1
|
Santaularia NJ, Hunt SL, Bonilla Z. Exploring the Links Between Immigration and Birth Outcomes Among Latine Birthing Persons in the USA. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01999-x. [PMID: 38713369 DOI: 10.1007/s40615-024-01999-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Birth outcomes are worse for birthing people and infants in the USA than other high-income economies and worse still for underprivileged communities. Historically, the Latine community has experienced positive birth outcomes, despite low socioeconomic status and other socio-political disadvantages, leading to what has been termed as the Hispanic birth paradox. However, this perinatal advantage and protective effect appears to have been shattered by unfavorable policies, structural conditions, societal attitudes, and traumatic events impacting Latine immigrants, leading to negative effects on the health and well-being of birthing Latines-regardless of citizenship status and increasing rates of preterm birth and low birth weight infants. METHODS AND RESULTS We conducted a comprehensive literature review and identified two pathways through which birth outcomes among Latine birthing persons may be compromised regardless of citizenship status: (1) a biological pathway as toxic levels of fear and anxiety created by racialized stressors accumulate in the bodies of Latines and (2) a social pathway as Latines disconnect from formal and informal sources of support including family, friends, health care, public health programs, and social services during the course of the pregnancy. CONCLUSION Future research needs to examine the impact of immigration climate and policies on health and racial equity in birth outcomes among Latines regardless of citizenship status. Attaining health and racial equity necessitates increased awareness among health providers, public health practitioners, and policy makers of the impact of larger socio-political pressures on the health of Latine birthing persons.
Collapse
Affiliation(s)
- N Jeanie Santaularia
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Shanda Lee Hunt
- University Libraries, University of Minnesota, Minneapolis, MN, USA
| | - Zobeida Bonilla
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
2
|
Cross FL, Marchand AD, Diaz M, Waller A, Ledón C, Kruger DJ. The Role of Documentation Status Concerns, Perceived Discrimination, and Social Support on Latinx Adults' Physical and Mental Health. J Racial Ethn Health Disparities 2024; 11:946-957. [PMID: 37010800 PMCID: PMC10069344 DOI: 10.1007/s40615-023-01575-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/14/2023] [Accepted: 03/19/2023] [Indexed: 04/04/2023]
Abstract
There is a growing number of immigrants arriving in the USA, with the majority being of Latinx descent. Coupled with this increase, there has also been growing anti-immigration legislation which impacts the experiences this group faces and creates additional concerns for those who are residing in this country without documentation. Experiences of overt and covert discrimination and marginalization have been shown to relate to poorer mental and physical health outcomes. Drawing from Menjivar and Abrego's Legal Violence Framework, this paper explores the impact of perceived discrimination and social support on the mental and physical health of Latinx adults. We further observe whether these relationships differ based on participants' concerns about their documentation status. This data comes from a community-based participatory study conducted in a Midwestern County. Our analytic sample was comprised of 487 Latinx adults. We found social support to be related to fewer self-reported days of mental health symptoms for all participants regardless of documentation status concern. Perceived discrimination was found to be related to worse physical health for participants with concerns about their status. These findings point to the pernicious role of discrimination for Latinx's physical health and the importance of social support as an asset beneficial for their mental health.
Collapse
Affiliation(s)
- Fernanda Lima Cross
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109-1106, USA.
| | - Aixa D Marchand
- University of Illinois at Urbana-Champaign, 1310 S. Sixth Street, Champaign, IL, 61820, USA
| | - Melissa Diaz
- Rhodes College, 2000 North Pkwy, Memphis, TN, 38112, USA
| | | | | | - Daniel J Kruger
- Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48109-1248, USA
| |
Collapse
|
3
|
Celeste-Villalvir A, Kovic C, Argüelles F. The Intersectional Impact of Disability and Immigration on Health: A Health Needs Assessment of Immigrants Living With Spinal Cord Injury in Houston, Texas. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:209-218. [PMID: 36670517 DOI: 10.1177/2752535x221132445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Immigrants with spinal cord injury (SCI) experience challenges with co-morbidities and lack of access to medical supplies and equipment. Much of the current disability and SCI literature does not include Latinx immigrants with SCI. To address this gap in knowledge, the present study explores the intersectional impact of disability and immigration on health as well as the health status and health needs of immigrants living with SCI. METHODS This community-partnered study is a secondary analysis of needs assessment data collected in February 2019 with 24 of the members of Living Hope Wheelchair Association, a nonprofit organization serving Latinx immigrants living with SCI in Houston, Texas. RESULTS Participants shared challenges with accessing healthcare, comorbidities, mental illness, transportation, and discrimination by healthcare professionals. They also shared difficulties accessing medical supplies, medical equipment, and the need for adaptations in their homes and vehicles. CONCLUSION The findings corroborate those of previous studies with people with SCI, but highlights additional layers of marginalization and challenges faced by immigrants living with SCI. More research is needed to understand the health needs and health status of this population, including their access to care and management of chronic diseases such as diabetes and heart disease. Findings support the need for public health and immigration policies to promote inclusion and equitable access to services as well as improve the health and quality of life of immigrants.
Collapse
Affiliation(s)
- Alane Celeste-Villalvir
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | | | | |
Collapse
|
4
|
Biddle L, Hintermeier M, Costa D, Wasko Z, Bozorgmehr K. Context, health and migration: a systematic review of natural experiments. EClinicalMedicine 2023; 64:102206. [PMID: 37936656 PMCID: PMC10626165 DOI: 10.1016/j.eclinm.2023.102206] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 11/07/2023] Open
Abstract
Background Migration health research pays little attention to the places into which people migrate. Studies on health effects of contextual factors are often limited because of the ability of individuals to self-select their environment, but natural experiments may allow for the causal effect of contexts to be examined. The objective was to synthesise the evidence on contextual health effects from natural experiments among migrant groups. Methods We performed a systematic review of natural experiments among migrant populations in PubMed/MEDLINE, The Cochrane Library, Web of Science, CINAHL and Google Scholar for literature published until 13 October 2022. 5870 articles were screened in duplicate using the following inclusion criteria: quantitative natural experiment design, migrant population, context factor as treatment variable and health or healthcare outcome variable. Synthesis without meta-analysis was performed following quality appraisal using the EPHPP tool for quantitative studies and data extraction (PROSPERO: CRD42020169236). Findings The 46 included articles provide evidence for negative effects of neighbourhood disadvantage on physical health and mortality, while finding mixed effects on mental health. Articles comparing migrants with those that stayed behind demonstrate detrimental effects of migration and adverse post-migratory contexts on physical health and mortality, while demonstrating favourable effects for mental and child health. Natural experiments of policy environments indicate the negative impacts of restrictive migration and social policies on healthcare utilization, mental health and mortality, as well as the positive health effects when restrictions are lifted. Interpretation Natural experiments complement observational studies and provide robust evidence to advocate for more inclusive migration, health and social policies as well as neighbourhood improvement programmes. In order to strengthen the methodological approach, future research utilising natural experiments should be more explicit in the mechanisms underlying the experiment and provide details on potential causal mechanisms for the observed effects. Funding German Science Foundation (FOR: 2928/GZ: BO5233/1-1).
Collapse
Affiliation(s)
- Louise Biddle
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Universitätsstraße 25, 33501, Bielefeld, Germany
- German Socio-Economic Panel, German Institute for Economic Research (DIW Berlin), Mohrenstraße 58, 10117, Berlin, Germany
- Section Health Equity Studies & Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Maren Hintermeier
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Universitätsstraße 25, 33501, Bielefeld, Germany
- Section Health Equity Studies & Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Diogo Costa
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Universitätsstraße 25, 33501, Bielefeld, Germany
| | - Zahia Wasko
- Section Health Equity Studies & Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Universitätsstraße 25, 33501, Bielefeld, Germany
- Section Health Equity Studies & Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| |
Collapse
|
5
|
Espinoza-Kulick M, Espinoza-Kulick A, González E, Takahashi J. Immigration Policy is Health Policy: News Media Effects on Health Disparities for Latinx Immigrant and Indigenous Groups. Health Promot Pract 2023; 24:818-827. [PMID: 36856165 DOI: 10.1177/15248399221150816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Legal exclusions and cultural factors reproduce barriers to health care by enforcing boundaries between citizens and immigrants, leading to a range of health risks and disparities for Latinx immigrant and Indigenous communities. This study utilized a mixed-methods examination of news media and ethnographic interviews guided by a decolonial-inspired framework to demonstrate the linkages between policy discourse and health behaviors. Both newspaper articles and interviews with affected stakeholders show how immigrants and their families experience more significant health risks because of policy changes and proposals. Regardless of the political regime, media discourses that promote fear and threat sustain the overall effects of immigration policy enforcement strategies on health. Immigration policy is health policy, and these laws should be evaluated in terms of their impact on public health, in addition to other factors. Furthermore, the news media is a contextual factor for health promotion strategies and a target for health advocates working with immigrant and Indigenous communities.
Collapse
Affiliation(s)
| | | | - Elisa González
- California Polytechnic State University, San Luis Obispo, CA, USA
| | | |
Collapse
|
6
|
De Trinidad Young ME, Tafolla S, Saadi A, Sudhinaraset M, Chen L, Pourat N. Beyond "Chilling Effects": Latinx and Asian Immigrants' Experiences With Enforcement and Barriers to Health Care. Med Care 2023; 61:306-313. [PMID: 36939228 PMCID: PMC10079615 DOI: 10.1097/mlr.0000000000001839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
OBJECTIVES Immigration enforcement policies are associated with immigrants' barriers to health care. Current evidence suggests that enforcement creates a "chilling effect" in which immigrants avoid care due to fear of encountering enforcement. Yet, there has been little examination of the impact of immigrants' direct encounters with enforcement on health care access. We examined some of the first population-level data on Asian and Latinx immigrants' encounters with law and immigration enforcement and assessed associations with health care access. METHODS We analyzed the 2018 and 2019 Research on Immigrant Health and State Policy survey in which Asian and Latinx immigrants in California (n=1681) reported on 7 enforcement experiences (eg, racial profiling and deportation). We examined the associations between measures of individual and cumulative enforcement experiences and the usual sources of care and delay in care. RESULTS Latinx, compared with Asian respondents, reported the highest levels of enforcement experiences. Almost all individual enforcement experiences were associated with delaying care for both groups. Each additional cumulative experience was associated with a delay in care for both groups (OR=1.30, 95% CI 1.10-1.50). There were no associations with the usual source of care. CONCLUSION Findings confirm that Latinx immigrants experience high levels of encounters with the enforcement system and highlight new data on Asian immigrants' enforcement encounters. Direct experiences with enforcement have a negative relationship with health care access. Findings have implications for health systems to address the needs of immigrants affected by enforcement and for changes to health and immigration policy to ensure immigrants' access to care.
