Relationships Between Integration and Drug Use Among Deported Migrants in Tijuana, Mexico

Cumulative Experiences of Immigration Enforcement Policy and the Physical and Mental Health Outcomes of Asian and Latinx Immigrants in the United States

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.

The structural impacts of enforcement policy on Latino immigrant health

As evidence of the negative health impact of immigration enforcement policy continues to mount, public health research has focused primarily on the psychosocial health mechanisms, such as fear and stress, by which immigration enforcement may harm health. We build on this research using structural vulnerability theory to investigate the structural processes by which enforcement policy may shape Latino immigrants' health. We conducted qualitative analysis of testimonios from a purposive sample of Latino immigrants (n=14) living in Southern California in 2015, a period of significant federal, state, and local enforcement policy change. Testimonios are a narrative methodology used across the social sciences and humanities to center the voices of marginalized people. Through unstructured testimonio interviews, we sought to understand Latino immigrants' experiences with immigration enforcement and identify specific structural factors by which those experiences may influence health. Respondents' narratives revealed that singular enforcement experiences were not viewed as the sole manifestation of enforcement, but as part of a system of intersecting physical, legal, institutional, and economic exclusions which shaped the social and economic conditions that influence health. These exclusions reinforced respondents' marginalization, produced instability about the future, and generated a sense of individual responsibility and blame. We discuss how physical, legal, institutional, and economic processes may influence health and propose a framework to inform population health research on intersecting structural health mechanisms.

Tattoo discrimination in Mexico motivates interest in tattoo removal among structurally vulnerable adults

Tattoos are less prevalent in Mexico and tattooed persons are frequently stigmatized. We examine the prevalence and correlates of interest in receiving tattoo removal services among 278 tattooed Mexican adults living in Tijuana, Mexico who responded to interviewer-administered surveys, including open-ended questions. Overall, 69% of participants were interested in receiving free tattoo removal services, 31% reported facing employment barriers due to their tattoos, and 43% of respondents regretted or disliked some of their tattoos. Having a voter identification card, reporting moderate/severe depression symptoms and believing that tattoo removal would remove employment barriers were independently associated with interest in tattoo removal. Our findings suggest that there is substantial interest in tattoo removal services. Publicly financed tattoo removal services may help disadvantaged persons gain access to Mexico's labor market and it may positively impact other life domains such as mental well-being and interactions with law enforcement.

Interrupted transit and common mental disorders among migrants in Tijuana, Mexico

BACKGROUND

Policies of migration contention can interrupt the transit of people on the move, forcing them to remain in wait in non-destination countries. This liminal condition might impact negatively on migrants' mental health.

AIMS

To assess the relationship between interrupted transit and common mental disorders (CMD; symptoms of depression or anxiety), among migrants in shelters in Tijuana, Mexico.

METHODS

Cross-sectional survey conducted in November to December 2020 and February to April 2021. We assessed depressive symptoms with the Centers for Epidemiological Studies Depression scale (CES-D-7), and symptoms of anxiety with the Generalized Anxiety Disorder scale (GAD-2). We evaluated the association of being in interrupted transit (sent back from the United States to Mexico), as compared to having not crossed to the United States yet or planning to stay in Mexico, with having a CMD (either depressive or anxiety symptoms), as well as the association of other migration-related variables with CMD.

RESULTS

Being in interrupted transit (OR = 1.74, 95% CI [1.12, 2.71]), and having experienced violence during transit (OR = 2.50, 95% CI [1.63, 3.82]) were associated with CMD.

CONCLUSIONS

Interrupted transit is a potential risk factor for mental health problems among migrants. Migration and public health policies should consider the mental health consequences of interrupted transit, and promote initiatives to address the mental health needs of migrants on the move.

