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Appelbäck M, Carlbom A, Eriksson L, Essén B. The dynamics of intercultural clinical encounters in times of pandemic crisis. Swedish healthcare providers' reflections on social norms in relation to sexual and reproductive healthcare. Midwifery 2024; 138:104129. [PMID: 39126859 DOI: 10.1016/j.midw.2024.104129] [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: 10/31/2022] [Revised: 07/17/2024] [Accepted: 07/28/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Experiences from the COVID-19 pandemic may help to better understand resilience, competences and skills for healthcare providers and the healthcare system. Within sexual and reproductive health inequalities for migrants exist and it is an area where promoting both cultural competency and healthcare equity in the clinical encounter is expected of healthcare providers yet can create tension. The aim is to explore healthcare providers experiences of encounters with migrants in the context of the pandemic and the subsequent changes in routines and norms. METHODS A qualitative study based on semi-structured interviews with 31 healthcare providers working in sexual and reproductive healthcare in southern Sweden. Interviews were conducted during the COVID-19 pandemic influencing how healthcare providers reflected on their experiences. Analysis was done using reflexive thematic data analysis. FINDINGS Healthcare providers reflected on how changes in routines increased the understanding of challenges and enablers in the intercultural encounter including the impact on communication and role of relatives and male partners. They emphasized the dynamics of culture in the clinical encounter and healthcare system through highlighting the importance of structural awareness, self-reflection and the flexibility of conducts and norms, often given a cultural connotation. CONCLUSION The COVID-19 pandemic resulted in changes of previously established routines directly affecting clinical encounters, which provided a unique opportunity for healthcare providers to reflect, with communication and self-reflection being discussed as central in complex encounters. It highlighted the dynamics of presumed deeply rooted cultural norms and the interplay with social factors affecting healthcare providers and patients alike.
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Affiliation(s)
- Mia Appelbäck
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - Aje Carlbom
- Faculty of Health and Society, Department of Social Work, Malmö University, Malmö, Sweden
| | - Lise Eriksson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Birgitta Essén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Morris AA, Masoudi FA, Abdullah AR, Banerjee A, Brewer LC, Commodore-Mensah Y, Cram P, DeSilvey SC, Hines AL, Ibrahim NE, Jackson EA, Joynt Maddox KE, Makaryus AN, Piña IL, Rodriguez-Monserrate CP, Roger VL, Thorpe FF, Williams KA. 2024 ACC/AHA Key Data Elements and Definitions for Social Determinants of Health in Cardiology: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Data Standards. J Am Coll Cardiol 2024; 84:e109-e226. [PMID: 39207317 DOI: 10.1016/j.jacc.2024.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
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3
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Anisman H, Doubad D, Asokumar A, Matheson K. Psychosocial and neurobiological aspects of the worldwide refugee crisis: From vulnerability to resilience. Neurosci Biobehav Rev 2024; 165:105859. [PMID: 39159733 DOI: 10.1016/j.neubiorev.2024.105859] [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: 02/28/2024] [Revised: 08/06/2024] [Accepted: 08/15/2024] [Indexed: 08/21/2024]
Abstract
Anisman, H., Doubad, D., Asokumar, A. & Matheson, K. Psychosocial and neurobiological aspects of the worldwide refugee crisis: From vulnerability to resilience. NEUROSCI BIOBEHAV REV, XXXX. Immigration occurs between countries either to obtain employment, for family reunification or to escape violence and other life-threatening conditions. Refugees and asylum seekers are often obligated to overcome a uniquely challenging set of circumstances prior to and during migration. Settlement following immigration may pose yet another set of stressors related to acculturation to the host country, as well as financial insecurity, discrimination, language barriers, and social isolation. Here we discuss the multiple consequences of immigration experiences, focusing on the health disturbances that frequently develop in adults and children. Aside from the psychosocial influences, immigration-related challenges may cause hormonal, inflammatory immune, and microbiota changes that favor psychological and physical illnesses. Some biological alterations are subject to modification by epigenetic changes, which have implications for intergenerational trauma transmission, as might disruptions in parenting behaviors and family dysfunction. Despite the hardships experienced, many immigrants and their families exhibit positive psychological adjustment after resettlement. We provide information to diminish the impacts associated with immigration and offer strength-based approaches that may foster resilience.