Collapse
Affiliation(s)
- Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA 95343, USA
| | - Sharon Tafolla
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA 95343, USA
| | - Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School; 100 Cambridge St, Suite 2000, Boston, MA 02114, USA
| | - May Sudhinaraset
- Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA
| | - Lei Chen
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, 337 Charles E Young Dr E, Los Angeles, CA 90095
| | - Nadereh Pourat
- Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA
| |
Collapse
|
7
|
Stafford AM, Tanna A, Bueno KM, Nagy GA, Felsman IC, de Marchi S, Cholera R, Evans K, Posada E, Gonzalez-Guarda R. Documentation Status and Self-Rated Physical Health Among Latinx Young Adult Immigrants: the Mediating Roles of Immigration and Healthcare Stress. J Racial Ethn Health Disparities 2023; 10:761-774. [PMID: 35175583 PMCID: PMC8853124 DOI: 10.1007/s40615-022-01264-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 01/14/2023]
Abstract
Previous research has demonstrated that undocumented Latinx immigrants in the USA report worse physical health outcomes than documented immigrants. Some studies suggest that immigration-related stress and healthcare related-stress may explain this relationship, but none have tested it empirically. The purpose of this study was to determine if immigration-related stress and healthcare-related stress in the USA explain the relationship between documentation status and physical health among Latinx immigrants in North Carolina. The conceptual model was tested utilizing baseline data from a longitudinal, observational, community-engaged research study of young adult (18-44 years) Latinx immigrants residing in North Carolina (N = 391). Structural equation modeling was used to determine relationships among documentation status, healthcare, and immigration stress in the past six months, and self-rated physical health. Goodness-of-fit measures indicated that data fit the model well (RMSEA = .008; CFI = 1.0; TLI = .999; SRMR = .02; CD = .157). Undocumented individuals were more likely to experience immigration stress than their documented counterparts ([Formula: see text] = - 0.37, p < 0.001). Both immigration stress ([Formula: see text] = - 0.22, p < 0.01) and healthcare stress ([Formula: see text] = - 0.14, p < 0.05) were negatively related to physical health. Additionally, immigration stress was positively related to healthcare stress ([Formula: see text] = 0.72, p < 0.001). Results demonstrate that documentation status is an important social determinant of health. Passage of inclusive immigration and healthcare policies may lessen the stress experienced by Latinx immigrants and subsequently improve physical health.
Collapse
Affiliation(s)
| | - Aneri Tanna
- Trinity College of Arts and Sciences, Duke University, Box 90046, Durham, NC 27710 USA
| | - Karina Moreno Bueno
- Trinity College of Arts and Sciences, Duke University, Box 90046, Durham, NC 27710 USA
| | - Gabriela A. Nagy
- Duke University School of Nursing, 307 Trent Dr. DUMC 3322, Durham, NC 27710 USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2213 Elba St, Durham, NC 27705 USA
| | - Irene Crabtree Felsman
- Duke University School of Nursing, 307 Trent Dr. DUMC 3322, Durham, NC 27710 USA
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710 USA
| | - Scott de Marchi
- Department of Political Science, Duke University, 140 Science Dr, Durham, NC 27708 USA
| | - Rushina Cholera
- Department of Pediatrics, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC 27707 USA
| | - Kate Evans
- Duke University School of Law, 210 Science Dr, Durham, NC 27708 USA
| | - Eliazar Posada
- El Centro Hispano Inc, 2000 Chapel Hill Rd, Durham, NC 27707 USA
| | - Rosa Gonzalez-Guarda
- Duke University School of Nursing, 307 Trent Dr. DUMC 3322, Durham, NC 27710 USA
| |
Collapse
|
8
|
Amuedo-Dorantes C, Bucheli JR, Martinez-Donate AP. Safe-zone schools and the academic performance of children in mixed-status households: Evidence from the 'between the lines' study. MIGRATION STUDIES 2023; 11:143-173. [PMID: 36909276 PMCID: PMC9996116 DOI: 10.1093/migration/mnac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In response to the intensification of immigration enforcement in the interior of the USA, some school districts have implemented 'safe-zone' policies to protect students' academic progression and well-being. Using primary data from a sample of US-born children of unauthorized migrants, we document the detrimental effect of stricter immigration enforcement on children's educational outcomes and the benefits of safe-zone policies. Our analyses show that restricting immigration authorities' access to schools and providing counseling on immigration-related issues are crucial policy components in strengthening children's focus, effort, expectations, parental involvement, and relationships. These findings highlight the damaging impact of immigration enforcement on US-citizen children in mixed-status households and advance our understanding of the role of local policies in mitigating these effects.
Collapse
Affiliation(s)
- Catalina Amuedo-Dorantes
- Department of Economics and Business Management, University of California, Merced, CA 95343, USA
| | - José R Bucheli
- Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM, USA
| | | |
Collapse
|
9
|
Bozorgmehr K, Kühne S, Biddle L. Local political climate and spill-over effects on refugee and migrant health: a conceptual framework and call to advance the evidence. BMJ Glob Health 2023; 8:bmjgh-2022-011472. [PMID: 36898715 PMCID: PMC10008416 DOI: 10.1136/bmjgh-2022-011472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
The health of refugees and migrants is determined by a wide range of factors. Among these, the local political climate in the postmigration phase is an important determinant which operates at interpersonal and institutional levels. We present a conceptual framework to advance theory, measurement and empirical evidence related to the small-area factors which shape and determine the local political climate, as these may translate into variations in health outcomes among refugees, migrants and other marginalised population groups. Using the example of Germany, we present evidence of small-area variation in factors defining political climates, and present and discuss potential pathways from local political climates to health outcomes. We show that anti-immigrant and antirefugee violence is a Europe-wide phenomenon and elaborate how resilience of individuals, communities, and the health system may function as moderator of the effects of the local political climate on health outcomes. Building on a pragmatic review of international evidence on spill-over effects identified in other racialised groups, we present a conceptual framework which incorporates direct effects as well as 'spill-over' effects on mental health with the aim to spark further academic discussion and guide empirical analysis on the topic. After presenting and discussing methodological challenges, we call for collective efforts to build coalitions between social sciences, conflict and violence studies, political science, data science, social psychologists and epidemiology to advance theory, measurement, and analysis of health effects of local political climates.
Collapse
Affiliation(s)
- Kayvan Bozorgmehr
- Department of Population Medicine & Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany .,Section Health Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany.,Institute for Interdisciplinary Research on Conflict and Violence (IKG), Bielefeld University, Bielefeld, Germany
| | - Simon Kühne
- Institute for Interdisciplinary Research on Conflict and Violence (IKG), Bielefeld University, Bielefeld, Germany.,Applied Social Data Science, Faculty of Sociology, Bielefeld University, Bielefeld, Germany
| | - Louise Biddle
- Department of Population Medicine & Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| |
Collapse
|
10
|
Alegría M, O’Malley IS, Smith R, Rosania AU, Boyd A, Cuervo-Torello F, Williams DR, Acevedo-Garcia D. Addressing health inequities for children in immigrant families: Psychologists as leaders and links across systems. AMERICAN PSYCHOLOGIST 2023; 78:173-185. [PMID: 37011168 PMCID: PMC10071405 DOI: 10.1037/amp0001016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
What can psychologists do to address social determinants of health and promote health equity among America's approximately 20 million children in immigrant families (CIF)? This article identifies gaps in current research and argues for a stronger role for psychologists. Psychologists can advocate for and enact changes in institutional systems that contribute to inequities in social determinants of health and promote resources and services necessary for CIF to flourish. We consider systemic exclusionary and discriminatory barriers faced by CIF, including a heightened anti-immigrant political climate, continued threat of immigration enforcement, restricted access to the social safety net, and the disproportionate health, economic, and educational burden of the COVID-19 pandemic. We highlight the potential role of psychologists in (a) leading prevention that addresses stressors such as poverty and trauma; (b) changing systems to mitigate risk factors for CIF; (c) expanding workforce development across multiple disciplines to better serve their needs; (d) identifying mechanisms, such as racial profiling, that contribute to health inequity, and viewing them as public health harms; and (e) guiding advocacy for resources at local, state, and federal levels, including by linking discriminatory policies or practices with health inequity. A key recommendation to increase psychologists' impact is for academic and professional institutions to strengthen relationships with policymakers to effectively convey these findings in spaces where decisions about policies and practices are made. We conclude that psychologists are well positioned to promote systemic change across multiple societal levels and disciplines to improve the well-being of CIF and offer them a better future. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Margarita Alegría
- Massachusetts General Hospital, Disparities Research Unit, Boston, MA
- Harvard Medical School, Departments of Medicine and Psychiatry, Boston, MA
| | | | - Robert Smith
- City University of New York, School of Public Affairs at Baruch College, New York, NY
- City University of New York, Graduate Center, Department of Sociology, New York, NY
| | | | - Azariah Boyd
- Harvard T.H. Chan School of Public Health, Department of Environmental Health Epidemiology, Boston, MA
| | | | - David R. Williams
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA
- Harvard University, Departments of Sociology and African and African American Studies, Boston, MA
| | - Dolores Acevedo-Garcia
- Brandeis University, The Heller School for Social Policy and Management, Institute for Child, Youth, and Family Policy, Waltham, MA
| |
Collapse
|
11
|
Cerda IH, Macaranas AR, Liu CH, Chen JA. Strategies for Naming and Addressing Structural Racism in Immigrant Mental Health. Am J Public Health 2023; 113:S72-S79. [PMID: 36696610 PMCID: PMC9877373 DOI: 10.2105/ajph.2022.307165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 01/27/2023]
Abstract
Immigrants account for 13.7% of the US population, and the great majority of these individuals originate from Latin America or Asia. Immigrant communities experience striking inequities in mental health care, particularly lower rates of mental health service use despite significant stressors. Structural barriers are a significant deterrent to obtaining needed care and are often rooted in racist policies and assumptions. Here we review and summarize key pathways by which underlying structural racism contributes to disparities in immigrant mental health, including anti-immigration policies, labor and financial exploitation, and culturally insensitive mental health services. Significant accumulated research evidence regarding these barriers has failed to translate into structural reform and financial investment required to address them, resulting in pronounced costs to both immigrant populations and society at large. We propose specific strategies for addressing relevant structural inequities, including reforming economic and financial policies, community education initiatives, and task-sharing and strengths-based interventions developed in partnership with immigrant communities to promote access to mental health care for populations in dire need of culturally appropriate services. (Am J Public Health. 2023;113(S1): S72-S79. https://doi.org/10.2105/AJPH.2022.307165).
