Fractured migrant families: paradoxes of hope and devastation

Psychological health outcome of Sub-Saharan African migrants in Germany

African migrants living in Europe have an increased risk of adverse psychological health outcomes compared to people without a migration background. The increased vulnerability may be due to their migration experience and possible challenges in adapting and integrating into the host community. This study explores the association between community solidarity and psychological health outcome among Sub-Saharan African (SSA) migrants in Germany.<br /> The study used data from 518 SSA migrants in Germany collected in a cross-sectional survey across the 16 German federal states. A correlation matrix was computed to evaluate the bivariate relationship between psychological health, community solidarity, and socioeconomic, and demographic features. Furthermore, regression models were calculated to predict the effect of community solidarity on psychological health outcomes and the added predictive effects of socioeconomic and demographic characteristics.<br /> Community solidarity shows a moderately significant positive association with psychological health (r=.41; p≤.01). A linear regression model suggests that community solidarity, education and age explained 19% of the variance in psychological health scores for SSA migrants in Germany.<br /> These results confirm community solidarity as a significant but multi-layered determinant of various factors that affect migrants’ psychological wellbeing. It supports implementing policies that promote community solidarity to facilitate SSA migrants’ wellbeing.

Examining the Independent Association Between Acculturative Stress and Psychological Distress Among Mexican Immigrants in New York City: An Exploratory Study

Objective

This study examines the association between acculturative stress and psychological distress among Mexican immigrants living in New York City. It takes account factors such as language barriers, legal status, fear of deportation, and avoidance of social health and human services, and how these factors are implicated in the mental health status of the study population.

Design

Study draws from a community-based sample of Mexican American adults from the Social Network of Mexican Americans study recruited from a church-based community center in the Bronx, New York. Eighty Mexican immigrants were included in this analysis. Descriptive statistics were used to display participants' characteristics. Pearson correlation and multiple regressions were run to determine the relationship between acculturative stress and psychological distress, and also with each of the items from the acculturative stress scale. Both scales have been validated among Spanish-speaking Latino immigrants.

Results

A significant moderate positive relationship was found between acculturative stress and psychological distress. Within the acculturative stress scale, those items related to language discrimination, evasion of health services, and feeling guilty for leaving family/friends in home country had significant associations with increased psychological distress.

Conclusion

The findings support the need for interventions that account for the major stressors associated with being a Mexican immigrant in the United States to prevent psychological distress, especially given the anti-immigration policies.

Latinx adolescent migrant challenges in reuniting with family members

Family reunification occurs when migrants relocate without intact family units, and later reunite in new countries. Family serial migration and reunification is a global issue, relating to both voluntary and involuntary migrants who seek physical safety, psychological well-being, and economic self-sufficiency in new countries. Early studies alluded to a joyful family reconsolidation, while recent studies have found stressful reunions. This study provides an overview of the family reunification process of Latinx adolescents who have migrated to join their families in the United States (U.S.). The study conducted detailed interviews of 20 Latinx adolescents, aged 12-18 years old, in order to provide an in-depth examination of their pre and postmigration experiences. The results reveal three phases of family reunification: Latinx adolescents' experiences after their parent(s) left to migrate to the U.S.; their own migration journey to the U.S.; and their family reunification, adaptation, and adjustment to the U.S. The findings suggest that it is essential for mental health professionals to understand and acknowledge the multiple psychosocial challenges of Latinx adolescents' reuniting with their families in a new country. This includes feelings of abandonment and grief after their parent(s) departure to the U.S., their own migration journey to the U.S. which may have been experienced as traumatic, and psychosocial challenges in adjustment and adaptation in the U.S. after family reunification.

Through our own eyes and voices: The experiences of those "left-behind" in rural, indigenous migrant-sending communities in western Guatemala

Migration from Central America to the United States has become a strategy to escape economic poverty, exclusionary state policies and violence for people of Mayan descent. Under the principles Community Based Participatory Research, we explored the health concerns of Indigenous Mayans in rural migrant-sending communities of Guatemala using their own visual images and narratives through a Social Constructivist lens. Half of households in the study region have at least one member emigrated to the United States, making many "transnational families." Focus groups and photographs and narratives from 20 Photovoice participants, aged 16-65, revealed significant health challenges related to conditions of poverty. Drivers of immigration to the United States included lack of access to healthcare, lack of economic opportunity, and an inability to pay for children's education. Health implications of living in communities "left-behind" to immigration centered around changes in societal structure and values. Mental health challenges, sadness and loss were experienced by both children and adults left behind. An increase in substance use as a coping mechanism is described as increasingly common, and parental absence leaves aging grandparents raising children with less guidance and supervision. Lack of economic opportunity and parental supervision has left young adults vulnerable to the influence of cartel gangs that are well-established in this region. Findings from this study provide insight into challenges driving immigration, and the health impacts faced by rural, Indigenous communities left behind to international immigration. Results may inform research and interventions addressing disparities and strategies to cope with economic and health challenges.