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Affiliation(s)
- H Anisman
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada.
| | - D Doubad
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
| | - A Asokumar
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
| | - K Matheson
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
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Grismer M, Duval-Couetil N, Yi S, Dukes A. Insights from a COVID-era health needs assessment of rural Midwestern Latinos. ETHNICITY & HEALTH 2024; 29:828-845. [PMID: 39097863 DOI: 10.1080/13557858.2024.2385108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/22/2024] [Indexed: 08/05/2024]
Abstract
Latino health and well-being are crucial to the growth and vibrancy of rural areas across the United States, particularly at a time when the demographics of many rural communities are transitioning from minority Latino to majority Latino populations. This manuscript details the findings of a study that explored the health and healthcare benefit status of 524 Latino households in rural Indiana during the COVID-19 pandemic. Via 20-minute, door-to-door interviews conducted by bilingual researchers, survey participants answered questions about access to healthcare services and benefits, dietary and safety habits, medical issues, and vaccination status. The study found that slightly more than half of those surveyed were enrolled in healthcare benefit plans; approximately a third were unsatisfied with their health/health status; almost two-thirds had not received a flu shot and were eating fast food/processed food on a daily basis. Top health concerns reported included: stress (52%), vision problems (34%), neck and back pain (30%), headaches/migraines (28%), anxiety and depression (28%) and weight problems (26%). The study also discovered that half of the respondents could not identify a primary healthcare provider (PCP) by name and that pregnant women faced a lack of resources for maternal health in the county where the study was conducted. The results indicate that Latinos in rural communities continue to endure significant health issues and barriers to healthcare. The study provides an excellent model of how a rural community can monitor the health of its residents, which can inform health interventions for underserved populations.
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Affiliation(s)
- Melinda Grismer
- Department of Curriculum & Instruction, Purdue University, West Lafayette, IN, USA
| | - Nathalie Duval-Couetil
- Department of Technology Leadership & Innovation, Purdue University, West Lafayette, IN, USA
| | - Soohyun Yi
- Department of Educational Psychology, Texas Tech University, Lubbock, TX, USA
| | - Austin Dukes
- School of Medicine, Indiana University, West Lafayette, IN, USA
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Lewis KM, Burns R, Cortina-Borja M, Heilmann A, Macfarlane A, Nath S, Salway SM, Saxena S, Villarroel-Williams N, Viner R, Hardelid P. Parental migration, socioeconomic deprivation and hospital admissions in preschool children in England: national birth cohort study, 2008 to 2014. BMC Med 2024; 22:416. [PMID: 39334300 PMCID: PMC11438240 DOI: 10.1186/s12916-024-03619-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 09/05/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND A third of children born in England have at least one parent born outside the United Kingdom (UK), yet family migration history is infrequently studied as a social determinant of child health. We describe rates of hospital admissions in children aged up to 5 years by parental migration and socioeconomic group. METHODS Birth registrations linked to Hospital Episode Statistics were used to derive a cohort of 4,174,596 children born in state-funded hospitals in England between 2008 and 2014, with follow-up until age 5 years. We looked at eight maternal regions of birth, maternal country of birth for the 6 most populous groups and parental migration status for the mother and second parent (UK-born/non-UK-born). We used Index of Multiple Deprivation (IMD) quintiles to indicate socioeconomic deprivation. We fitted negative binomial/Poisson regression models to model associations between parental migration groups and the risk of hospital admissions, including interactions with IMD group. RESULTS Overall, children whose parents were both born abroad had lower emergency admission rates than children with parents both born in the UK. Children of UK-born (73.6% of the cohort) mothers had the highest rates of emergency admissions (171.6 per 1000 child-years, 95% confidence interval (CI) 171.4-171.9), followed by South Asia-born mothers (155.9 per 1000, 95% CI 155.1-156.7). The high rates estimated in the South Asia group were driven by children of women born in Pakistan (186.8 per 1000, 95% CI 185.4-188.2). A socioeconomic gradient in emergency admissions was present across all maternal regions of birth groups, but most pronounced among children of UK-born mothers (incidence rate ratio 1.43, 95% CI 1.42-1.44, high vs. low IMD group). Patterns of planned admissions followed a similar socioeconomic gradient and were highest among children with mothers born in Middle East and North Africa, and South Asia. CONCLUSIONS Overall, we found the highest emergency admission rates among children of UK-born parents from the most deprived backgrounds. However, patterns differed when decomposing maternal place of birth and admission reason, highlighting the importance of a nuanced approach to research on migration and health.