Collapse
Affiliation(s)
- Ivo H Cerda
- Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| | - Anjeli R Macaranas
- Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| | - Cindy H Liu
- Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| | - Justin A Chen
- Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| |
Collapse
|
12
|
Rojas Perez OF, Silva MA, Galvan T, Moreno O, Venta A, Garcini L, Paris M. Buscando la Calma Dentro de la Tormenta: A Brief Review of the Recent Literature on the Impact of Anti-Immigrant Rhetoric and Policies on Stress Among Latinx Immigrants. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2023; 7:24705470231182475. [PMID: 37441366 PMCID: PMC10334021 DOI: 10.1177/24705470231182475] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 06/01/2023] [Indexed: 07/15/2023]
Abstract
The mental health burden associated with anti-immigrant rhetoric and ever-changing immigration policies is undeniable, though the psychological and emotional sequalae may remain invisible for years to come. Exclusionary immigration policies, as a form of structural racism, have also led to an epidemic of stress-related health within the Latinx community, particularly the Latinx immigrant community, across the United States. Recent examples of anti-Latinx and anti-immigrant rhetoric and policies include the 45th President's implementation of the Zero Tolerance policy, Migrant Protection Protocols, and Title 42. The recognition of previous and existing anti-immigrant policies, and the impact on Latinx immigrants, is critical in understanding the manifestation of psychological stress to prevent it from becoming chronic. For mental health providers, attention to existing policies that can be detrimental to the Latinx immigrant community is essential to understanding their mental health trajectory and applying frameworks that honor an individual's psychological stress to prevent pathologizing the immigrant experience and negative health outcomes. The objective of the present brief review is to shed light on recent research and offer recommendations for practice (eg, educating the Latinx community about the link between the immigrant experience and psychological stress) and policy (eg, drafting of legislation aimed at rescinding harmful immigration policies) regarding the relation between aggressive anti-immigration rhetoric and psychological stress among Latinx immigrants in the United States.
Collapse
Affiliation(s)
| | | | - Thania Galvan
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Oswaldo Moreno
- Psychology Department, Virginia Commonwealth University, Richmond, VA, USA
| | - Amanda Venta
- Psychology, University of Houston, Houston, TX, USA
| | - Luz Garcini
- Psychological Sciences, Rice University, Houston, TX, USA
| | - Manuel Paris
- Psychiatry, Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|
13
|
Cumulative Experiences of Immigration Enforcement Policy and the Physical and Mental Health Outcomes of Asian and Latinx Immigrants in the United States. INTERNATIONAL MIGRATION REVIEW 2022. [DOI: 10.1177/01979183221126726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Immigration enforcement policies in the United States and other nations have long been enacted and implemented as intentional tools of racial control. There is mounting evidence that immigration raids, arrests, and deportations in the United States are associated with poor immigrant health outcomes, but this research has primarily focused on associations between health and single, specific enforcement actions or experiences that may not capture the entirety of immigrants’ experiences with racialized exclusion. Further, there has been little examination of Asian immigrants’ experiences with enforcement in the United States. This article assesses the relationship between Asian and Latinx immigrants’ physical and mental health and their cumulative experiences of immigration enforcement. We analyze responses to a 2018 population-based telephone survey of 1,103 Asian and Latin American immigrants in California. Participants were asked about seven distinct exclusionary immigration and local law enforcement experiences and their self-rated health (SRH) and psychological distress. We tested the association between each enforcement experience and SRH and psychological distress, controlling for covariates. After creating a cumulative measure of exclusion by summing participants’ total number of enforcement experiences, we examined the association between cumulative enforcement experiences and SRH and psychological distress and tested interactions by ethnicity and citizenship. While a greater proportion of Latinx than Asian participants reported enforcement experiences, each additional enforcement experience was associated with poorer self-rated health and greater psychological distress for both groups. This article suggests that the overall immigration enforcement system, from surveillance to deportation, is associated with worse health outcomes for immigrants.
Collapse
|
14
|
Espinoza-Kulick MAV, Cerdeña JP. "We Need Health for All": Mental Health and Barriers to Care among Latinxs in California and Connecticut. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12817. [PMID: 36232112 PMCID: PMC9565216 DOI: 10.3390/ijerph191912817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Latinx (im)migrant groups remain underserved by existing mental health resources. Past research has illuminated the complex factors contributing to this problem, including migration-related trauma, discrimination, anti-immigrant policies, and structural vulnerability. This paper uses decolonial-inspired methods to present and analyze results from two studies of Latinx (im)migrant communities in central California and southern Connecticut in the United States. Using mixed quantitative and qualitative analysis, we demonstrate the intersectional complexities to be addressed in formulating effective mental health services. Relevant social and structural factors including knowledge of mental health, access to insurance, and experiencing discrimination were significantly associated with anxiety symptoms, based on linear regression analysis. Ethnographic interviews demonstrate how complex trauma informs mental health needs, especially through the gendered experiences of women. Overlapping aspects of gender, language barriers, fear of authorities, and immigration status contoured the lived experiences of Latinx (im)migrants. Thematic analyses of open-ended survey responses also provide recommendations for solutions based on the experiences of those directly affected by these health disparities, particularly relating to healthcare access, affordability, and capacity. Building from these findings and past research, we recommend the adoption of a comprehensive model of mental health service provision for Latinx (im)migrants that takes into account Indigenous language access, structural competency, expanded health insurance, and resources for community health workers.
Collapse
Affiliation(s)
| | - Jessica P. Cerdeña
- Yale School of Medicine, Yale University, New Haven, CT 06520, USA
- Institute for Collaboration on Health, Implementation, and Policy (InCHIP), University of Connecticut, Storrs, CT 06269, USA
- Department of Anthropology, University of Connecticut, Storrs, CT 06269, USA
| |
Collapse
|
15
|
Allgood KL, Mack JA, Novak NL, Abdou CM, Fleischer NL, Needham BL. Vicarious structural racism and infant health disparities in Michigan: The Flint Water Crisis. Front Public Health 2022; 10:954896. [PMID: 36148337 PMCID: PMC9486078 DOI: 10.3389/fpubh.2022.954896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/12/2022] [Indexed: 01/24/2023] Open
Abstract
Building on nascent literature examining the health-related effects of vicarious structural racism, we examined indirect exposure to the Flint Water Crisis (FWC) as a predictor of birth outcomes in Michigan communities outside of Flint, where residents were not directly exposed to lead-contaminated water. Using linear regression models, we analyzed records for all singleton live births in Michigan from 2013 to 2016, excluding Flint, to determine whether birth weight (BW), gestational age (GA), and size-for-gestational-age (SzGA) decreased among babies born to Black people, but not among babies born to White people, following the highly publicized January 2016 emergency declaration in Flint. In adjusted regression models, BW and SzGA were lower for babies born to both Black and White people in the 37 weeks following the emergency declaration compared to the same 37-week periods in the previous 3 years. There were no racial differences in the association of exposure to the emergency declaration with BW or SzGA. Among infants born to Black people, GA was 0.05 weeks lower in the 37-week period following the emergency declaration versus the same 37-week periods in the previous 3 years (95% CI: -0.09, -0.01; p = 0.0177), while there was no change in GA for infants born to White people following the emergency declaration (95% CI: -0.01, 0.03; p = 0.6962). The FWC, which was widely attributed to structural racism, appears to have had a greater impact, overall, on outcomes for babies born to Black people. However, given the frequency of highly publicized examples of anti-Black racism over the study period, it is difficult to disentangle the effects of the FWC from the effects of other racialized stressors.
Collapse
Affiliation(s)
- Kristi L. Allgood
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States,*Correspondence: Kristi L. Allgood
| | - Jasmine A. Mack
- 2Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Nicole L. Novak
- 3Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, United States
| | - Cleopatra M. Abdou
- 4Department of Children, Youth, and Families, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Nancy L. Fleischer
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Belinda L. Needham
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States
| |
Collapse
|
16
|
Young MEDT, Crookes DM, Torres JM. Self-rated health of both US citizens and noncitizens is associated with state-level immigrant criminalization policies. SSM Popul Health 2022; 19:101199. [PMID: 36016587 PMCID: PMC9396227 DOI: 10.1016/j.ssmph.2022.101199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 12/03/2022] Open
Abstract
Evidence shows that state-level restrictive immigrant policies are associated with health disparities between noncitizens and citizens. Most research has focused on Latinos and there is limited knowledge of the relationship between restrictive policies and citizenship status among other groups, particularly Asian and Pacific Islanders (API). We examined whether state-level criminalization policy contexts (e.g., law enforcement collaboration with immigration authorities, E-Verify employment authorization) were associated with self-rated health (SRH) by citizenship, with a focus on Latinos and APIs. We expected that criminalization policies would be associated with worse health for noncitizens and citizens, but with a more negative influence for noncitizens; and that this pattern would be the same for Latinos and APIs. We merged a state-level immigrant criminalization policy database with a multi-racial/ethnic sample from 2014 to 2015 National Health Interview Survey (NHIS, n = 70,335). We tested the association between SRH and the number of state-level criminalization policies and generated predicted probabilities of noncitizens and citizens reporting excellent health in states with the most and fewest criminalization policies for the full sample, Latino, and API respondents. In states with the most criminalization policies, all noncitizens had a higher and all US-born citizens had a lower probability of excellent health. In states with the fewest criminalization policies there were no differences by citizenship status. Findings provide new evidence that state-level immigrant policies may harm the health of US-born citizens. As immigrant policymaking at the state level continues, understanding the relationship between state-level immigrant policies and health inequities across citizenship statuses will continue to be critical to improving population health. State policies that criminalize immigrants may harm the health of both noncitizens and citizens of different races/ethnicities. More state immigrant criminalization policies are associated with health inequities between US citizens and noncitizens. Immigrant criminalization policies are associated with worse self-reported health for US born citizens.
Collapse
Affiliation(s)
- Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA, USA
| | - Danielle M Crookes
- Department of Health Sciences, Bouvé College of Health Sciences and Department of Sociology and Anthropology, College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA
| | - Jacqueline M Torres
- Department of Epidemiology & Biostatistics, UC San Francisco, San Francisco, CA, USA
| |
Collapse
|
17
|
Fox M. How demographics and concerns about the Trump administration relate to prenatal mental health among Latina women. Soc Sci Med 2022; 307:115171. [PMID: 35803053 PMCID: PMC9542647 DOI: 10.1016/j.socscimed.2022.115171] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/11/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
Abstract
RATIONALE The 2016 U.S. presidential election and its aftermath involved political rhetoric and policies that especially targeted women, Latinos, and immigrants. It is possible that concerns about the political environment could affect mental health of individuals in targeted groups. OBJECTIVE In a cohort of 148 pregnant Latina women, this study investigated how demographics and political concerns related to each other and to maternal anxiety, depression, and perceived stress, which have been associated with adverse birth and child development outcomes. METHODS In this cross-sectional, self-report study, participants in Southern California completed a one-time questionnaire from January 2017 to May 2018. RESULTS The highest rates of endorsement were for concerns regarding President Trump's racism, attitude towards women, and deportation risk for family or friends. From several demographic variables, the only significant predictor of state anxiety was expectant parents' birthplaces. From several political concerns variables, the only significant predictor of state anxiety was President Trump's attitude towards women or women's rights. There were no significant effects on other mental health outcomes. CONCLUSIONS Results suggest that birthplace and women's issues may be particularly salient anxiety risk factors for Latina pregnant women in this context. Because of the cross-sectional study design, it is possible that, conversely, pregnant women with high anxiety levels are particularly sensitive to the issue of birthplace or women's rights. Results imply that the political climate and events in the U.S. could have deleterious consequences that may cascade across generations of Latino Americans via effects on pregnant women.