Transnational migration and Mexican women who remain behind: An intersectional approach

OBJECTIVE

To explore the scope, range, and nature of the existing literature on Mexican women who remain behind in their communities of origin while their partners migrate abroad.

DESIGN

A scoping review informed by an intersectionality framework was conducted over four months, January-April 2020.

DATA SOURCES

The electronic databases Medline, PsyINFO, Global Health, CINAHL, Gender Studies Database, Dissertations & Theses Global, LILACS, IBECS, and Sociological Abstracts were searched.

REVIEW METHODS

Articles were included if they focused on Mexican women who remain behind across transnational spaces. Two independent reviewers screened and selected articles. Data were analyzed and synthesized using descriptive statistics for quantitative data and content analysis for qualitative data.

RESULTS

A total of 19 articles were included for analysis; within those, the methods used included quantitative (n = 5), qualitative (n = 11), mixed methods (n = 2), and intervention (n = 1). Most studies lacked a theoretical framework (n = 10); the majority were empirical published studies (n = 11), and most used interviews (n = 12) and surveys (n = 6) to collect data. All of the articles studied cis-heterosexual Mexican women. Major areas identified were 1) research context, 2) gender roles, and 3) women's health.

CONCLUSION

Implications for practice and future research are discussed.

Testing of the factor structure of the Center for Epidemiologic Studies Depression Scale 10 in a sample of Korean "geese" mothers

The author's purpose in this study was to establish the factor structure of the Korean version of the Center for Epidemiologic Studies Depression Scale 10 (CES-D 10) by conducting confirmatory factor analysis based on preexisting models with a sample of Korean transnational mothers (referred to as "geese mothers"). Hundred and fifty-three Korean geese mothers in the USA and New Zealand completed the Korean version of the CES-D 10 questionnaire. The resulting data was subjected to confirmatory factor analysis, which tested three competing models. Our goodness-of-fit indices for the two-factor model indicated an acceptable fit with the current sample. Our results in the present study show that the CES-D 10 can be a useful tool for understanding the concept of depression in Korean geese mothers.

Elevated Depressive Symptoms Among Hired Crop Workers in the United States: Variation by Sociodemographic and Employment Characteristics

We present prevalence rates, along with demographic and economic characteristics associated with elevated depressive symptoms (EDS), in a nationally representative sample of hired crop workers in the United States. We analyzed in-person interviews with 3,691 crop workers collected in 2009-2010 as part of a mental health and psychosocial supplement to the National Agricultural Workers Survey. The prevalence of EDS was 8.3% in men and 17.1% in women. For men, multivariate analysis showed that EDS was associated with years of education, family composition, having a great deal of difficulty being separated from family, having fair or poor general health, ability to read English, fear of being fired from their current farm job, and method of payment (piece, salary, or a combination). Interactions were found between region of the country and family composition. Multivariate analyses for women showed that fear of being fired, fair or poor general health, having children ≤15 years of age, being unaccompanied by their nuclear family, expectation for length of time continuing to do farm work in the United States, and authorization status were associated with EDS. Interactions were found with Hispanic ethnicity and region of the country, as well as presence of the nuclear family and region. The present study identifies important risk factors in this first population-based assessment of EDS in a nationally representative sample of U.S. crop workers. The importance of social support from family, job insecurity, and high prevalence of EDS in female crop workers support the need for screening and outreach in this primarily rural group of men and women crop workers.

Cultural perceptions and negotiations surrounding sexual and reproductive health among migrant and non-migrant indigenous Mexican women from Yucatán, Mexico

Information regarding sexual and reproductive health of indigenous women from Mexican sending and US receiving communities is limited. This research aims to explore the perceptions of indigenous women from US migrant receiving and Mexican migrant sending communities regarding their sexual health experiences and reproductive health practices. From January to March 2012, two key informant interviews and 31 in-depth, semi-structured interviews were conducted among women ages 18-55 in Tunkás, Yucatán and Anaheim and Inglewood, California. Women reported challenges to obtaining routine reproductive clinical care, including access to care barriers and lack of perceived power over their own sexual health. This was further compounded by migration processes and deficiencies in health care delivery systems. Socio-cultural beliefs and gendered power dynamics influence sexual and reproductive health decisions and behaviors of migrant and non-migrant women. Findings underscore existing gender-based reproductive health norms and serve to inform future transnational research and public health education to improve the health of indigenous migrant and non-migrant women in the US and Mexico.