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Affiliation(s)
- Kate M Lewis
- Great Ormond Street Institute of Child Health, University College London, London, UK.
| | - Rachel Burns
- Institute of Health Informatics, University College London, London, UK
| | - Mario Cortina-Borja
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Anja Heilmann
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Alison Macfarlane
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | - Selina Nath
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Sarah M Salway
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | | | - Russell Viner
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Pia Hardelid
- Great Ormond Street Institute of Child Health, University College London, London, UK
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Davitian K, Noack P, Eckstein K, Hübner J, Ahmadi E. Barriers of Ukrainian refugees and migrants in accessing German healthcare. BMC Health Serv Res 2024; 24:1112. [PMID: 39317924 PMCID: PMC11423494 DOI: 10.1186/s12913-024-11592-x] [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: 04/14/2024] [Accepted: 09/16/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND This study focused on Ukrainian refugees and migrants, a population that, with an ongoing war, is expected to grow in Germany. Over 1 million Ukrainians with exceptional legal status and access to public insurance in Germany significantly burden governmental services, especially German healthcare. It is thus essential to facilitate their integration into the healthcare system and ensure its proper usage. Identifying the obstacles Ukrainian refugees and migrants encounter while accessing healthcare services is crucial to ease their integration. METHODS A qualitative study was conducted from February 2023 to April 2023. Thirty semi-structured interviews were performed with Ukrainian migrants and refugees. The interviews were transcribed verbatim, organized, and categorized. Thematic analysis was performed to identify barriers related to the use of German healthcare services. To assess possible differences in the experiences of Ukrainian refugees and migrants, the responses of these two groups for each topic were analysed separately. RESULTS Ukrainian migrants and refugees experience similar barriers while accessing German healthcare services. Predominantly, language barriers and a lack of understanding of the German healthcare system posed the main barriers in both groups. Additionally, structural challenges, such as differences in referral processes, appointment scheduling, and consultation duration, presented further challenges. CONCLUSION This research study emphasizes the importance of addressing cultural and structural barriers to improve healthcare accessibility and utilization for Ukrainian refugees and migrants in Germany to better facilitate their integration into the healthcare system.
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Affiliation(s)
- Karina Davitian
- Klink für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Peter Noack
- Lehrstuhl für pädagogische Psychologie, Humboldtstr. 27, 07743, Jena, Germany
| | - Katharina Eckstein
- Lehrstuhl für pädagogische Psychologie, Humboldtstr. 27, 07743, Jena, Germany
| | - Jutta Hübner
- Klink für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Emadaldin Ahmadi
- Klink für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
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Diaz CJ, Samayoa E, Chavez S, Bejarano V. Away from home, into the fields: Assessing the health of undocumented and indigenous farmworkers. Soc Sci Med 2024; 360:117299. [PMID: 39332386 DOI: 10.1016/j.socscimed.2024.117299] [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: 05/21/2024] [Revised: 09/04/2024] [Accepted: 09/04/2024] [Indexed: 09/29/2024]
Abstract
A large and growing literature argues that the agricultural labor market is stratified by ethnicity and legal status. However, other markers of distinction, such as indigeneity, may overlap with legal status to reveal additional health inequalities. Our study contributes to this scholarly dialogue by assessing the relation between indigeneity, legality, and health among immigrant-origin farmworkers from Latin America. To this end, we use data from the National Agricultural Worker Survey (N = 21,092) to examine health outcomes among indigenous and non-indigenous immigrants. Results indicate that indigenous farmworkers experience higher rates of pain-but not chronic conditions-than their non-indigenous counterparts. While undocumented farmworkers who are not indigenous exhibit especially favorable health, indigenous workers who are documented are significantly more likely to suffer from pain. Finally, there is limited evidence that differences in insurance coverage can fully explain the patterning between legal status, indigeneity, and health. This project sheds light on the well-being of indigenous migrant laborers in the U.S. food system, a population that experiences pervasive barriers to socioeconomic advancement at home and abroad.
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Affiliation(s)
- Christina J Diaz
- Department of Sociology, Rice University, 255 Kraft Hall, 6100 Main St, Houston, TX 77005, USA.
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Siddiq H, Choi KR, Jackson N, Saadi A, Gelberg L, Ponce NA, Takada S. Determinants to Tele-Mental Health Services Utilization Among California Adults: Do Immigration-Related Variables Matter? J Immigr Minor Health 2024:10.1007/s10903-024-01628-z. [PMID: 39235551 DOI: 10.1007/s10903-024-01628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2024] [Indexed: 09/06/2024]
Abstract
To investigate the relationship of predisposing, enabling, need, and immigration-related factors to tele-mental health services utilization among California adults, we conducted a secondary analysis of two waves of the California Health Interview Survey (CHIS) collected between 2015 and 2018 (N = 78,345). A series of logistic regression models were conducted to examine correlates and predictors to tele-mental health services use. Approximately 1.3% reported the use of tele-mental health services. Overall, health insurance status, severe psychological distress, perceived need for mental health services, and identifying as Asian, remained strong predictors for tele-mental health service use. When accounting for all factors, we found that being a non-citizen was associated with lower odds of tele-mental health service use (AOR = 0.47, CI = 0.26, 0.87, p < 0.05). These findings suggest that citizenship, resources to access, and perceived need for mental health care collectively are the most significant factors driving the use of tele-mental health services. There is a need to address inequitable access to tele-mental health services among immigrants who do not qualify for healthcare coverage due to citizenship status.