Collapse
Affiliation(s)
- Molly Fox
- Departments of Anthropology and Psychiatry & Biobehavioral Sciences, UCLA, Los Angeles, CA, 90095, USA.
| |
Collapse
|
18
|
M P, P MZ, Ke P, Sj S. Immigration policies as political determinants of alcohol and drug misuse among US-born Latinos. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 106:103754. [PMID: 35688060 PMCID: PMC10676018 DOI: 10.1016/j.drugpo.2022.103754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The role of immigration policies as political determinants of health among US-born Latinos is significantly understudied. Immigration policies can produce immigration-related stressors that have 'spill over' effects on the health behaviors of US-born Latinos. However, less is known about how immigration-related stressors relate to substance misuse among US-born Latinos. METHODS 1,784 US-born Latinos were recruited via web-panels in September 2021 to complete an online questionnaire. Inclusion criteria included: (1) self-identifying as Latino; (2) born in the US; and (3) being 18 years of age or older. Participants were asked 14-items related to immigration-related stressors and past-year substance use behaviors. Dependent variables included past-year: heavy drinking, high intensity drinking, illicit drug use, prescription drug misuse, cannabis use, cocaine use, methamphetamine use, prescription sedative misuse, and prescription opioid misuse. Two separate multivariable logistic regression models were conducted for each outcome to investigate associations between (1) specific immigration-related stressors and substance misuse; and (2) experiencing greater (vs. fewer) number of immigration-related stressors and substance misuse. RESULTS On average, US-born Latinos reported experiencing 3 immigration-related stressors. In multivariable analyses, being fearful or worried about being detained for immigration reasons was associated with increased odds of engaging in heavy drinking, high intensity drinking, and illicit drug use. Having ever feared or worried about being potentially deported for immigration reasons and having ever witnessed or experienced an immigration raid was associated with high intensity drinking. Parental detentions and deportations in childhood were independently associated with high intensity drinking, illicit drug use, and prescription drug misuse. Notably, greater number of immigration-related stressor experiences increased the odds of substance misuse. CONCLUSION Punitive immigration and enforcement policies give rise to multiple stressors that may render US-born Latinos vulnerable to misusing substances as a way of coping. Policies and public health interventions aimed at preventing and treating substance misuse should consider how immigration policies impact the behaviors of US-born Latinos.
Collapse
Affiliation(s)
- Pinedo M
- Department of Kinesiology & Health Education, College of Education, University of Texas at Austin, United States.
| | - Montero-Zamora P
- Department of Kinesiology & Health Education, College of Education, University of Texas at Austin, United States
| | - Pasch Ke
- Department of Kinesiology & Health Education, College of Education, University of Texas at Austin, United States
| | - Schwartz Sj
- Department of Kinesiology & Health Education, College of Education, University of Texas at Austin, United States
| |
Collapse
|
19
|
Held ML, First JM, Huslage M. Effects of COVID-19, Discrimination, and Social Support on Latinx Adult Mental Health. J Immigr Minor Health 2022; 24:1446-1458. [PMID: 35841445 PMCID: PMC9288212 DOI: 10.1007/s10903-022-01382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
We investigated the role of COVID-19 exposure and discrimination on depressive and posttraumatic stress symptoms among Latinx adults residing in the southeastern United States. Survey data were collected from 264 Latinx adults. Using structural equation modeling (SEM) procedures, we estimated a structural model for hypothesized direct and indirect relationships between the risk factors of COVID-19 exposure and discrimination, social support, and two mental health conditions: depression and posttraumatic stress. COVID-19 exposure and discrimination each had a significant and positive relationship with both depression and posttraumatic stress. Social support was found to have a significant and inverse relationship with depression and posttraumatic stress, as well as to mediate the relationship between discrimination and both mental health symptoms. Implications for service provision and program design are presented. Future studies should examine variation between southeastern states and consider the influence of documentation status among an immigrant-only sample.
Collapse
Affiliation(s)
- Mary Lehman Held
- College of Social Work, University of Tennessee, TN, Knoxville, USA.
| | - Jennifer M First
- College of Social Work, University of Tennessee, TN, Knoxville, USA
| | - Melody Huslage
- College of Social Work, University of Tennessee, TN, Knoxville, USA
| |
Collapse
|
20
|
Crocker RM, Duenas K, Vázquez L, Ingram M, Cordova-Marks FM, Torres E, Carvajal S. "Es Muy Tranquilo Aquí": Perceptions of Safety and Calm among Binationally Mobile Mexican Immigrants in a Rural Border Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148399. [PMID: 35886251 PMCID: PMC9323766 DOI: 10.3390/ijerph19148399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/25/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023]
Abstract
Perceptions of community can play an important role in determining health and well-being. We know little, however, about residents’ perceptions of community safety in the Southwestern borderlands, an area frequently portrayed as plagued by disorder. The qualitative aim of this community-based participatory research study was to explore the perceptions of Mexican-origin border residents about their communities in southern Yuma County, Arizona. Our team of University of Arizona researchers and staff from Campesinos Sin Fronteras, a grassroots farmworker support agency in Yuma County, Arizona, developed a bilingual interview guide and recruited participants through radio adds, flyers, and cold calls among existing agency clientele. Thirty individual interviews with participants of Mexican origin who live in and/or work in rural Yuma County were conducted remotely in 2021. Participants overwhelmingly perceived their communities as both calm and safe. While some participants mentioned safety concerns, the vast majority described high levels of personal security and credited both neighbors and police for ensuring local safety. These perceptions were stated in direct contrast to those across the border, where participants had positive familial and cultural ties but negative perceptions regarding widespread violence. In conclusion, we argue that to understand environmental factors affecting health and well-being in Mexican immigrant populations, it is critical to examine the role of binational external referents that color community perceptions.
Collapse
Affiliation(s)
- Rebecca M. Crocker
- Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (K.D.); (F.M.C.-M.)
- Correspondence:
| | - Karina Duenas
- Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (K.D.); (F.M.C.-M.)
| | - Luis Vázquez
- Campesinos Sin Fronteras, Somerton, AZ 85350, USA; (L.V.); (E.T.)
| | - Maia Ingram
- Arizona Prevention Research Center, Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (M.I.); (S.C.)
| | - Felina M. Cordova-Marks
- Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (K.D.); (F.M.C.-M.)
| | - Emma Torres
- Campesinos Sin Fronteras, Somerton, AZ 85350, USA; (L.V.); (E.T.)
| | - Scott Carvajal
- Arizona Prevention Research Center, Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (M.I.); (S.C.)
| |
Collapse
|
21
|
Payan T. Understanding the Nexus between Undocumented Immigration and Mental Health. Curr Opin Psychol 2022; 47:101414. [DOI: 10.1016/j.copsyc.2022.101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
|
22
|
Mahoney West H, Milliren CE, Manne-Goehler J, Davis J, Gallegos J, Perez JH, Köhler JR. Effect of clinician information sessions on diagnostic testing for Chagas disease. PLoS Negl Trop Dis 2022; 16:e0010524. [PMID: 35709253 PMCID: PMC9242495 DOI: 10.1371/journal.pntd.0010524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 06/29/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Chagas disease is a potentially life-threatening neglected disease of poverty that is endemic in continental Latin America. Caused by Trypanosoma cruzi (T. cruzi), it is one of six parasitic diseases in the United States targeted by the Centers for Disease Control as a public health problem in need of action. An estimated 300,000 people are infected with T. cruzi in the United States (US). Although its morbidity, mortality and economic burden are high, awareness of Chagas disease is lacking among many healthcare providers in the US. The purpose of this analysis is to determine if the number of diagnostic tests performed at a community health center serving an at-risk population for Chagas disease increased after information sessions. A secondary aim was to determine if there was a difference by provider type, i.e., nurse practitioner vs. physician, or by specialty in the number of patients screened. Methodology/Principal findings We conducted a retrospective data analysis of the number of Chagas serology tests performed at a community health center before and after information sessions for clinicians. A time series analysis was conducted focusing on the Adult and Family Medicine Departments at East Boston Neighborhood Health Center (EBNHC). Across all departments there were 1,957 T. cruzi tests performed before the sessions vs. 2,623 after the sessions. Interrupted time series analysis across departments indicated that testing volume was stable over time prior to the sessions (pre-period slope = +4.1 per month; p = 0.12), followed by an immediate shift after the session (+51.6; p = 0.03), while testing volume remained stable over time after the session (post-period slope = -6.0 per month; p = 0.11). Conclusion/Significance In this study, Chagas testing increased after information sessions. Clinicians who began testing their patients for Chagas disease after learning of the importance of this intervention added an extra, potentially time-consuming task to their already busy workdays without external incentives or recognition. Chagas disease is a potentially fatal neglected disease of poverty. It is endemic in continental Latin America with an estimated 300,000 cases in the United States, primarily among low-income people who have immigrated to the US from Latin America. Few Chagas screening programs have been established in the US. Existing recommendations for Chagas disease testing and treatment are rarely followed for many reasons including a paucity of knowledge among providers. We aimed to determine if the number of Chagas tests performed increased after information sessions at a community health center. A secondary aim was to determine if there was a difference in number of tests performed by provider type. We found that the number of T. cruzi serologies performed in the ten months after information sessions increased significantly over that in the ten preceding months. Chagas testing increased across departments, though Chagas diagnostics were an extra and unmitigated time burden on clinicians. Increasing provider knowledge is a major step to increase diagnosis and treatment of this neglected disease, when clinicians are motivated by their inherent prosocial preferences including altruism i.e., by the positive impact of their work on patients’ lives.
Collapse
Affiliation(s)
- Helen Mahoney West
- Division of Infectious Disease Boston Children’s Hospital, Boston, Massachusetts, United States of America
- * E-mail:
| | - Carly E. Milliren
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | | | - Jillian Davis
- East Boston Neighborhood Health Center, Boston, Massachusetts, United States of America
| | - Jaime Gallegos
- East Boston Neighborhood Health Center, Boston, Massachusetts, United States of America
| | - Juan Huanuco Perez
- East Boston Neighborhood Health Center, Boston, Massachusetts, United States of America
| | - Julia R. Köhler
- Division of Infectious Disease Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America
| |
Collapse
|
23
|
Toney AM, Martin T, Sanchez S, Kelley MS, Palmer-Wackerly AL, Chaidez V. Examining the Macrosystem Level of Influence on Community Health Worker Effectiveness in the State of Nebraska: A Qualitative Approach. J Community Health 2022; 47:510-518. [PMID: 35244819 PMCID: PMC8894838 DOI: 10.1007/s10900-022-01075-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 11/25/2022]
Abstract
Community health workers (CHWs) serve as the linkage between community and providers and are stakeholders for bridging services to the public. However, integration of CHWs into health care organizations is often lacking. This study explored macrosystem level barriers faced by CHWs and their ability to do their jobs effectively. Using qualitative interviews from CHWs (n = 28) in Nebraska, we used an abductive approach to derive the following themes: (1) CHWs and client macrosystem barriers, (2) CHW workforce supports, and (3) macrosystem solutions for CHW workforce sustainability. Study results also found various macrosystem barriers affecting CHW workforces including immigration policies, insurance policies, funding sources, supervisor support, and obstacles for health seeking of clients. Moreover, through the lens of CHWs, results revealed the need to provide and advocate for solutions that prioritize the needs of CHWs as they continue to fill a crucial gap in community healthcare systems.