Immigration as a Social Determinant of Health

Although immigration and immigrant populations have become increasingly important foci in public health research and practice, a social determinants of health approach has seldom been applied in this area. Global patterns of morbidity and mortality follow inequities rooted in societal, political, and economic conditions produced and reproduced by social structures, policies, and institutions. The lack of dialogue between these two profoundly related phenomena—social determinants of health and immigration—has resulted in missed opportunities for public health research, practice, and policy work. In this article, we discuss primary frameworks used in recent public health literature on the health of immigrant populations, note gaps in this literature, and argue for a broader examination of immigration as both socially determined and a social determinant of health. We discuss priorities for future research and policy to understand more fully and respond appropriately to the health of the populations affected by this global phenomenon.

Immigration as a social determinant of health

Although immigration and immigrant populations have become increasingly important foci in public health research and practice, a social determinants of health approach has seldom been applied in this area. Global patterns of morbidity and mortality follow inequities rooted in societal, political, and economic conditions produced and reproduced by social structures, policies, and institutions. The lack of dialogue between these two profoundly related phenomena-social determinants of health and immigration-has resulted in missed opportunities for public health research, practice, and policy work. In this article, we discuss primary frameworks used in recent public health literature on the health of immigrant populations, note gaps in this literature, and argue for a broader examination of immigration as both socially determined and a social determinant of health. We discuss priorities for future research and policy to understand more fully and respond appropriately to the health of the populations affected by this global phenomenon.

Borders, centers, and margins: critical landscapes for migrant health

Nurses in North America have a distinguished history of involvement in immigrant health due to the immigrant character of this region. The Western Hemisphere is a region composed of recent migrants from nearly every corner of the globe. Complicated economic, environmental, and social dynamics contribute to these various migration patterns and commensurate health-related issues-physical, psychological, and spiritual. Nurses attuned to health issues of newer immigrants' lives use newfound knowledge to shape the care they provide, and political advocacy. This article updates our understandings of migration, utilizing critical perspectives to analyze contemporary dynamics of migration and respective health issues.

Psychological and Family Well-Being of Unaccompanied Mexican Child Migrants Sent Back From the U.S. Border Region of Sonora-Arizona

This study explores the psychological and family well-being of Mexican undocumented and unaccompanied children sent back through the U.S. border region of Sonora-Arizona. Procedures included exploring children’s own accounts using semi-structured interviews with 13 minors (9-17 years old) conducted at border shelters within Mexico. Based on previous qualitative findings, psychological measurement scales were administered to 53 participant children and adolescents during the second phase. There were statistically significant correlations between number of crossing attempts and resilience, as well as between number of days in the shelter and depression. The findings suggest that children possess psychological resources to face distress and negative affect caused by family separation, unaccompanied travel, and crossing experiences. These findings contribute to informing future public health policy and programs directed at the increasing population of unaccompanied minor migrants.

Separation and reunification: the experiences of adolescents living in transnational families

There are increasing numbers of mothers as well as fathers who engage in long-term migration to support their children and other family members in their home countries. In this article, the current state of the literature about children and adolescents left at home in these transnational families is surveyed and reviewed. The article reviews the effects on children of the process of separation from parents, the impact of gifts and remittances home, communication with distant parents and the quality of life with their substitute caregivers. The effects of immigration in late childhood or adolescence on these separated children are examined, as well as what is known about the processes of adaptation and family reunification, including migration traumas, impact of gender, and educational outcomes. Suggestions are given for pediatric clinicians working with reunifying families. Gaps in the literature are highlighted and the need for research into factors that promote successful family re-engagement and overall adaptation upon reunification.

Those easily forgotten: the impact of emigration on those left behind

Much has been written about the experiences and stresses of those who emigrate. By contrast, little attention has been paid to the experiences of those who stay behind-family members and friends who for various reasons do not to join their loved ones in the destination country. In this article, I describe the experiences of some South Africans whose families and friends have emigrated. This study forms part of a larger research project focusing on the impact of emigration on South African family life. Twenty-one participants were interviewed by means of a semistructured interview at least 6 months after one or more family member(s) and/or friend(s) left South Africa, to explore participants' experiences around their loved ones' emigration. A thematic analysis of the data reveals that those left behind experience various emotions, ranging from emotional ambivalence to anger and distress. Emigration is mostly experienced as a vast loss, almost akin to a "death," bringing about significant changes in social networks and relationships. The therapeutic significance of the findings for those working with emigrant families is also explored.