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Affiliation(s)
- Hafifa Siddiq
- Mervyn M. Dymally College of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
- Division of General and Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Kristen R Choi
- School of Nursing, UCLA, Los Angeles, CA, USA
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Nicholas Jackson
- Division of General and Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lillian Gelberg
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
- Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, USA
| | - Ninez A Ponce
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Sae Takada
- Division of General and Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Krannich S, Massey DS. The effect of the COVID-19 pandemic on immigration and immigrant wellbeing in the United States. SSM Popul Health 2024; 27:101705. [PMID: 39253628 PMCID: PMC11382114 DOI: 10.1016/j.ssmph.2024.101705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 08/04/2024] [Accepted: 08/07/2024] [Indexed: 09/11/2024] Open
Abstract
This article highlights the effect of the COVID-19 pandemic on immigration. and immigrant wellbeing in the United States by focusing on all categories of migrants, documented and undocumented. We argue that in the wake of the pandemic, immigrants disproportionately experienced higher rates of unemployment, greater losses of income, more exposure occupational risks, and higher rates of food and housing insecurity, all of which exacerbated preexisting differentials in access to health and health care to generate higher rates of COVID infection, morbidity, and mortality among adults and stunted educational outcomes for their children. The prospects for a full post-pandemic recovery of immigrants' wellbeing are dampened by the severe nature of COVID's negative effects on immigrants; the unusually hostile context of reception immigrants face after the pandemic; the large number of immigrants lacking legal status or holding tenuous documentation; and the formidable deportation regime that prevails in the United States that puts a great strain on immigrant communities. Undocumented migration has surged to restart undocumented population growth, further clouding the future for immigrants in the country. It is unclear whether reforms proposed by the Biden Administration be enacted and successful in improving their prospects. In general, this article aims to contribute to the broader discussion about migration and health policies.
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Affiliation(s)
- Sascha Krannich
- Institute for History, Theory and Ethics of Medicine, Giessen University, Leihgesterner Weg 52, 35392, Gießen, Germany
| | - Douglas S Massey
- Sociology and Public Affairs, Princeton University, 239 Wallace Hall, 08544, Princeton, NJ, United States
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Nayak SS, Cardone A, Soberano K, Dhond M. The Health Status of Undocumented Immigrants from Asian Countries in the United States: A Scoping Review and Recommendations for Future Directions. J Immigr Minor Health 2024:10.1007/s10903-024-01625-2. [PMID: 39180638 DOI: 10.1007/s10903-024-01625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2024] [Indexed: 08/26/2024]
Abstract
Immigrants from Asian countries are the fastest-growing undocumented population in the United States (U.S.), yet not much is known about their health. This scoping review identifies the nature and extent of scientific literature on the health of undocumented Asian immigrants in the U.S. We conducted a comprehensive search of six electronic databases in 2024. Inclusion criteria were empirical articles written in English, published in peer-reviewed scientific journals from 2010 to 2024, and focused on a health outcome or health-related issue involving undocumented Asian immigrants. Results are summarized narratively. We identified 13 peer-reviewed publications. Nine studies were quantitative, and four were qualitative. Eight studies were conducted in California; two studies used national secondary data sources. Studies were mixed in their research focus. They covered a range of health outcomes and issues, such as mental health (n = 4), health services and access (n = 2), contraceptive use (n = 1), COVID-19 (n = 2), and HIV (n = 1). Three studies measured self-rated health alongside other conditions, such as disability, health insurance coverage, chronic health conditions, and obesity. Scholarship on the health of undocumented Asian immigrants is a growing research area. Given the small number of studies identified, future research with larger diverse samples, more robust methodology, and greater topical variety are warranted to understand the health of this population better and reduce potential inequities.