Collapse
Affiliation(s)
- Ashley Mulcahy Toney
- Nutrition and Health Sciences, University of Nebraska-Lincoln, 104A Leverton Hall, Lincoln, NE, 68583-0806, USA
- School of Public Health, UTHealth Center for Community Health Impact, The University of Texas Health Science Center at Houston, El Paso, TX, USA
| | - Tyler Martin
- Nutrition and Health Sciences, University of Nebraska-Lincoln, 104A Leverton Hall, Lincoln, NE, 68583-0806, USA
| | - Sophi Sanchez
- Communication Studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Megan S Kelley
- Nutrition and Health Sciences, University of Nebraska-Lincoln, 104A Leverton Hall, Lincoln, NE, 68583-0806, USA
| | | | - Virginia Chaidez
- Nutrition and Health Sciences, University of Nebraska-Lincoln, 104A Leverton Hall, Lincoln, NE, 68583-0806, USA.
| |
Collapse
|
24
|
Lechuga J, Galletly CL, Glasman LR, Dickson-Gomez JB, McAuliffe TL. Latinx Immigrants' Legal Concerns About SARS-CoV-2 Testing and COVID-19 Diagnosis and Treatment. J Immigr Minor Health 2022; 24:1-9. [PMID: 35013844 PMCID: PMC8747869 DOI: 10.1007/s10903-021-01314-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 12/03/2022]
Abstract
Immigration concerns can deter immigrants from utilizing healthcare services. We examined Latinx immigrants' immigration concerns related to COVID-19 testing and treatment. A multi-state sample of 336 US Latinx immigrants (documented and undocumented) completed a cross-sectional online survey in Spanish. Factor analysis informed the construction of a COVID-19 Immigration Concerns Scale. Multiple logistic regression was used to examine associations between the scale and indices of perceived immigration risk and healthcare access and utilization. Concerns clustered around two factors: (1) providers' release of information to immigration authorities and drawing government attention; and (2) eligibility for COVID-19 services and the immigration ramifications of using these. The regression equation highlighted strong associations between these and perceived instability of immigration laws and enforcement concerns after controlling for healthcare access and utilization. COVID-19-related immigration concerns were substantial and multifaceted. Perceived instability of laws was strongly related to concerns but remains understudied.
Collapse
Affiliation(s)
- Julia Lechuga
- Department of Public Health Sciences, The University of Texas at El Paso, 500 W. University, El Paso, TX, 79968, USA.
| | - Carol L Galletly
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, USA
| | - Laura R Glasman
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, USA
| | - Julia B Dickson-Gomez
- Center for AIDS Intervention Research and the Institute for Health Equity, Medical College of Wisconsin, Milwaukee, USA
| | - Timothy L McAuliffe
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, USA
| |
Collapse
|
25
|
Saadi A, Patler C, De Trinidad Young ME. Cumulative Risk of Immigration Prison Conditions on Health Outcomes Among Detained Immigrants in California. J Racial Ethn Health Disparities 2022; 9:2518-2532. [PMID: 34845673 PMCID: PMC8628823 DOI: 10.1007/s40615-021-01187-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The USA maintains the world's largest immigration detention system. This study examines the mechanisms by which detention serves as a catalyst for worsening health. METHODS Using data from detained immigrants in California (n = 493) from 2013 to 2014, we assessed the prevalence of exposure to conditions of confinement hypothesized to negatively influence health; the extent to which conditions of confinement are associated with psychological stress, diagnosed mental health conditions, and/or declines in general health; and the cumulative impact of confinement conditions on these outcomes. RESULTS We found that each condition increased the likelihood of one or more negative health conditions, but there was also a cumulative effect: for each additional confinement condition, the odds of worsening general health rose by 39% and reporting good health decreased by 24%. CONCLUSIONS Confinement conditions are associated with poor physical and mental health outcomes among immigrants detained in immigration prisons. Policies that seek to improve specific conditions in detention centers may remove some risks of harm, but alternatives to detention are likely to be most effective.
Collapse
Affiliation(s)
- Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 100 Cambridge St, Suite 2000, Boston, MA 02114 USA
| | - Caitlin Patler
- Department of Sociology, UC Davis, 1283 Social Sciences & Humanities, One Shields Ave, Davis, CA 95616 USA
| | - Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, 5200 N. Lake Rd, Merced, CA 95343 USA
| |
Collapse
|
26
|
Held ML, Villarreal-Otálora T, Jennings-McGarity P. Latino Immigrant Service Provision in Tennessee and Georgia: Provider Perceptions. J Immigr Minor Health 2021; 24:875-888. [PMID: 34654993 DOI: 10.1007/s10903-021-01286-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/26/2022]
Abstract
Latinos and Latino immigrants are increasingly settling in new immigrant destinations, such as Tennessee and Georgia, that have historically lacked sufficient infrastructure for delivery of culturally and linguistically competent health and social services. This cross-sectional survey study was designed to assess providers' (n = 109) perspectives of the service provision landscape in each state. Descriptive analyses and t-tests (by state) were conducted to explore service concerns, access barriers, and organizational capacity to address concerns and barriers. Among most prevalently reported concerns were income/wages and fear of deportation. Key access barriers included language, lack of driver's license and insurance, and fear of deportation. Most (63%) organizations had sufficient Spanish language proficiency, though building trust was a notable barrier within 58% of organizations. Results provide meaningful data to inform existing strengths and service gaps in two exclusionary policy states. Future research should include perspectives of Latino community members.
Collapse
Affiliation(s)
- Mary Lehman Held
- College of Social Work, University of Tennessee, Knoxville, 193 Polk Avenue, Suite E, Nashville, TN, 37210, USA.
| | | | | |
Collapse
|
27
|
Ornelas-Dorian C, Torres JM, Sun J, Aleman A, Cordova E, Orue A, Taira BR, Anderson E, Rodriguez RM. Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement. PLoS One 2021; 16:e0256073. [PMID: 34506493 PMCID: PMC8432754 DOI: 10.1371/journal.pone.0256073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
STUDY OBJECTIVES Heightened immigration enforcement may induce fear in undocumented patients when coming to the Emergency Department (ED) for care. Limited literature examining health system policies to reduce immigrant fear exists. In this multi-site qualitative study, we sought to assess provider and system-level policies on caring for undocumented patients in three California EDs. METHODS We recruited 41 ED providers and administrators from three California EDs (in San Francisco, Oakland, and Sylmar) with large immigrant populations. Participants were recruited using a trusted gatekeeper and snowball sampling. We conducted semi-structured interviews and analyzed the transcripts using constructivist grounded theory. RESULTS We interviewed 10 physicians, 11 nurses, 9 social workers, and 11 administrators, and identified 7 themes. Providers described existing policies and recent policy changes that facilitate access to care for undocumented patients. Providers reported that current training and communication around policies is limited, there are variations between who asks about and documents status, and there remains uncertainty around policy details, laws, and jurisdiction of staff. Providers also stated they are taking an active role in building safety and trust and see their role as supporting undocumented patients. CONCLUSIONS This study introduces ED-level health system perspectives and recommendations for caring for undocumented patients. There is a need for active, multi-disciplinary ED policy training, clear policy details including the extent of providers' roles, protocols on the screening and documentation of status, and continual reassessment of our health systems to reduce fear and build safety and trust with our undocumented communities.
Collapse
Affiliation(s)
- Carolina Ornelas-Dorian
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, United States of America
- School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Jacqueline M. Torres
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Jennifer Sun
- Department of Emergency Medicine, Highland Hospital - Alameda Health System, Oakland, California, United States of America
| | - Alexis Aleman
- Department of Emergency Medicine, Olive View - UCLA Medical Center, Sylmar, California, United States of America
| | - Emmanuel Cordova
- Department of Emergency Medicine, Olive View - UCLA Medical Center, Sylmar, California, United States of America
| | - Aristides Orue
- Department of Emergency Medicine, Olive View - UCLA Medical Center, Sylmar, California, United States of America
| | - Breena R. Taira
- Department of Emergency Medicine, Olive View - UCLA Medical Center, Sylmar, California, United States of America
| | - Erik Anderson
- Department of Emergency Medicine, Highland Hospital - Alameda Health System, Oakland, California, United States of America
| | - Robert M. Rodriguez
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, United States of America
| |
Collapse
|
28
|
Cohodes EM, Kribakaran S, Odriozola P, Bakirci S, McCauley S, Hodges HR, Sisk LM, Zacharek SJ, Gee DG. Migration-related trauma and mental health among migrant children emigrating from Mexico and Central America to the United States: Effects on developmental neurobiology and implications for policy. Dev Psychobiol 2021; 63:e22158. [PMID: 34292596 PMCID: PMC8410670 DOI: 10.1002/dev.22158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/11/2021] [Accepted: 06/20/2021] [Indexed: 12/24/2022]
Abstract
Children make up over half of the world's migrants and refugees and face a multitude of traumatic experiences prior to, during, and following migration. Here, we focus on migrant children emigrating from Mexico and Central America to the United States and review trauma related to migration, as well as its implications for the mental health of migrant and refugee children. We then draw upon the early adversity literature to highlight potential behavioral and neurobiological sequalae of migration-related trauma exposure, focusing on attachment, emotion regulation, and fear learning and extinction as transdiagnostic mechanisms underlying the development of internalizing and externalizing symptomatology following early-life adversity. This review underscores the need for interdisciplinary efforts to both mitigate the effects of trauma faced by migrant and refugee youth emigrating from Mexico and Central America and, of primary importance, to prevent child exposure to trauma in the context of migration. Thus, we conclude by outlining policy recommendations aimed at improving the mental health of migrant and refugee youth.
Collapse
Affiliation(s)
- Emily M Cohodes
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sahana Kribakaran
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Paola Odriozola
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah Bakirci
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah McCauley
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - H R Hodges
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Lucinda M Sisk
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sadie J Zacharek
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| |
Collapse
|
29
|
Kline N. Policing Race and Performing State Power: Immigration Enforcement and Undocumented Latinx Immigrant Precarity in Central Florida. CITY & SOCIETY 2021. [DOI: 10.1111/ciso.12409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Tabler J, Mykyta L. Forgoing Care in Southernmost Texas: Compounding Hardship and Health Among Latinx Immigrant Border Residents. FAMILY & COMMUNITY HEALTH 2021; 44:171-183. [PMID: 32841999 DOI: 10.1097/fch.0000000000000269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study examines how material hardship and perceived discrimination are associated with health care access and self-rated health among lower Rio Grande Valley residents. Of respondents to surveys administered at 2 clinic systems (N = 546), approximately 67% reported forgoing medical care in the past 12 months. Regression results suggested that perceived discrimination (odds ratio [OR] = 1.05, P < .05) and material hardship (OR = 1.63, P < .001) increased the odds of forgoing care. Also, discrimination (OR = 1.04, P < .01) and material hardship (OR = 1.24, P < .001) were independently associated with worse self-rated health. Service providers should consider screening for hardship experiences to target resources to address these stressors on patient health.