Assessing the Role of Culture in Korean Goose Mothers’ Lives

Korean women who migrate to a foreign country with their children for the latter’s education while their husbands stay in Korea as breadwinners are referred to as “goose mothers.” The cultural beliefs that have contributed to the formation of this family form and the experiences of these women need to be explored within their cultural context. To understand this population, Confucianism as a cultural background and its influence on goose mothers’ value systems, family systems, and view of self were explored. Based on the learning, their potential health issues are described and implications for culturally competent care are suggested.

Using Qualitative Methods for Revising Items in the Hispanic Stress Inventory

Despite progress in the development of measures to assess psychosocial stress experiences in the general population, a lack of culturally informed assessment instruments exist to enable clinicians and researchers to detect and accurately diagnosis mental health concerns among Hispanics. The Hispanic Stress Inventory (HSI) was developed specifically for Hispanic adults, however, significant social and geopolitical changes over the past two decades have affected the types and intensity of stress experienced by Hispanics. Immigration related policy changes, for example, affect stress experiences among newer immigrants from Mexico and other Latin American countries in ways that items in the original HSI may no longer capture the full range of today’s stressors. Using expert interviews from Hispanic mental health experts and data gathered in 16 community-based focus groups at two distinct study sites, the goal of the current study was to identify new item content to include in a revised HSI. Using content analysis of all interview data, a total of 155 new stressor items and seven unique stress domains were generated. Content validity analysis using Kappa coefficient reveal high interrater validity for new HSI item content. Findings are described in depth, and recommendations for future research are identified.

Transnational mothers crossing the border and bringing their health care needs

PURPOSE

The purpose of this study was to explore the experiences of transnational Latina mothers who immigrated to the United States without legal documentation or their children.

DESIGN

The study used a qualitative approach to collect data from eight transnational Latina mothers from South Florida during the summer of 2009.

METHODS

Data were collected using open-ended questions in one-on-one, in-depth interviews that lasted 1 to 2 hr.

FINDINGS

A hermeneutic phenomenological analysis of the data yielded seven essential themes from the participants' stories: living in extreme poverty, having hope, choosing to walk away from poverty, suffering through the trip to and across the border, mothering from afar, valuing family, and changing personally.

CONCLUSIONS

The results indicate that transnational Latina mothers find meaning in mothering from afar through embodied sacrifice, suffering, hoping for a better life for their children, and family reunification. These results have implications for healthcare providers, social workers, policy makers, and educators whose professional responsibility is to advocate for, and to enhance the health and social well-being of, transnational mothers.

CLINICAL RELEVANCE

Although this study focused on transnational Latina mothers in the United States, transnational motherhood is a worldwide phenomenon. Healthcare professionals play an instrumental role in providing culturally specific and evidence-based care to women who migrate without their children.

International migration of partner, autonomy and depressive symptoms among women from a mexican rural area

BACKGROUND

The emigration of Mexicans to the USA has increased in the last decades, and little is known about the effect of this on the mental health of those who stay behind.

AIMS

To evaluate the association of emigration of husband and depressive symptoms (DS) among women who stay in Mexico. We also tested the hypothesis that the husband's migration would increase the woman's autonomy, which in turn would decrease DS.

METHODS

A survey was conducted in a rural area in Mexico. Participants (n = 418) were selected through probabilistic sampling in three stages: localities, households and individuals. DS were evaluated using the Centre for Epidemiological Studies-Depression (CES-D) scale.

RESULTS

Having a partner in the USA was associated with higher odds of scoring above the cut-off point in CES-D (OR 3.77, 95% CI 1.92-7.43). Economic autonomy was also associated with DS (OR 1.45, 95% CI 1.04-2.02).

CONCLUSION

Migration of husband was associated with DS among women. The construct of autonomy and its operational definition should be further explored.

Bio-power, Agamben, and emerging nursing knowledge

This philosophical article posits that an emerging theme in contemporary nursing epistemology is bio-power and proposes the use of philosopher Giorgio Agamben's perspectives as a useful approach for the future investigation of bio-power in nursing knowledge. Building upon Meleis' characterization of diversity as the most recent "milestone" of contemporary theoretical development of the nursing discipline, selected recent texts from the nursing literature are analyzed, and implications for future nursing knowledge in the context of Agamben's work are explored.