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

Self-rated health of Latino day laborers during the COVID-19 pandemic: a cross-sectional study

Background

This study assesses the relationship between trust in sources of information in regard to the Coronavirus Disease 2019 (COVID-19) pandemic and self-rated health (SRH) in a sample of Latino Day Laborers (LDLs) and explores whether these associations were mediated by mental health measures.

Methods

A rapid needs assessment survey was conducted with 300 LDLs, recruited at randomly selected hiring locations in Houston, Texas, during November and December 2021. Two measures of trust were developed, and SRH was measured by a single item. Depression, anxiety, and stress were measured by previously validated scales. We applied the product of coefficients approach to assess our mediation model. Using Hayes' PROCESS version 4.2 in SPSS, linear regression models were generated simultaneously to assess the total effect of trust on SRH, effect of trust on the mental health mediator, and effect of the mediator on SRH, controlling for trust. Demographic characteristics were entered as covariates.

Results

Greater trust in formal sources of information (such as Spanish-speaking television networks) as well as greater levels of anxiety and depression were associated with lower SRH. There were no significant associations between formal trust and mental health measures. As such, the association between formal trust and decreased SRH was not mediated by mental health. Trust in informal sources of information (conversations with friends, family, and coworkers) was not significantly associated with SRH or mental health. Higher levels of depression and anxiety, however, were associated with lower SRH.

Conclusions

LDLs' perception of their health was inversely associated with their level of trust in formal sources of information and with greater levels of depression and anxiety. Nevertheless, these pathways were independent of each other. The results indicate the direct impact of COVID-19 public information on subjective well-being, a relationship that merits further exploration.

A brief but comprehensive three-item social connectedness screener for use in social risk assessment tools

BACKGROUND

The 2014 IOM report "Capturing Social and Behavioral Domains and Measures in Electronic Health Records" described three subdomains of social relationships that affect patient health and well-being. However, most social risk screeners currently assess only one subdomain, frequency of social connections. We are proposing a three-item Brief Social Connectedness (SC) screener that additionally assesses risks in social/emotional support and loneliness/social isolation subdomains.

METHODS

For this cross-sectional study, we used data from a 2021 Kaiser Permanente Northern California (KPNC) social risk survey for 2244 members ages 35-85 years. The survey included three validated questions that covered the SC subdomains (frequencies of social contacts with people they care about, feeling lonely/socially isolated, and getting enough social/emotional support). Variables representing moderate/high versus low risk were created for each subdomain. We used weighted data for bivariate analyses and modified log-Poisson regression models that adjusted for age, sex, race, and ethnicity to examine cross-sectional associations among the three subdomain risks, as well as with two structural SC risks, living alone and not being in a committed relationship. We then used modified log-Poisson regression models to study cross-sectional associations of these five SC variables with three single-item self-report measures of emotional health.

RESULTS

In regression models that included all five SC variables, loneliness/social isolation and social/emotional support risks were significantly associated with all three emotional health measures, while frequency of social contacts, living alone, and no committed relationship were not. However, low frequency of social contacts and no committed relationship significantly increased risk of often feeling lonely/socially isolated and lacking in social/emotional support.

CONCLUSIONS

A three-item social connectedness screener that assessed risks of loneliness/social isolation, inadequate social/emotional support, and low frequency of social contacts provided more comprehensive information about emotional health risks than social connection frequency alone.

The relationship between political efficacy and self-rated health: An analysis of Mexican, Puerto Rican, and Cuban subgroups compared to non-Latinx whites in the United States

Latinx represent a growing population in the United States (US) that continue to experience a disproportionate burden of disease. However, health disparities vary across Latinx subgroups, including Mexican, Puerto Rican, and Cuban communities, particularly when assessing self-rated health. Given the nature of political exclusion in the US, these differences may be associated with underexplored political factors, or political determinants of health, within the social environment that distinctly shape health among racial and ethnic minorities. To explore potential pathways that connect the political environment to individual-level health outcomes among Latinx subgroups, political efficacy (or one's perceptions about one's power to influence political affairs) was assessed as a correlate of self-rated health. We used secondary data from the 2016 Collaborative Multiracial Post-election Survey to conduct ordered logistic regression analysis to determine whether two domains of political efficacy, internal and external political efficacy, were correlates of self-rated health among Mexican, Puerto Rican, and Cuban subgroups as compared to non-Latinx whites in the US. We also tested for differential associations across Latinx subgroups as compared to non-Latinx whites. The sample consisted of 3156 respondents (1486 Mexicans, 484 Puerto Ricans, 159 Cubans and 1027 non-Latinx whites). Among Puerto Ricans, results revealed that lower levels of internal political efficacy were associated with higher levels of self-rated health. Conversely, among other subgroups, positive associations between internal political efficacy and self-rated health were observed. This study provides empirical evidence of a relationship between internal political perceptions and health perceptions that has not previously been established within the Latinx health disparities literature. Future investigations should continue to examine pathways that connect political determinants to individual-level health outcomes, particularly among communities that disproportionately experience political exclusion.

Improving the sense of city belonging among migrant elderly following family from an elderly service perspective: a cross-sectional study

Background

The migrant elderly following family (MEFF), who migrates to new community to reunite with families, may face challenges of city integration and belonging. This study aims to explore from an elderly service perspective how to improve the sense of city belonging for MEFFs with and without hypertension/diabetes conditions.