Collapse
Affiliation(s)
- Jennifer Tabler
- Department of Criminal Justice and Sociology, University of Wyoming, Laramie (Dr Tabler); and Department of Sociology and Anthropology, The University of Texas Rio Grande Valley, Edinburg (Dr Mykyta)
| | | |
Collapse
|
31
|
Pushing them to the edge: Suicide in immigrant detention centers as a product of organizational failure. Soc Sci Med 2021; 283:114177. [PMID: 34216885 DOI: 10.1016/j.socscimed.2021.114177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/08/2021] [Accepted: 06/21/2021] [Indexed: 01/26/2023]
Abstract
In this paper, we argue that the U.S. immigrant apparatus is a racial project that jeopardizes immigrants' wellbeing through organizational failure (Omi and Winant, 2014; Meyer & Rowman, 1977; Mellahi and Wilkinson, 2004). We utilize Provine and Doty's (2011) work as a foundation to understand how this racial project is systemic and multifaceted in nature. It begins with the negative characterization and criminalization of certain immigrants, mostly Latinx, followed by a poor infrastructure of processing and detention riddled with impediments to their wellbeing, which ultimately pushes detainees to the edge, to poor mental health, and suicidality. ICE's system of detention consistently operates poorly and normalizes organizational failure, jeopardizing immigrant lives through basic human rights violations, family separation, substandard living conditions, and minimal consideration to poor mental health, suicide prevention, and prompt and adequate intervention. Utilizing qualitative data from ICE inspection reports, contracts, and detainee death reports, we examine suicide policies across 116 detention facilities in the United States to highlight how detention facilities supervised by ICE unsuccessfully prevents detainee suicide due to organizational failure. Under ICE's oversight, facilities are inadequately staffed and resourced, resulting in the failure to implement federally mandated protocols regarding detainees' well-being competently and promptly. Their organizational failure leads to unequal health outcomes for Latinxs who are overrepresented across immigrant detention.
Collapse
|
32
|
Living Near an Immigration Detention Center: Impact on Latinas' Health. J Immigr Minor Health 2021; 24:626-638. [PMID: 34097163 PMCID: PMC8181535 DOI: 10.1007/s10903-021-01219-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
There is ample evidence that exposure to Immigration and Customs Enforcement (ICE) activities could widen Latinas’ health disparities. Whether or not residing near an ICE detention center (IDC) further impacts their health is unknown. During nationwide increased ICE activities Latinas (N=45) attended an intervention at two separate sites: one near and another one far from an IDC. A focus group discussion and an interview were conducted using a grounded theory approach. Quantitative data were collected and analyzed. Participants residing near an IDC benefited less from the intervention and reported changes in anxiety levels and in mobility, and a sense of powerlessness. They also requested resources to respond to ICE overreach and broadcasting of their reality. Our results suggest that proximity to IDCs impacts immigrant communities and public health programming, which is inevitably embedded in political realities. These need to be addressed when providing much needed interventions.
Collapse
|
33
|
Stanhope KK, Suglia SF, Hogue CJR, Leon JS, Comeau DL, Kramer MR. Spatial Variation in Very Preterm Birth to Hispanic Women Across the United States: The Role of Intensified Immigration Enforcement. Ethn Dis 2021; 31:333-344. [PMID: 34045835 DOI: 10.18865/ed.31.s1.333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Limited existing research suggests that immigration climate and enforcement practices represent a social determinant of health for immigrants, their families, and communities. However, national research on the impact of specific policies is limited. The goal of this article is to estimate the effect of county-level participation in a 287(g) immigration enforcement agreement on very preterm birth (VPTB, <32 weeks' gestation) rates between 2005-2016 among US-born and foreign-born Hispanic women across the United States. Methods We fit spatial Bayesian models to estimate the effect of local participation in a 287(g) program on county VPTB rates, accounting for variation by maternal nativity, county ethnic density, and controlling for individual specific Hispanic background and nativity and county-level confounders. Results While there was no global effect of county participation in a 287(g) program on county VPTB rates, rates were slightly increased in some counties, primarily in the Southeast (Virginia, North Carolina, South Carolina). Future Directions Future research should consider the mechanisms through which immigration policies and enforcement may impact health of both immigrants and wider communities.
Collapse
Affiliation(s)
- Kaitlyn K Stanhope
- Emory University School of Medicine, Gynecology and Obstetrics, Atlanta, GA
| | - Shakira F Suglia
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA
| | - Carol J R Hogue
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA
| | - Juan S Leon
- Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA
| | - Dawn L Comeau
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA
| | - Michael R Kramer
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA
| |
Collapse
|
34
|
Ornelas IJ, Yamanis TJ, Ruiz RA. The Health of Undocumented Latinx Immigrants: What We Know and Future Directions. Annu Rev Public Health 2021; 41:289-308. [PMID: 32237989 DOI: 10.1146/annurev-publhealth-040119-094211] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Undocumented Latinx immigrants experience unique factors prior to migration, during migration, and after migration that shape their health. Our review summarizes the limited but growing literature highlighting how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect the mental and physical health of undocumented Latinx immigrants. We also discuss how policies and social ties can promote their health. We focus on areas of particular concern, including health care, mental health, and HIV. Future research should use interdisciplinary approaches and intersectional frameworks to understand and address health inequities. Conducting research with undocumented Latinx immigrant communities requires community engagement, assurance of confidentiality, and creative recruitment and retention strategies. Recommendations for public health practice include investing in community health centers and organizations to ensure access to health and social services; presenting results with sufficient contextualization to interpret their generalizability; and advocating for federal-, state-, and local-level policy changes that reduce the negative health consequences associated with being undocumented.
Collapse
Affiliation(s)
- India J Ornelas
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
| | - Thespina J Yamanis
- School of International Service, American University, Washington, DC 20016-8071, USA;
| | - Raymond A Ruiz
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
| |
Collapse
|
35
|
Kanamori M, Shrader CH, De La Rosa M. A Timely Concern: Would Immigration Policies and Enforcement Actions Influence Higher Alcohol Dependence among Latina Seasonal Farmworkers? J Agromedicine 2021; 26:266-272. [PMID: 32238054 PMCID: PMC7530090 DOI: 10.1080/1059924x.2020.1744494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: We report the potential negative health consequences of immigration policies and enforcement actions, such as the increase of at-risk drinking, in the US Latino seasonal farmworker (LSFW) community.Method: Logistic regression analysis was performed using data from 213 female LSFWs over age 18 years.Results: The prevalence of at-risk drinking varied across participants' age groups: 18% for ages 21-29, 14% ages 30-39, 12% ages 40-49, and 32% ages 50 and older. Half of the participants reported being worried/tense, because they had difficulties finding legal services for their immigration status, and 65% reported that they have been questioned about their legal status. Of participants, 55% reported feeling worried/tense, because they were treated badly due to their lack of English; 42% because they have felt unaccepted by others due to their Latino culture; and 44% because they have been discriminated against. Legal and discrimination concerns were associated with at-risk drinking.Discussion: Enactment of new immigration policies and enforcement of existing immigration policies should consider negative public health implications. Novel approaches should be explored to more effectively reach and engage LSFW at-risk of problematic alcohol use or in need of substance use treatment.
Collapse
Affiliation(s)
- Mariano Kanamori
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Cho Hee Shrader
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mario De La Rosa
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| |
Collapse
|
36
|
Alson JG, Robinson WR, Pittman L, Doll KM. Incorporating Measures of Structural Racism into Population Studies of Reproductive Health in the United States: A Narrative Review. Health Equity 2021; 5:49-58. [PMID: 33681689 PMCID: PMC7929921 DOI: 10.1089/heq.2020.0081] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose: Black women in the United States face poor outcomes across reproductive health measures-from pregnancy outcomes to gynecologic cancers. Racial health inequities are attributable to systemic racism, but few population studies of reproductive health outcomes integrate upstream measures of systemic racism, and those who do are limited to maternal and infant health outcomes. Advances in understanding and intervening on the pathway from racism to reproductive health outcomes are limited by a paucity of methodological guidance toward this end. We aim to fill this gap by identifying quantitative measures of systemic racism that are salient across reproductive health outcomes. Methods: We conducted a review of literature from 2000 to 2019 to identify studies that use quantitative measures of exposure to systemic racism in population reproductive health studies. We analyzed the catalog of literature to identify cohesive domains and measures that integrate data across domains. For each domain, we contextualize its use within population health research, describe metrics currently in use, and present opportunities for their application to reproductive health research. Results: We identified four domains of systemic racism that may affect reproductive health outcomes: (1) civil rights laws and legal racial discrimination, (2) residential segregation and housing discrimination, (3) police violence, and (4) mass incarceration. Multiple quantitative measures are available for each domain. In addition, a multidimensional measure exists and additional domains of systemic racism are salient for future development into distinct measures. Conclusion: There are quantitative measures of systemic racism available for incorporation into population studies of reproductive health that investigate hypotheses, including and beyond those related to maternal and infant health. There are also promising areas for future measure development, such as the child welfare system and intersectionality. Incorporating such measures is critical for appropriate assessment of and intervention in racial inequities in reproductive health outcomes.
Collapse
Affiliation(s)
- Julianna G. Alson
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Whitney R. Robinson
- Department of Epidemiology, UNC Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - LaShawnDa Pittman
- Department of American Ethnic Studies, University of Washington, Seattle, Washington, USA
| | - Kemi M. Doll
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA
| |
Collapse
|
37
|
La Charite J, Braverman DW, Goplerud D, Norton A, Bertram A, Berger ZD. Healthcare Professionals' Experience, Training, and Knowledge Regarding Immigration-Related Law Enforcement in Healthcare Facilities: An Online Survey. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2021; 49:50-58. [PMID: 33966653 DOI: 10.1017/jme.2021.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
U.S. immigration policies and enforcement can make immigrants fearful of accessing healthcare. Although current immigration policies restrict enforcement in "sensitive locations" including healthcare facilities, there are reports of enforcement actions in such settings.