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Affiliation(s)
- Sameera S Nayak
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, 1000 Hilltop Circle, Public Policy Building, Baltimore, MD, 21250, USA.
| | - Amanda Cardone
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, 1000 Hilltop Circle, Public Policy Building, Baltimore, MD, 21250, USA
| | - Kina Soberano
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, 1000 Hilltop Circle, Public Policy Building, Baltimore, MD, 21250, USA
| | - Meghan Dhond
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, 1000 Hilltop Circle, Public Policy Building, Baltimore, MD, 21250, USA
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Debray A, Petit V, Ruyssen I, Sow N, Toma S. Well-being amid (im)mobility struggles: Youth's experiences in Casamance, Senegal. BMC Public Health 2024; 24:2241. [PMID: 39154189 PMCID: PMC11329987 DOI: 10.1186/s12889-024-19702-4] [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: 03/22/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Large numbers of young people worldwide, especially in the Global South, wish to migrate but lack the capacity to do so, with potentially detrimental consequences for their well-being and mental health. Termed 'involuntary immobility', this phenomenon is numerically larger than migration, but remains for now a largely underexplored area of research. Focusing on young Senegalese living in Casamance, this paper contributes to the limited literature on the implications of immobility for subjective well-being. It does so by (i) considering different degrees and types of involuntary immobility and their intersections, (ii) laying out the implications of (interacting) social and spatial immobilities for well-being with particular attention to youth's agency in navigating a lack of capabilities, and (iii) by accounting for heterogenous experiences taking a gendered approach. METHODS For this study, 35 semi-structured interviews were conducted with 18- to 39-year-olds in Ziguinchor region, recruited through purposive and snowball sampling. Thematic analysis was employed on verbatim transcriptions of audio-recorded interviews. RESULTS Our study reveals a nuanced reality where aspirations to (temporarily) move abroad coexist with aspirations to stay in Casamance. Participants' life aspirations and overarching projects clash, however, both with a lack of capabilities to move abroad and to enact these locally. This pervasive immobility decreases life satisfaction and generates negative emotions, such as stress, anxiety, discouragement, and distress. Despite these obstacles, our findings also underscore the agency and resourcefulness displayed by the youth as they navigate their limited control over life choices and paths. CONCLUSIONS Involuntary spatial immobility exacerbates the dominant experience of social immobility, magnifying its effect on youth's well-being, revealing a previously unacknowledged phenomenon. Our findings further emphasize the pressing need for a more cohesive alignment between migration policies and information campaigns on one hand and the real experiences and challenges encountered by their intended audience on the other.
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Affiliation(s)
- Alix Debray
- United Nations University, Comparative Regional Integration Studies, Bruges, Belgium.
- Department of Economics, Ghent University, Ghent, Belgium.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | | | - Ilse Ruyssen
- United Nations University, Comparative Regional Integration Studies, Bruges, Belgium
- Department of Economics, Ghent University, Ghent, Belgium
| | - Ndiémé Sow
- Center for Interdisciplinary Research on Languages, Literatures, History, Arts and Cultures (Université Assane Seck Ziguinchor, Ziguinchor, Senegal), Université Amadou Mahtar Mbow, Dakar, Senegal
| | - Sorana Toma
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Luo H, Wu B, Wu Y, Moss ME. Dental Caries and Preventive Dental Visits Among Children in the U.S.: The Impact of Race/Ethnicity and Immigration. AJPM FOCUS 2024; 3:100230. [PMID: 38766463 PMCID: PMC11099302 DOI: 10.1016/j.focus.2024.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Introduction National data on dental caries and dental service use among immigrant children in U.S. are limited. It is not known whether race/ethnicity would interact with immigration status to increase these disparities. Using a nationally representative sample, this study assessed the interaction effects of immigrant generation status and race/ethnicity on dental caries and dental visits among children in the U.S. Methods Data were from the 2020 and 2021 National Survey of Children's Health. All data were self-reported by parents/guardians. The 2 outcomes were (1) dental caries (yes/no) in the past 12 months and (2) preventive dental visits (yes/no) in the past 12 months. Racial/ethnic groups included non-Hispanic White, Black, Hispanics, and Asian Americans. The analytical sample included 66,167 children aged 2-17 years, including 1,243 first-generation immigrant children; 11,017 second-generation immigrant children; and 53,907 nonimmigrant children. Study authors ran separate multiple logistic regression models for the 2 outcome variables. All analyses accounted for the survey design of National Survey of Children's Health. Results First-generation immigrant children were more likely to have dental caries than nonimmigrant children (AOR=1.44). The interaction of race/ethnicity and immigrant generation status was significant (p=0.04) in the preventive dental visits model, indicating increased challenges in getting dental visits among minority immigrant children in comparison with that among non-Hispanic White immigrant children, especially among first-generation immigrant children of Asian Americans (AOR=0.41) and non-Hispanic Black immigrant children (AOR=0.37). Conclusions First-generation immigrant children were less likely to see a dentist and more likely to have dental caries than nonimmigrants. Moreover, first-generation immigrant children from minority racial/ethnic groups were the least likely to seek dental services. To further reduce disparities in oral health and dental use among children in the U.S., culturally sensitive health promotion is warranted to improve oral health literacy and reduce barriers to dental care for immigrants, especially immigrant children of the minority groups.
