Hispanic health disparities and housing: Comparing measured and self-reported health metrics among housed and homeless Latin individuals

The Impact of Cultural Health Capital on Market Choice Along the Texas-Mexico Border

Transnational cultural health capital (CHC) includes individual resources such as skills and behaviors patients use to manage healthcare exclusion and negotiate care. This study examines the impact of CHC on decisions by Hispanic people who live in El Paso, Texas, to utilize one or more markets for healthcare. We expand on the current literature and present novel findings by quantifying several aspects of CHC that may contribute to cross-border health-seeking behaviors in this vulnerable group which tends to suffer various health disparities and limited access to health insurance. Results support the hypotheses related to how the various cultural, social, and economic resources that comprise CHC affect market choices. This research has significant implications for understanding how border residents may mitigate a lack of accessibility and affordability for healthcare, developing transnational health policy, and aiding healthcare providers to understand their patients' choice(s) of healthcare markets.

The Implications of Health Disparities: A COVID-19 Risk Assessment of the Hispanic Community in El Paso

Since the outbreak of the COVID-19 pandemic in the United States, Latinos have suffered from disproportionately high rates of hospitalization and death related to the virus. Health disparities based on race and ethnicity are directly associated with heightened mortality and burden of illness and act as underlying causes for the staggering impacts of COVID-19 in Latin communities in the United States. This is especially true in the city of El Paso, Texas, where over 82% of the population is Hispanic. To ascertain the level of danger that COVID-19 poses in El Paso, we constructed a point-in-time risk assessment of its Latin population and assessed a Latin individual's likelihood of hospitalization or death related to COVID-19 by comparing relevant health profiles with high-risk co-morbidities that the Centers for Disease Control (CDC) identified in 2020. Data for this risk assessment come from 1152 surveys conducted in El Paso. The assessment included comprehensive demographic, socioeconomic, and health data to analyze disparities across Hispanic sub-populations in the city. Results revealed that around 49.3% of Hispanics in the study had been previously diagnosed with a high-risk co-morbidity and therefore have an increased likelihood of hospitalization or death related to COVID-19. Additional factors that led to increased risk included low income, homelessness, lack of U.S. citizenship, and being insured. The findings from this study additionally demonstrate that structural inequality in the U.S. must be addressed, and preventive measures must be taken at local and state levels to decrease the mortality of pandemics. Baseline population health data can help with both of these goals.

Investing in Public Health Infrastructure to Address the Complexities of Homelessness

Homelessness is now recognized as a significant public health problem in North America and throughout advanced economies of the world. The causes of homelessness are complex but the lack of affordable housing, unemployment, poverty, addiction, and mental illness all contribute to the risk for homelessness. We argue that homelessness is increasingly exacerbated by system-wide infrastructure failures occurring at the municipal, state, and federal government levels and whose catastrophic impacts on population health and the response to the COVID-19 pandemic are the consequence of the decades-long devolution of government and neglect to invest in public infrastructure, including a modern public health system.

Symptoms of PTSD and Depression among Central American Immigrant Youth

The aim of this paper is to explore the mental health challenges that Central American immigrant youth face before and after arriving in the United States. This population is hard to reach, marginalized, and disproportionately exposed to trauma from a young age. This paper investigates the mental health stressors experienced by Central American immigrant youth and asylum seekers, including unaccompanied minors, surveyed in the U.S. in 2017. This mixed methods study uses qualitative data from interviews along with close-ended questions and the validated PHQ-8 Questionnaire and the Child PTSD Symptom Scale (CPSS). These new migrants face numerous challenges to mental health, increased psychopathological risk exacerbated by high levels of violence and low state-capacity in their countries of origin, restrictive immigration policies, the fear of deportation for themselves and their family members, and the pressure to integrate once in the U.S. We find that Central American youth have seen improvements in their self-reported mental health after migrating to the U.S., but remain at risk of further trauma exposure, depression, and PTSD. We find that they exhibit a disproportionate likelihood of having lived through traumatizing experiences that put them at higher risk for psychological distress and disorders that may create obstacles to integration. These can, in turn, create new stressors that exacerbate PTSD, depression, and anxiety. These conditions can be minimized through programs that aid immigrant integration and mental health.

Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study

(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox's proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 people died during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89-10.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62-5.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12-3.29), and infectious diseases (HR = 1.6; 95% CI = 1.09-2.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years). (4) Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality.