Comparative Fit Index, and the Root Mean Square Error of Approximation.

RESULTS

Inconsistent with the first hypothesis, SRH was negatively associated with social integration, as measured by the number of trusted friends. Consistent with the second hypothesis, SRH was negatively associated with social isolation, as measured by needing someone to talk to. More frequent contact with family was also negatively associated with social isolation.

DISCUSSION

Our findings suggest social integration may not always protect and promote health. Therefore, assessing the quality of LDLs' different relationships, not just the quantity, is vital. Future studies should further analyze the effects that social resources have on perceptions of social isolation and health in LDLs and other migrant populations.

Impacts of Immigration Actions and News and the Psychological Distress of U.S. Latino Parents Raising Adolescents

PURPOSE

U.S. Latino parents of adolescents face unprecedented threats to family stability and well-being due to rapid and far-reaching transformations in U.S. immigration policy.

METHODS

Two hundred thirteen Latino parents of adolescents were recruited from community settings in a suburb of a large mid-Atlantic city to complete surveys assessing parents' psychological distress and responses to immigration actions and news. Univariate and bivariate analyses were conducted to describe the prevalence of parents' responses to immigration news and actions across diverse residency statuses. Multiple logistic regression models examined associations between immigration-related impacts and the odds of a parent's high psychological distress.

RESULTS

Permanent residents, temporary protected status, and undocumented parents reported significantly more negative immigration impacts on psychological states than U.S. citizens. Parents reporting frequent negative immigration-related impacts had a significantly higher likelihood of high psychological distress than did other parents, and these associations were maintained even when accounting for parents' residency status, gender, education, and experience with deportation or detention. The odds of a parent reporting high psychological distress due to negative immigration impacts ranged from 2.2 (p < .05) to 10.4 (p < .001).

CONCLUSIONS

This is one of the first empirical accounts of how recent immigration policy changes and news have impacted the lives of Latino families raising adolescent children. Harmful impacts were manifest across a range of parent concerns and behaviors and are strong correlates of psychological distress. Findings suggest a need to consider pathways to citizenship for Latina/o parents so that these parents, many of whom are legal residents, may effectively care for their children.

Legal Status, Time in the USA, and the Well-Being of Latinos in Los Angeles

In the USA, undocumented Latino immigrants may have poorer health because of barriers to health care, stressors, and detrimental effects of immigration enforcement. Previous immigrant health research, however, suggests that recently arrived Latino immigrants have better health than US-born Latinos and their health deteriorates over time. Given the current environments that undocumented immigrants face, legal status is a structural factor that likely influences the patterns of immigrant health. Therefore, the aim of this study was to examine the extent to which physical and mental health differed by legal status and duration in the USA for the Latino population in Los Angeles County, California. We conducted analysis of Latino respondents (n = 1396) to the Los Angeles Family and Neighborhood Survey (L.A.FANS) Wave II. We examined self-reported health, depression measured by the Composite International Diagnostic Interview-Short Form, and blood pressure collected by trained interviewers. Respondents reported their legal status, time in the USA, and other sociodemographic characteristics. Regression models were used to test associations between each outcome and 1) legal status and 2) legal status by duration (≤ 15 and > 15 years) in the USA. Without taking duration into account, we found no significant differences in outcomes between undocumented, documented, or US-born Latinos. Taking duration into account, shorter duration undocumented immigrants had worse self-reported health than the US born. Undocumented immigrants, regardless of duration, had higher blood pressure than documented immigrants who had been in the USA for less time and the same level of blood pressure as the US born. In contrast, shorter duration documented immigrants had lower blood pressure compared to longer duration documented immigrants and US-born counterparts, and marginally lower blood pressure than shorter duration undocumented immigrants. The findings suggest that the "health advantage" generally presumed to exist among immigrants may not affect undocumented immigrants.

Documenting legal status: a systematic review of measurement of undocumented status in health research

Background

Undocumented status is rarely measured in health research, yet it influences the lives and well-being of immigrants. The growing body of research on undocumented status and health shows the need to assess the measurement of this legal status. We discuss the definition of undocumented status, conduct a systematic review of the methodological approaches currently taken to measure undocumented status of immigrants in the USA, and discuss recommendations for advancement of measurement methods.

Methods

We conducted a systematic review of 61 studies indexed in PubMed, conducted in the USA, and published from 2004 to 2014. We categorized each of the studies’ data source and type, measurement type, and information for classifying undocumented participants. Studies used self-reported or proxy measures of legal status.

Results

Information to classify undocumented participants included self-reported status, possession of a Social Security number, possession of health insurance or institutional resources, concern about deportation, and participant characteristics. Findings show it is feasible to collect self-reported measures of undocumented status.

Conclusions

We recommend that researchers collect self-reported measures of undocumented status whenever possible and limit the use of proxy measures. Validated and standardized measures are needed for within and across country measurement. Authors should provide methodological information about measurement in publications. Finally, individuals who are undocumented should be included in the development of these methodologies.

Trial registration

This systematic review is not registered.

Does Acculturative Stress Influence Immigrant Sexual HIV Risk and HIV Testing Behavior? Evidence from a Survey of Male Mexican Migrants

OBJECTIVE

Migration is a structural factor that increases HIV vulnerability. Acculturative stress represents a possible mechanism through which migration may negatively impact HIV risk. This study investigated socio-ecological factors associated with acculturative stress levels and examined the association between acculturative stress and HIV-related behavior among Mexican im/migrants.