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Affiliation(s)
- Huabin Luo
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Yanyan Wu
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Mark E. Moss
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina
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Chuquitarco-Morales A, Rivera-Navarro J, La Parra-Casado D, Fuster M, Franco M. Madrid immigrants' perceptions of urban food environments and their dietary behaviours. Appetite 2024; 199:107390. [PMID: 38703792 DOI: 10.1016/j.appet.2024.107390] [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: 01/24/2024] [Revised: 04/17/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
Large cities are home to several groups of immigrants who undergo important changes in their environmental conditions and lifestyles that significantly modify their risk of chronic diseases. Quantitative evidence indicates that both their health and diet worsen over time; much less is known about the qualitative mechanisms that cause these changes. The aim of this article is to understand how immigrants in the city of Madrid perceive the relation between the urban food environment and dietary behaviour. Based on a Social Ecological Framework, we conducted a secondary qualitative analysis derived from data from 41 immigrant residents, collected in eight focus groups (FGs), conducted in two neighbourhoods in the city of Madrid. We identified the following main categories: 1) Transnational identity and dietary behaviour in the neighbourhood; 2) Transitions in dietary behaviour; and 3) Societal/structural factors determining dietary behaviour in the neighbourhood. The participants in the FGs mentioned that they try to maintain traditional dietary customs and perceive that the taste of their typical dishes is better than those of Spanish dishes. Contradictorily, some participants considered their traditional dietary patterns to be less healthy than Mediterranean ones (consuming olive oil, vegetables, fish). Some participants acknowledged having adapted to the latter voluntarily or through dietary negotiations with their children. Immigrant families with two working parents have difficulties cooking homemade food and resort to less healthy options, such as eating fast food or ready-made meals. Due to their low purchasing power, they buy both ethnic products and other products, as well as considering the prices and offers in supermarkets. Our study highlights several structural mechanisms connecting the physical and social urban food environment with dietary behaviours among immigrant residents of a large city.
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Affiliation(s)
| | - Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain
| | - Daniel La Parra-Casado
- Department of Sociology 2, Universidad de Alicante, San Vicente del Raspeig, Alicante, Spain.
| | - Melissa Fuster
- Department of Social, Behavioral, and Population Sciences, Tulane University, School of Public Health & Tropical Medicine, New Orleans, LA, United States
| | - Manuel Franco
- Surgery and Medical and Social Sciences Department, Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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14
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Langer PD, Patler C, Hamilton ER. Adverse Infant Health Outcomes Increased After the 2016 U.S. Presidential Election Among Non-White U.S.-born and Foreign-born Mothers. Demography 2024; 61:1211-1239. [PMID: 39049503 DOI: 10.1215/00703370-11477581] [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: 07/27/2024]
Abstract
Macro-level events such as elections can improve or harm population health across existing axes of stratification through policy changes and signals of inclusion or threat. This study investigates whether rates of, and disparities in, adverse birth outcomes between racialized and nativity groups changed after Donald Trump's November 2016 election, a period characterized by increases in xenophobic and racist messages, policies, and actions in the United States. Using data from 15,568,710 U.S. births between November 2012 and November 2018, we find that adverse birth outcomes increased after Trump's election among U.S.- and foreign-born mothers racialized as Black, Hispanic, and Asian and Pacific Islander (API), compared with the period encompassing the two Obama presidencies. Results for Whites suggest no change or a slight decrease in adverse outcomes following Trump's election, yet this finding was not robust to checks for seasonality. Black-White, Hispanic-White, and API-White disparities in adverse birth outcomes widened among both U.S.- and foreign-born mothers after Trump's election. Our findings suggest that Trump's election was a racist and xenophobic macro-level political event that undermined the health of infants born to non-White mothers in the United States.