Collapse
|
38
|
Valentín-Cortés M, Benavides Q, Bryce R, Rabinowitz E, Rion R, Lopez WD, Fleming PJ. Application of the Minority Stress Theory: Understanding the Mental Health of Undocumented Latinx Immigrants. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 66:325-336. [PMID: 32776579 DOI: 10.1002/ajcp.12455] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This paper applies the Minority Stress framework to data collected from an ongoing community-based participatory research project with health and social service agencies in Southeast Michigan. We examine the stressors and coping strategies employed by undocumented Latinx immigrants and their families to manage immigration-related stress. We conducted in-depth interviews with 23 immigrant clients at Federally Qualified Health Care Centers (FQHC) in Southeast Michigan and 28 in-depth interviews with staff at two FQHC's and a non-profit agency serving immigrants. Findings suggest that immigrants face heightened anxiety and adverse mental health outcomes because of unique minority identity-related stressors created by a growing anti-immigrant social environment. Chronic stress experienced stems from restrictive immigration policies, anti-immigrant rhetoric in the media and by political leaders, fear of deportation, discriminatory events, concealment, and internalized anti-immigrant sentiment. Though identity can be an important effect modifier in the stress process, social isolation in the immigrant community has heightened the impact of stress and impeded coping strategies. These stressors have resulted in distrust in community resources, uncertainty about future health benefits, delayed medical care, and adverse mental health outcomes. Findings provide a framework for understanding the unique stressors experienced by immigrants and strategies for interventions by social service agencies.
Collapse
Affiliation(s)
| | | | - Richard Bryce
- Community Health and Social Services Center, Detroit, MI, USA
| | - Ellen Rabinowitz
- Washtenaw County Health Department, Washtenaw Health Plan, Ypsilanti, MI, USA
| | | | - William D Lopez
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Paul J Fleming
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| |
Collapse
|
39
|
Samari G, Catalano R, Alcalá HE, Gemmill A. The Muslim Ban and preterm birth: Analysis of U.S. vital statistics data from 2009 to 2018. Soc Sci Med 2020; 265:113544. [PMID: 33261902 DOI: 10.1016/j.socscimed.2020.113544] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/10/2020] [Accepted: 11/18/2020] [Indexed: 11/16/2022]
Abstract
Anti-immigrant stigma or xenophobia is increasingly pervasive globally. Racism is a determinant of adverse health outcomes, but the epidemiological implications of the recent wave of xenophobic policies have not been well studied. The 2017 travel ban on individuals from Muslim majority countries is an example of such policy efforts in the United States. Using the 2009-2018 National Center for Health Statistics period linked infant birth-death data, we used time series methods to compare the monthly odds of preterm births to women from travel ban countries (Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen) after the January 2017 travel ban to the number expected had the ban not been implemented. We estimated our counterfactual from the history of preterm birth among women born in countries included in the ban as well as trends in preterm birth among native-born non-Hispanic (NH) White women. Among the 18,945,795 singleton live births included in our study period (including 191,121 born to women from banned countries), the average monthly rate of births that were preterm birth was 8.5% (range: 6.8%, 10.6%) among women born in the countries affected by the ban and 8.6% (range: 7.7%, 9.8%) among native-born NH White women. Our results show an increase in the odds of preterm birth among infants born to women from travel ban countries in September 2017 and persisting through the cohort born in August 2018. The coefficient for exposed infants born in these months suggests that the odds of preterm birth increased by 6.8% among women from banned countries (p < 0.001). Our results suggest that the first U.S. Executive Order (#13769) of the travel ban targeting individuals from Muslim majority countries may be associated with preterm births. We therefore conclude that structurally xenophobic and racist policies in the U.S. may have a harmful effect on birth outcomes and early life indicators of life-long health outcomes.
Collapse
Affiliation(s)
- Goleen Samari
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, USA.
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley, USA
| | - Héctor E Alcalá
- Program in Public Health, Department of Family, Population & Prevention Medicine, Stony Brook University, USA
| | - Alison Gemmill
- Department of Family, Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, USA
| |
Collapse
|
40
|
Dias J, Echeverria S, Mayer V, Janevic T. Diabetes Risk and Control in Multi-ethnic US Immigrant Populations. Curr Diab Rep 2020; 20:73. [PMID: 33216289 DOI: 10.1007/s11892-020-01358-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW The goal of this review is to assess current evidence on diabetes risk and control among adult immigrants in the USA. RECENT FINDINGS Patterns of diabetes risk in US immigrants may reflect global diabetes trends. Asian, Black, and Latinx immigrants all see a diabetes disadvantage relative to US-born Whites. Diabetes risk in Asian immigrants also surpasses US-born Asians. Relative diabetes risk among all groups increases with time in the USA. Research to explain patterns in diabetes risk and control among immigrants has broadened from lifestyle factors to include multi-level, life course influences on trajectories of risk. Some determinants are shared across groups, such as structural racism, healthcare access, and migration stress, whereas others such as diet are embedded in sending country culture. Current literature on diabetes in immigrant populations suggests a need to shift towards a transnational lens and macro-level social determinants of health framework to understand diabetes risk and potential prevention factors.
Collapse
Affiliation(s)
- Jennifer Dias
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sandra Echeverria
- Department of Public Health Education, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Victoria Mayer
- General Internal Medicine, Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Teresa Janevic
- Obstetrics, Gynecology, and Reproductive Science, Population Health Science & Policy, Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
41
|
Mesa H, Doshi M, Lopez W, Bryce R, Rion R, Rabinowitz E, Fleming PJ. Impact of anti-immigrant rhetoric and policies on frontline health and social service providers in Southeast Michigan, U.S.A. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2004-2012. [PMID: 32462702 DOI: 10.1111/hsc.13012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 03/02/2020] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
Rising hostility towards immigrants characterised the 2016 Presidential election in the United States (US) and subsequent policy priorities by the new presidential administration. The political shift towards aggressive policies targeting undocumented immigrants is far-reaching and extends into other communities that convive con-or coexist with-immigrant communities. Our study aims to examine the rippling effects of these anti-immigrant policies and rhetoric on health and social service providers in Southeast Michigan who predominantly serve Latino immigrants. Between April and August 2018, we conducted in-depth individual interviews in two Federally Qualified Health Centers and a non-profit social service agency at a county health department. We interviewed 28 frontline health and social service providers. After coding and thematic analyses, we found that staff members' experiences in supporting immigrant clients was congruent with definitions of secondary trauma stress and compassion fatigue, whereby exposure to clients' trauma combined with job burden subsequently impacted the mental health of providers. Major themes included: (a) frontline staff experienced a mental and emotional burden in providing services to immigrant clients given the restrictive anti-immigrant context; and (b) this burden was exacerbated by the increased difficulties in providing these services to their clients. Staff described psychological and emotional distress stemming from exposure to clients' immigration-related trauma and increased mental health needs. This distress was exacerbated by an increased demand to meet clients' needs, which involved explaining or translating documents into English, assisting with legal paperwork, referring clients to mental health resources, addressing increased transportation barriers, and reestablishing trust with the community. Our findings add qualitative data on the mental health implications for frontline providers who support Latino immigrant clients impacted by immigration and highlights the need for further research and resources that address the workplace-related stress generated by heightened immigration enforcement.
Collapse
Affiliation(s)
- Hannah Mesa
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Monika Doshi
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - William Lopez
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Richard Bryce
- Community Health and Social Services Center, Detroit, MI, USA
| | | | - Ellen Rabinowitz
- Washtenaw Health Department, Washtenaw Health Plan, Ypsilanti, MI, USA
| | - Paul J Fleming
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
42
|
Alberto CK, Kemmick Pintor J, Young ME, Tabb LP, Martínez-Donate A, Langellier BA, Stimpson JP. Association of Maternal Citizenship and State-Level Immigrant Policies With Health Insurance Coverage Among US-Born Latino Youths. JAMA Netw Open 2020; 3:e2021876. [PMID: 33084899 PMCID: PMC7578764 DOI: 10.1001/jamanetworkopen.2020.21876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE The association of state-level immigrant policies with uninsurance among Latino youths remains unknown. OBJECTIVE To assess the association of state-level immigrant integration and criminalization policies with health insurance coverage among US-born Latino youths by maternal citizenship. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study analyzed secondary data from the American Community Survey, January 1, 2016, to December 31, 2018, for US-born Latino youths (age, ≤17 years) and their mothers (age, 18-64 years) as well as state-level indicators of immigrant integration and criminalization policies (in all 50 states and the District of Columbia). EXPOSURES Immigrant integration and criminalization policies. MAIN OUTCOMES AND MEASURES The main outcome was maternal reports of youth uninsurance status at the time of the American Community Survey interview. Variation in youth uninsurance by maternal citizenship, state immigrant integration policy context, and state immigrant criminalization policy context were examined. All analyses were conducted with weighted survey data. RESULTS Of the 226 691 US-born Latino youths (115 431 [50.92%] male; mean [SD] age, 7.66 [4.92] years) included in the study, 36.64% (95% CI, 36.21%-36.92%) had noncitizen mothers. Overall, 7.09% (95% CI, 6.78%-7.41%) of noncitizen mothers reported that their youths were uninsured compared with 4.68% (95% CI, 4.49%-4.88%) of citizen mothers. Of uninsured youths who resided in states with a low level of immigrant integration policies, 9.10% (8.22%-10.06%) had noncitizen mothers and 4.75% (95% CI, 4.19%-5.37%) had citizen mothers; of uninsured youths who resided in states with high criminalization policies, 9.37% (95% CI, 8.90%-9.87%) had noncitizen mothers and 5.91% (95% CI, 5.64%-6.20%) had citizen mothers. In states with few immigrant integration policies, the probability of uninsurance among youths with noncitizen mothers was 3.3% (95% CI, 2.3%-4.4%) higher than that among youths with citizen mothers. Among youths with noncitizen mothers, the difference in the probability of uninsurance between those residing in states with a low level vs a high level of immigrant integration policies was 2.1% (95% CI, 0.6%-3.6%). Among youths residing in states with high levels of immigrant criminalization policies, those with noncitizen mothers had a 2.6% (95% CI, 1.9%-3.0%) higher probability of being uninsured compared with those whose mothers were citizens. Among youths with noncitizen mothers, the difference in the probability of uninsurance between those who resided in a state with a low level vs a state with a high level of immigrant criminalization policies was 1.7% (95% CI, 0.7%-2.7%). CONCLUSIONS AND RELEVANCE The findings of this cross-sectional study suggest that among US-born Latino youths, disparities in uninsurance by maternal citizenship are associated with state-level immigrant integration and criminalization policies and that anti-immigrant policies may be associated with disparities in health care access for US-born Latino youths.
Collapse
Affiliation(s)
- Cinthya K. Alberto
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | | | - Maria-Elena Young
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced
| | - Loni Philip Tabb
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Ana Martínez-Donate
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Brent A. Langellier
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Jim P. Stimpson
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| |
Collapse
|
43
|
Reyes AM, Garcia MA. Gender and Age of Migration Differences in Mortality Among Older Mexican Americans. J Gerontol B Psychol Sci Soc Sci 2020; 75:1707-1718. [PMID: 30953078 PMCID: PMC7489075 DOI: 10.1093/geronb/gbz038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Using a gendered life course perspective, we examine whether the relationship between age of migration and mortality is moderated by gender among a cohort of older Mexican Americans. METHODS Data from the Hispanic Established Populations for the Epidemiological Study of the Elderly and recently matched mortality data are used to estimate Cox proportional hazard models. RESULTS Our findings indicate that the relationship between age of migration and mortality is moderated by gender, suggesting a more nuanced perspective of the immigrant mortality paradox. Among men, midlife migrants exhibit an 18% lower risk of mortality compared to their U.S.-born co-ethnics, possibly due to immigrant selectivity at the time of migration. Conversely, late-life migrant women exhibit a 17% lower risk of mortality relative to U.S.-born women, attributed in part to socio-cultural characteristics that influence lifestyle risk factors across the life course. DISCUSSION Selection mechanisms and acculturation processes associated with the immigrant experience are contingent on both age and gender, suggesting the utility of an integrated life course approach to contextualize the mortality profiles of older immigrants. These findings demonstrate the heterogeneity among immigrants and highlight the need to understand gender differences in the migration process when assessing the immigrant mortality paradox.