METHODOLOGY

We used data from a probability survey of Mexican im/migrants (N = 1383) conducted in Tijuana, Mexico, in 2009-2010. The sample included migrants returning to Mexico via deportation or voluntarily after a recent stay in the USA. Linear regression models were estimated to identify individual, migration, and contextual factors independently associated with overall acculturative stress levels. Logistic regression models were used to test for associations between acculturative stress, sexual HIV risk, and HIV testing history behavior.

RESULTS

We found that levels of acculturative stress were significantly and independently related to socio-economic markers, acculturation level, legal residence status, and sexual minority status. The analyses also showed that acculturative stress was positively related to sexual HIV risk behavior and negatively related to recent HIV testing.

CONCLUSIONS

The results underscore that both individual and environmental factors contribute to levels of acculturative stress among Mexican im/migrants. In turn, acculturative stress may exacerbate sexual HIV risk and impede testing among this im/migrant population. Targeted interventions to prevent and decrease acculturative stress represent a potential strategy to reduce sexual HIV risk behavior and promote HIV testing among this vulnerable population of im/migrants in the USA.

Marginalisation, discrimination and the health of Latino immigrant day labourers in a central North Carolina community

The morbidity and mortality of Latino immigrants in the United States (US) stem from a complex mix of policy, culture, discrimination and economics. Immigrants working as day labourers may be particularly vulnerable to the negative influences of these social factors due to limited access to social, financial and legal resources. We aimed to understand how the health of male Latino day labourers in North Carolina, US is influenced by their experiences interacting with their community and perceptions of their social environment. To respond to our research questions, we conducted three focus groups (n = 9, n = 10, n = 10) and a photovoice project (n = 5) with Latino male immigrants between October 2013 and March 2014. We conducted a thematic analysis of transcripts from the discussions in the focus groups and the group discussions with Photovoice participants. We found that men's health and well-being were primarily shaped by their experiences and feelings of discrimination and marginalisation. We identified three main links between discrimination/marginalisation and poor health: (i) dangerous work resulted in workplace injuries or illnesses; (ii) unsteady employment caused stress, anxiety and insufficient funds for healthcare; and (iii) exclusionary policies and treatment resulted in limited healthcare accessibility. Health promotion with Latino immigrant men in new settlement areas could benefit from community-building activities, addressing discrimination, augmenting the reach of formal healthcare and building upon the informal mechanisms that immigrants rely on to meet their health needs. Reforms to immigration and labour policies are also essential to addressing these structural barriers to health for these men.

Living Conditions and Psychological Distress in Latino Migrant Day Laborers: The Role of Cultural and Community Protective Factors

The purpose of this study was to examine the relationship between typically difficult living conditions and psychological distress in Latino migrant day laborers (LMDLs), with attention to the potentially protective roles of contact with family in country of origin (i.e., communication, sending money, etc.), availability of local culture (i.e., food, music, people from one's country of origin), and utilization of community resources perceived to be culturally competent (i.e., services that are respectful, able to serve Latinos, able to solve problems, in Spanish, etc.). Participants were 344 LMDLs surveyed in the San Francisco Bay Area. As hypothesized: (a) difficult living conditions were related to depression, anxiety, and desesperación [desperation], the latter a popular Latino idiom of psychological distress recently validated on LMDLs; (b) contact with family moderated the relation between difficult living conditions and depression and desesperación but not anxiety and (c) access to local culture, and utilization of community resources, mediated the relation between difficult living conditions and depression and desesperación but not anxiety. Implications for intervening at local and larger levels in order to provide some protection against distress built into the LMDL experience in the United States are discussed.

Perceived Immigration Policy Effects Scale

The present study describes the development and testing of the Perceived Immigration Policy Effects Scale (PIPES). The measure was developed in Spanish to assess the impact of state-level immigration policies on Latino immigrant parents. This study describes the steps taken to develop the scale items and psychometric testing. The scale was completed by 300 Latino immigrant parents in the state of Arizona. Exploratory factor analysis and confirmatory factor analysis revealed/confirmed a four-factor model (discrimination, social exclusion, threat to family, and children’s vulnerability). The subscales and total scale have excellent reliability (α = .824-.934). Additional testing is needed to examine the application of the scale beyond states passing restrictive immigration policies.

Living Sin Papeles

In the United States, the construction of “illegality” of undocumented Latino workers is predicated upon multiple interacting social, economic, political, and sociological factors and consignment to an inferior social status, harsh living conditions, and exploitation. These “cumulative vulnerabilities” contribute to increased stressors and poor psychological health outcomes. However, little is known about these marginalized workers’ experience of negotiating life in “illegality.” This qualitative study adopts a social constructivist perspective to examine the strategies these undocumented workers use to manage “illegality” and psychosocial stress. We conducted four focus groups with 27 participants and in-depth interviews with eight of these participants. Thematic analysis combined with constant comparison yielded the overarching theme of living sin papeles (without legal papers). Findings reveal that, phenomenologically, sin papeles extends far beyond legal status, being a condition of ever-present instability, insecurity, and hypervigilance that affects the social, work, health, and living conditions of undocumented Latino immigrants.