Methods

Data were derived from the 2017 China Migrants Dynamic Survey and China National Statistical Yearbooks in 2017. The study included 882 MEFFs with hypertension or diabetes and 1266 MEFFs without hypertension and diabetes. Hierarchical linear modeling was applied to analyze the effects of individual and provincial elderly services on sense of city belonging among the MEFF with and without hypertension/diabetes.

Results

The MEFFs with hypertension or diabetes exhibited a greater sense of city belonging when they were familiar with a wider range of health education topics (γ = 0.05, p = 0.033) and were in those provinces with a greater number of licensed doctors (γ = 0.39, p < 0.001) and hospitals (p = 0.042). For those MEFFs without hypertension or diabetes, social security cards (γ = 0.57, p < 0.001) and awareness of a wider range of health education topics (γ = 0.07, p = 0.018) may help to improve their sense of city belonging.

Conclusion

This study calls for strengthening the accessibility in inclusive elderly services, and minimizing or even eliminating the inequality in elderly services at the individual and provincial levels to increase sense of city belonging among the MEFFs. For the MEFFs with hypertension or diabetes, health managers should focus on improving health information dissemination and increasing the number of doctors per 1000 people as well as and the number of hospitals to enhance the sense of city belonging. Moreover, the government should strengthen social security and health education to facilitate the adaptation and integration of MEFFs without hypertension and diabetes into the host city.

Heterogeneous Impact of Social Integration on the Health of Rural-to-Urban Migrants in China

BACKGROUND

While several studies have found that lower levels of social integration may lead to a deterioration in the health status of migrants, previous research on the nexus between social integration and health has generally ignored the potential endogeneity of social integration. This paper examines the heterogeneous impact of social integration on the health of rural-to-urban migrants in China by exploiting plausibly exogenous, long-term, geographic variation in dialectal diversity.

METHODS

Drawing on nationally representative data from the 2017 China Migrants Dynamic Survey (n = 117,446), we first regressed self-reported health on social integration using ordinary least squares estimation and then used an ordered probit model as a robustness check. Additionally, to rule out the potential endogeneity of social integration, we relied mainly on an instrumental variable approach and used dialectal diversity as a source of exogenous variation for social integration.

RESULTS

We found that social integration has a significant positive impact on rural-to-urban migrants' health. We also detected considerable heterogeneity in the effects of social integration across gender, generation, and wage levels: the health status of women, more recent generation migrants, and migrants with wages in the middle of wage distribution are more likely to be affected by social integration.

CONCLUSIONS

We confirmed the beneficial impact of social integration on migrants' health, which has some important policy implications. Successful migration policies should take the fundamental issue of migrants' social integration into account.

Social Integration and Health Among Young Migrants in China: Mediated by Social Mentality and Moderated by Gender

Population mobility has been one of the most basic social characteristics of China’s reform and opening up for more than 40 years. As the main labor force in Chinese cities, young migrants have made major contributions toward China’s economic miracle as the country has experienced rapid industrialization and urbanization. However, frequent mobility has caused an imbalanced social mentality in young migrants and often leads to issues with social integration, which has made this group more vulnerable with respect to their health. This study used the 2013 and 2015 Chinese General Social Survey (CGSS) data of 1,007 young migrants to investigate social mentality mediating the linkage between social integration and health among young migrants. Additionally, to probe the moderating role of gender, multi-group structural equation modeling was applied to test if the pathways in the mediation model differed between young male and female migrants in a significant way. The results suggested that after controlling for the influence of age, marital status, education, and personal annual income, social integration positively impacted the health of young migrants in a significant way; social mentality mediated the action of social integration on this group’s health; and with respect to gender difference, on the three paths of social integration affecting health, social integration affecting social mentality, and social mentality affecting health, young male migrants were more affected than young female migrants. The findings of this study could help improve gender-specific policies on the health of the floating population and offer important theoretical reference and practical suggestions for future research.

Social Integration as Mediator and Age as Moderator in Social Capital Affecting Mental Health of Internal Migrant Workers: A Multi-Group Structural Equation Modeling Approach

The rise of migrant workers has been a unique social phenomenon as China goes through industrialization, urbanization, and modernization. They are a special social group formed during the economic and social transition of the country. Migration of rural labor has pushed China on its new path toward industrialization and urbanization. Because of the urban-rural dual system of the country, however, it is difficult for migrant workers to be fully integrated into host cities, making them susceptible to negative emotions and mental health issues. Therefore, their mental health is an issue of great volume in the domains of social undertakings, people's livelihood, and public health. However, existing studies have paid limited attention to the psychological profile of migrant workers and even less to the interplays among their social capital, social integration, and mental health. Targeting China's internal migrant workers, this article tapped the interactions among their social integration, social capital, and mental health with a sample of the cross-sectional data from the China Labor Dynamics Survey (CLDS) in 2018. Multi-group structural equation modeling (SEM) was employed to test the moderating action of age by analyzing whether the mediation model differed significantly in the paths among young, middle-aged, and older migrant workers. The SEM based on bootstrapping suggested that, after controlling for the influence of gender, education, marital status, personal annual income, employer type, and self-rated health, migrant workers' social capital positively affect their mental health in a significant way, with social integration playing a mediating role. In terms of age difference, middle-aged migrant workers were more subject to the aforementioned mechanism than young ones, and young migrant workers were more affected by the mechanism than older ones. This study revealed different psycho-social interplays among social capital, social integration, and mental health across young, middle-aged, and elderly migrant workers. The findings could serve as an important theoretical reference and as practical guidance for improving policies concerning migrant workers' mental health and social benefits in the context of economic transition.

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusions

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

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

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