Collapse
Affiliation(s)
- Adriana M Reyes
- Cornell University, Policy Analysis and Management, Ithaca, New York
| | - Marc A Garcia
- University of Nebraska, Sociology and Institute of Ethnic Studies, Lincoln, Nebraska
| |
Collapse
|
44
|
Pinedo M, Valdez CR. Immigration Enforcement Policies and the Mental Health of US Citizens: Findings from a Comparative Analysis. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 66:119-129. [PMID: 32935882 PMCID: PMC7944641 DOI: 10.1002/ajcp.12464] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We examined the differential impact of having a family member, friend, or co-worker/community member detained or deported on the mental health of US citizens. In 2019, a sample of 3446 adult participants of White, Black, and Latinx racial/ethnic descent were recruited to complete an online questionnaire. Participants completed the Patient Health Questionnaire-4 to screen for anxiety, depression, and psychological distress. Analyses were restricted to US citizens (n = 3282). Multivariable logistic and linear regressions were conducted to examine the mental health of US citizens who reported personally knowing a migrant who has been detained or deported and by their relationship to the migrant, overall and among Latinxs only. Among US citizens, 32% reported personally knowing someone who has been detained or deported. In multivariable analyses, US citizens who personally knew a detained or deported migrant were more likely to report anxiety, depression, and greater psychological distress. Associations were more pronounced among those who reported having a family member detained or deported. US-citizen Latinxs with social ties to migrants who have been detained or deported were especially more likely to report poor mental health than White and Latinx participants who did not personally know a migrant who has been detained or deported. It is critical that policy makers consider the potential mental health harms on migrants and its own citizens when designing policies targeting migrant communities.
Collapse
Affiliation(s)
- Miguel Pinedo
- Department of Kinesiology & Health Education, College of Education, University of Texas, Austin, 2109 San Jacinto Blvd., Stop D3700, Austin, TX 78712, USA
| | - Carmen R. Valdez
- Department of Population Health, Dell Medical School, & Steve Hicks School of Social Work, University of Texas, Austin, 1701 Trinity Street, Austin, TX, USA
| |
Collapse
|
45
|
Yamanis TNJ, Morrissey T, Bochey L, Cañas N, Sol C. " Hay que seguir en la lucha": An FQHC's Community Health Action Approach to Promoting Latinx Immigrants' Individual and Community Resilience. Behav Med 2020; 46:303-316. [PMID: 32701390 DOI: 10.1080/08964289.2020.1738320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Latinx immigrants have poorer access to health care, compared to non-Latinx Whites. Federally-Qualified Health Centers (FQHCs) provide clinical and community programing to address their clients' health needs. One mechanism by which FQHC's may strengthen Latinx immigrant well-being is by promoting their individual and community resilience. We partnered with La Clínica del Pueblo (La Clínica), an FQHC serving Latinx immigrants in Washington, DC and Prince George's County, Maryland. We conducted in-depth interviews in Spanish with 30 La Clínica clients to explore the daily adversities they faced, how they coped, and how La Clínica helped them cope. We conducted thematic analysis using Dedoose software. All participants were from Central America; 37% were undocumented. Participants were 18-78 years old, 70% cis-females, 23% cis-males (10% gay men), and 7% transgender. 57% reported a serious health issue, including diabetes. Participants identified three main adversities: immigration legal status, language, and isolation/depression. Residents of Prince George's, compared to DC, as well as sexual/gender minorities, reported more barriers to accessing health care. Sources of individual resilience for participants included fighting to improve their children's lives, relying on supportive networks, and using La Clínica as a safety net to overcome health access barriers. Sources of community resilience included La Clínica's safe spaces, support groups, referrals to outside legal service providers, and health promoter training. Latinx immigrants face multiple daily adversities, but we find evidence that La Clínica's community health action approach promotes their resilience. We offer a conceptual model for how FQHCs can foster resilience and strengthen immigrant health.
Collapse
Affiliation(s)
| | | | - Lisa Bochey
- School of International Service, American University
| | - Natalia Cañas
- School of International Service, American University
| | | |
Collapse
|
46
|
Cariello AN, Perrin PB, Derlan CL, Espinoza GA, Morlett-Paredes A, Moreno OA, Trujillo MA. Moderating influence of enculturation on the relations between minority stressors and physical health via anxiety in Latinx immigrants. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2020; 26:356-366. [PMID: 31556631 PMCID: PMC8153969 DOI: 10.1037/cdp0000308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The Latinx population in the United States has grown rapidly, now standing at over 56 million people. Discrimination and acculturative stress have been found to affect the mental and physical health of Latinx immigrants, yet enculturation has been identified as an important cultural strength for this population. The purpose of this study was to examine the relations among minority stressors, anxiety, and physical health in a sample of Latinx immigrants living in the United States. A secondary aim was to examine whether the direct and indirect effects among these variables were moderated by enculturation (i.e., moderated mediation). METHOD A community sample of 202 Latinx immigrants completed questionnaires measuring these constructs. RESULTS Both acculturative stress (b = -1.68, p < .001) and discrimination (b = -1.69, p < .001) yielded direct effects on physical health, as well as indirect effects (b = -.10, 95% confidence interval [-.23, -.01]; b = -.21, 95% confidence interval [-.40, -.08], respectively) through anxiety. CONCLUSIONS Psychologists and allied health care providers are recommended to assess for the impact of minority stressors on anxiety and physical health when providing care to Latinx immigrants. Future intervention research targeting Latinx mental and physical health can consider ways to include innate cultural strengths like enculturation and partner with Latinx cultural centers, churches, and local communities to make enculturation more salient. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Annahir N. Cariello
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Chelsea L. Derlan
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - G. Antonio Espinoza
- Department of History, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Oswaldo A. Moreno
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michael A. Trujillo
- Department of Psychiatry, University of California, San Francisco, San Francisco, USA
| |
Collapse
|
47
|
Doshi M, Lopez WD, Mesa H, Bryce R, Rabinowitz E, Rion R, Fleming PJ. Barriers & facilitators to healthcare and social services among undocumented Latino(a)/Latinx immigrant clients: Perspectives from frontline service providers in Southeast Michigan. PLoS One 2020; 15:e0233839. [PMID: 32502193 PMCID: PMC7274400 DOI: 10.1371/journal.pone.0233839] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 05/13/2020] [Indexed: 12/05/2022] Open
Abstract
Immigration- and enforcement-related policies and laws have significantly and negatively impacted the health and well-being of undocumented immigrants. We examine barriers and facilitators to healthcare and social services among undocumented Latino(a)/Latinx immigrants specifically in the post 2016 US presidential election socio-political climate. By grounding our study on the perspectives of frontline providers, we explore their challenges in meeting the needs of their undocumented clients. These include client access to healthcare and social services, the barriers providers face in providing timely and effective services, and avenues to reduce or overcome factors that impede service provision to improve quality of care for this population. Data are from 28 in-depth interviews with frontline healthcare and social service providers. Based on data analysis, we found that the domains of the Three Delays Model used in obstetric care provided a good framework for organizing and framing the responses. Our findings suggest that these undocumented clients encounter three phases of delay: delay in the decision to seek care, delay in identifying and traveling to healthcare facilities, and delay in receiving adequate and appropriate care at healthcare facilities. Given the current socio-political climate for immigrants, healthcare and social services organizations that serve undocumented clients should adapt existing services or introduce new services, including those that are not site-based.
Collapse
Affiliation(s)
- Monika Doshi
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
- * E-mail:
| | - William D. Lopez
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Hannah Mesa
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Richard Bryce
- Community Health and Social Services (CHASS) Center, Detroit, MI, United States of America
| | | | - Raymond Rion
- Packard Health, Ann Arbor, MI, United States of America
| | - Paul J. Fleming
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| |
Collapse
|
48
|
Lopez MM, Holmes SM. Raids on Immigrant Communities During the Pandemic Threaten the Country's Public Health. Am J Public Health 2020; 110:958-959. [PMID: 32324421 DOI: 10.2105/ajph.2020.305704] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Miriam Magaña Lopez
- Miriam Magaña Lopez is with the Berkeley Center for Social Medicine and the Institute for Research on Labor and Employment, University of California, Berkeley. Seth M. Holmes is with the Division of Society and Environment, the Program in Medical Anthropology, the School of Public Health, and the Berkeley Center for Social Medicine, University of California, Berkeley, and University of California, San Francisco
| | - Seth M Holmes
- Miriam Magaña Lopez is with the Berkeley Center for Social Medicine and the Institute for Research on Labor and Employment, University of California, Berkeley. Seth M. Holmes is with the Division of Society and Environment, the Program in Medical Anthropology, the School of Public Health, and the Berkeley Center for Social Medicine, University of California, Berkeley, and University of California, San Francisco
| |
Collapse
|
49
|
Balakrishnan A, Jordan N. The Undocumented Elderly: Coverage Gaps and Low Health Care Use. J Health Care Poor Underserved 2020; 30:891-898. [PMID: 31422977 DOI: 10.1353/hpu.2019.0062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Near-elderly and elderly undocumented immigrants constitute a growing subpopulation in the U.S. with potentially high rates of preventable chronic conditions, but limited access to insurance coverage and low use of care. Associated impacts on health outcomes, safety-net resources, and health care costs are potentially significant. More research is needed to better understand the prevalence of avoidable conditions and the barriers to seeking care among the undocumented elderly.
Collapse
|
50
|
Abstract
Deportation has become more commonplace in the United States since the mid-2000s. Latin American noncitizens-encompassing undocumented and documented immigrants-are targeted for deportation. Deportation's threat also reaches naturalized and US-born citizens of Latino descent who are largely immune to deportation but whose loved ones or communities are deportable. Drawing on 6 y of data from the National Survey of Latinos, this article examines whether and how Latinos' deportation fears vary by citizenship and legal status and over time. Compared with Latino noncitizens, Latino US citizens report lower average deportation fears. However, a more complex story emerges when examining this divide over time: Deportation fears are high but stable among Latino noncitizens, whereas deportation fears have increased substantially among Latino US citizens. These trends reflect a growing national awareness of-rather than observable changes to-deportation policy and practice since the 2016 US presidential election. The article highlights how deportation or its consequences affects a racial group that the US immigration regime targets disproportionately.
Collapse
Affiliation(s)
- Asad L Asad
- Department of Sociology, Stanford University, Stanford, CA 94305
| |
Collapse
|