Tattoo Removal as a Resettlement Service to Reduce Incarceration Among Mexican Migrants

In Mexico, tattooed migrants face discrimination and are at high-risk of incarceration, thus, we assessed whether receiving laser tattoo removal affected the likelihood of incarceration. In 2015-2016, 89 adults ages ≥ 18 years with visible tattoos were recruited at a free-clinic to receive laser tattoo removal or assigned to the wait-list; all completed baseline and 6-month questionnaires. Overall, 97.8% of participants ever migrated to the USA. In multivariate analyses restricted to migrants (n = 87), those receiving laser tattoo removal [Adjusted Odds Ratio (AOR) 0.27, 95% CI 0.07-0.89] and possessing a Mexican Voting card (AOR 0.14; 95% CI 0.03-0.58) were significantly less likely than wait-list participants to be incarcerated at 6-months. Previously incarcerated participants were significantly more likely to be incarcerated at follow-up. Tattoo removal may reduce incarceration among Mexican migrants. Future studies can assess other health and social benefits of tattoo removal for migrants/deportees returning to Mexico.

Deported Men's and Father's Perspective: The Impacts of Family Separation on Children and Families in the U.S

Background: Family separation due to the deportation of a migrant is pervasive, yet less is known about its potential impacts on the social, economic and mental well-being of families remaining in the United States. Methods: We conducted a mixed-methods study. In 2013, 303 Mexican male nationals completed an interviewer-administered questionnaire at a free clinic in Tijuana, Mexico. For this analysis, participants were: (1) ≥18 years; (2) seeking services; (3) Spanish or English speakers and (4) reported a U.S. deportation. Participants answered migration history items and open-ended questions regarding the impact of their deportation on U.S.-based family members. We present descriptive statistics and illustrative quotes for themes identified in the qualitative text data. Using a grounded-theory approach, we considered all data to develop a conceptual framework that others may use to study the consequences of family separation due to deportation. Results: Nearly two-thirds of participants reported living in the U.S. for 11+ years, a similar proportion reported 2+ deportations, and 31% reported being banned from re-entering the U.S. for 11+ years. More than one-half of participants were separated from their nuclear families (spouse/partner and/or children). Deportees who were separated from any family members reported that their families lost income for basic needs (rent/utilities: 50%, food: 44%, clothing: 39%, daycare: 16%, health insurance: 15%); school participation was also negatively impacted (31%). Qualitative data revealed that children ≤18 years remaining in the U.S. experienced mental health symptoms post-parental deportation (i.e., persistent crying, depression, sadness, anger, resentment). Deported fathers consistently expressed frustration at being unable to provide love, care, support, mentorship for their children. Based on our mixed-methods approach, we propose a framework to systematically study the consequences of family separation due to the deportation of fathers. Conclusion: Findings are consistent with the extant research. Binational interventions to support families that experience forced-separation are needed to mitigate short and long-term adverse mental health outcomes, especially among youth in the U.S., and other unfavorable family and household-level outcomes. Funding to understand the implications of maternal deportation and for longitudinal qualitative and quantitative research on migrant-focused interventions and related outcomes is needed.

The impact of deportation policies on the substance using behaviors of US-citizen Latinos

BACKGROUND

Scant data has found that the deportation of a migrant family member has adverse health consequences for their US-citizen family members. However, no study has investigated how the detention or deportations of others (e.g., family, friends) relate to the alcohol and drug-using behaviors of US-citizen Latinos.

METHODS

From April to May 2019, 3,446 adult participants of White, Black, and Latino racial/ethnic descent were recruited to complete a self-administered, structured, online questionnaire. Analyses were restricted to US-citizens only (n = 3,282). Using the Alcohol Use Disorders Identification Test-Concise and the Substance Use Brief Screen scale, the two dependent outcome variables were hazardous drinking and symptoms of a drug use disorder (DUD). Three separate multivariable logistic regression models were conducted to explore how Latinos who personally knew a detained or deported migrant, and their relationship to the detainee/deportee (e.g., family, friend), related to each outcome, relative to other racial/ethnic groups.

RESULTS

Overall 39% of Latinos reported personally knowing a detained or deported migrant. In multivariable analyses, Latinos who knew a detained or deported migrant had significantly higher odds of reporting hazardous drinking and DUD symptoms relative to Whites. Latinos who had a family member detained or deported had 3.91 times the odds of reporting symptoms of DUD, respectively, than Whites. Latinos who had a friend detained or deported had also greater odds of reporting hazardous drinking and DUD symptoms than Whites. Importantly, Latinos who did not personally know a detainee or deportee were not any more likely than Whites to report hazardous drinking and DUD symptoms.