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Affiliation(s)
- Paola D Langer
- Goldman School of Public Policy, University of California, Berkeley, Berkeley, CA, USA
| | - Caitlin Patler
- Goldman School of Public Policy, University of California, Berkeley, Berkeley, CA, USA
| | - Erin R Hamilton
- Department of Sociology, University of California, Davis, Davis, CA, USA
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15
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Liu X, Li J, Cho Y, Wu B. Heterogeneities in sleep duration and quality among U.S. immigrants from different racial and ethnic backgrounds. Sleep Health 2024; 10:393-401. [PMID: 38777645 PMCID: PMC11309898 DOI: 10.1016/j.sleh.2024.03.006] [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] [Received: 01/27/2024] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES Sleep plays an essential role in well-being. Although U.S. immigrants are considerably growing, few studies have examined sleep in this diverse population, particularly those from Asian backgrounds. It is also unclear how sleep differs by the length of residence across immigrant groups. In this study, we examined the relationships among race/ethnicity, length of residence, and sleep using a nationally representative cohort of U.S. immigrants. METHODS We analyzed data from the 2013-2018 National Health Interview Survey. The sample (N = 27,761; 14% ≥65 years old) included foreign-born adults from the following racial/ethnic backgrounds: non-Hispanic White, non-Hispanic Black, Asian (Chinese, Filipino, Asian Indian), and Hispanic/Latino. Length of residence was categorized as <5, 5-9, 10-14, and ≥15years. Sleep was assessed with self-reported sleep duration (normal, short, and long) and poor sleep quality (trouble falling asleep, trouble staying asleep, and waking up unrested). RESULTS Filipino and Hispanic/Latino immigrants reported the highest prevalence of short (41.8%) and long (7.0%) sleep, respectively. Non-Hispanic White immigrants had the highest prevalence rate across all three poor sleep quality measures (range 17.7-41.5%). Length of residence ≥15years was significantly associated with worse sleep, and it moderated White-Asian differences in sleep quality. Immigrants from different racial/ethnic groups showed variations in sleep patterns as they resided longer in the US. CONCLUSIONS Immigrants exhibited substantial heterogeneities in sleep. Future research should investigate the contributing factors to the variations in their sleep patterns, both between groups and within the same group of immigrants, in order to inform tailored interventions.
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Affiliation(s)
- Xiaoyue Liu
- New York University Rory Meyers College of Nursing, New York, New York, USA.
| | - Junxin Li
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Yeilim Cho
- Veteran's Affairs Puget Sound Health Care System, VISN20 Mental Illness Research Education Clinical Center, Seattle, Washington, USA
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York, New York, USA; New York University College of Dentistry, New York, New York, USA
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Pérez‐Aronsson A, Inge E, Alanbari H, Alsalamah I, Ghannoum M, Mohammad ZA, Metso FJ, Holmqvist F, Belachew J, Filén T, Hennoks FP, Sarkadi A, Warner G. Co-Design Workshops to Develop a Psychosocial Support Service Model for Refugees in Sweden Affected by Gender-Based Violence. Health Expect 2024; 27:e14177. [PMID: 39129706 PMCID: PMC11317807 DOI: 10.1111/hex.14177] [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] [Received: 04/10/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Experiencing gender-based violence (GBV) is common among refugees. Intersecting systems of oppression can increase the risk of GBV and of suffering detrimental consequences, while concurrently creating barriers to meaningful support. Despite this, refugees with lived experience of GBV are rarely involved in the development, planning and adaptation of services and policies. METHODS This article reports on a formative research process that aimed to involve public contributors (refugee victim-survivors of GBV) and relevant stakeholders in co-designing a service model aimed at improving psychosocial support in Sweden. Led by a partnership of public contributors and academic researchers, the research process consisted of iterative cycles of co-design workshops, complemented by scoping of existing literature. RESULTS The co-design process resulted in a characterisation of the psychosocial service system needs, as perceived by the survivor co-researchers and stakeholders, and a two-level empowerment and support service model. The model included (i) a community-based intervention to promote help-seeking and (ii) psychosocial group support delivered in specialist clinics. Outcomes of the project included perceived benefits for those involved, service-led direct changes and acquisition of funding for continued research on the co-designed model. CONCLUSION Improving psychosocial support for refugees in Sweden affected by GBV requires safe spaces to connect with peers and familiarise with available services, laws and rights in the society. Further, strengthened collaborations across sectors are necessary to meet the variety of needs. Co-design workshops were an effective way to initiate changes in the service delivery model for psychosocial support for refugees in Sweden affected by GBV. PATIENT OR PUBLIC CONTRIBUTIONS This is a participatory reflection on a participatory process. The survivor co-researchers contributed to designing and carrying out the PPI process and have co-authored this manuscript.