CONCLUSION

Findings underscore that detentions and deportations may be influencing the substance using behaviors of US-citizen Latinos and may potentially exacerbate or perpetuate substance abuse-related disparities. Public health and policy implications are discussed.

Deportation of non-citizen military veterans: A critical analysis of implications for the right to health

Military personnel are commonly exposed to health-harming conditions during their service, resulting in higher rates of physical and mental health conditions compared with the general population. In an era of mass deportations, it is notable that non-citizen military veterans are not exempt from deportation. We utilised a human rights framework to conduct a critical analysis of potential health consequences of deportation for U.S. military veterans, identifying three ways in which veterans' rights to health may be constrained through deportation. First, honourably discharged deported veterans may be denied access to free or subsidised Veterans Affairs health services to which they would likely otherwise be entitled. Second, availability of and access to healthcare may be limited for reasons including barriers to enrolling in public insurance schemes, challenges navigating unfamiliar health systems and stigma and discrimination towards deported migrants. Finally, quality of available care may be sub-optimal due to limited expertise in service-related health issues and lack of evidence-based treatment for some health conditions (e.g. substance abuse/dependence). Binational multi-sectoral efforts are necessary to ensure that the rights to health of deported military veterans are adequately protected.

Injection Drug Use Trajectories among Migrant Populations: A Narrative Review

BACKGROUND

Dual epidemics of injection drug use and blood-borne disease, characterized as "syndemics," are present in a range of settings. Behaviors that drive such syndemics are particularly prevalent among mobile drug-using populations, for whom cross-border migration may pose additional risks.

OBJECTIVES

This narrative review aims to characterize the risk factors for injection drug use initiation associated with migration, employing a risk environment framework and focusing on the San Diego-Tijuana border region as the most dynamic example of these phenomena.

METHODS

Based on previous literature, we divide migration streams into three classes: intra-urban, internal, and international. We synthesized existing literature on migration and drug use to characterize how mobility and migration drive the initiation of injection drug use, as well as the transmission of hepatitis and HIV, and to delineate how these might be addressed through public health intervention.

RESULTS

Population mixing between migrants and receiving communities and the consequent transmission of social norms about injection drug use create risk environments for injection drug use initiation. These risk environments have been characterized as a result of local policy environments, injection drug use norms in receiving communities, migration-related stressors, social dislocation, and infringement on the rights of undocumented migrants.

CONCLUSION

Policies that exacerbate risk environments for migrants may inadvertently contribute to the expansion of epidemics of injection-driven blood-borne disease. Successful interventions that address emerging syndemics in border regions may therefore need to be tailored to migrant populations and distinguish between the vulnerabilities experienced by different migration classes and border settings.

Cross-border migration and initiation of others into drug injecting in Tijuana, Mexico

INTRODUCTION AND AIMS

Efforts to prevent injection drug use (IDU) are increasingly focusing on the role that people who inject drugs (PWID) play in facilitating the entry of others into this behaviour. This is particularly relevant in settings experiencing high levels of IDU, such as Mexico's northern border region, where cross-border migration, particularly through forced deportation, has been found to increase a range of health and social harms related to injecting.

DESIGN AND METHODS

PWID enrolled in a prospective cohort study in Tijuana, Mexico, since 2011 were interviewed semi-annually, which solicited responses on their experiences initiating others into injecting. Univariate and multivariable logistic regression analyses were conducted at the Preventing Injection by Modifying Existing Responses (PRIMER) baseline, with the dependent variable defined as reporting ever initiating others into injection. The primary independent variable was lifetime deportation from the USA to Mexico.

RESULTS

Among 532 participants, 14% (n = 76) reported initiating others into injecting, the majority of participants reporting initiating acquaintances (74%, n = 56). In multivariable analyses, initiating others into injecting was independently associated with reporting living in the USA for 1-5 years [adjusted odds ratio (AOR) = 2.42; 95% confidence interval (CI) 1.22-4.79, P = 0.01], and methamphetamine and heroin injection combined (AOR = 3.67; 95% CI 1.11-12.17, P = 0.03). Deportation was not independently associated with initiating others into injecting.

DISCUSSION AND CONCLUSIONS

The impact of migration needs to be considered within binational programming seeking to prevent the expansion of epidemics of injecting and HIV transmission among mobile populations residing in the Mexico-USA border region.