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Affiliation(s)
- Anna Pérez‐Aronsson
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
- Centre for Women's Mental Health During the Reproductive Lifespan—WOMHERUppsala UniversityUppsalaSweden
| | - Elin Inge
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Heba Alanbari
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Iman Alsalamah
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Miras Ghannoum
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Zozan Abu Mohammad
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Frida Johansson Metso
- Swedish Red Cross Competence Centre for Rehabilitation of Torture and War TraumaStockholmSweden
| | - Frida Holmqvist
- Information SwedenCounty Administrative Boards of Västra GötalandGothenburgSweden
| | - Johanna Belachew
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Tove Filén
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Frida Pålsson Hennoks
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
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Hagan MJ, Hernandez MM, Enriquez LE, Ayón C. Immigration Status, Legal Vulnerability, and Suicidal/Self-harm Ideation Disparities Among Immigrant-Origin Latinx Young Adults in the U.S. J Racial Ethn Health Disparities 2024; 11:2129-2140. [PMID: 37349669 DOI: 10.1007/s40615-023-01682-7] [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: 04/22/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
Theories of suicidality typically center intrapersonal processes, with limited attention to social determinants of mental health disparities. Using a legal vulnerability framework, we examined the association between self/parental immigration status and suicidal and self-harm ideation (SI) disparities in three groups of immigrant-origin Latinx young adults attending college in the USA: undocumented students (n = 564), US citizens with undocumented parents (n = 605), and US citizens with lawfully present parents (n = 596). We also evaluated whether self/parental immigration status differences in SI could be accounted for by six dimensions of legal vulnerability and, based on prominent theories of suicidality, explored the role of campus belongingness as a protective factor. Participants completed self-report measures, and SI was assessed using one item from the Patient Health Questionnaire-9, a screening tool that assesses the severity of depression symptomatology. Rates of SI were significantly higher among undocumented students (23.1%) and US citizens with undocumented parents (24.3%) compared to US citizens with lawfully present parents (17.8%). Immigration policy-related social exclusion and discrimination-mediated self/parental immigration status differences in SI. Although food insecurity did not differ by self/parental immigration status, greater food insecurity was associated with higher likelihood of SI. Greater campus belongingness was associated with a lower likelihood of endorsing SI for all students regardless of immigration status or legal vulnerability factors. Findings underscore the importance of examining self and parental immigration status as a social determinant of SI and the value of investigating aspects of legal vulnerability as explanatory factors.
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Affiliation(s)
- Melissa J Hagan
- San Francisco State University, San Francisco, CA, USA.
- University of California, Riverside, Riverside, CA, USA.
| | | | | | - Cecilia Ayón
- University of California Irvine, Irvine, CA, USA
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18
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Blukacz A, Oyarte M, Cabieses B. Adequate housing as a social determinant of the health of international migrants and locals in Chile between 2013 and 2022. BMC Public Health 2024; 24:2021. [PMID: 39075425 PMCID: PMC11285377 DOI: 10.1186/s12889-024-19491-w] [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] [Received: 03/21/2024] [Accepted: 07/15/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Adequate housing is a fundamental right and a social determinant of health. It also represents a historically contentious topic in Latin America. Migratory flows to Chile have become increasingly precarious in the past few years, limiting opportunities for adequate housing, with potential repercussions on the health of international migrants and the general population. This study aims to analyse adequate housing as a social determinant of health among international migrants and locals between 2013 and 2022 in Chile. METHODS Observational cross-sectional study based on repeated versions of the nationally representative Socioeconomic Characterization Survey in Chile. Adequate housing indicators adapted from the United Nations Housing Rights Programme guidelines were analyzed with relation to individual health, distinguishing between the local and international migrant populations. Logistic regression models were fitted for housing indicators with migration as the main independent variable and for short-term and long-term healthcare needs in locals and immigrants with housing as the main dependent variables. Models were adjusted for sociodemographic variables and considered the complex sample design. RESULTS Descriptive findings indicated higher availability of services and infrastructure among international migrants, and a disadvantage for habitability, location, and affordability by quintiles compared to locals. Logistic regression models, adjusting for demographic variables, revealed significant associations between migration status and overcrowding (OR 6.14, 2022), poor housing materiality (OR 5.65, 2022) and proximity to healthcare centres (OR 1.4, 2022) compared to locals. Experiencing hazardous situations consistently predicted short-term healthcare needs in both migrants (OR = 1.4, 2022) and locals (OR = 2.8, 2022). Overcrowding predicted both long and short-term healthcare needs among locals across the years and long term needs among migrants in 2013 and 2015. CONCLUSIONS We found significant inequities in adequate housing between migrant populations and locals in Chile, and some inequities among both populations based on structural socioeconomic deprivation. Experiencing hazardous situations emerged as a social determinant of health among international migrants in 2022, potentially suggesting growing challenges related to social exclusion in urban areas. However, limitations such as exclusion criteria of the survey and sample sizes for data on the migrant population potentially suggest that housing challenges and their impact on health are underestimated.
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Affiliation(s)
- Alice Blukacz
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Marcela Oyarte
- Unidad de estudios, Instituto de Salud Pública (ISP), Santiago, Chile
| | - Báltica Cabieses
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile.
- Department of Health Sciences, University of York, York, UK.
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19
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Evensen M, Cools S, Hermansen AS. Adolescent Health Inequality Across Immigrant Generations. J Adolesc Health 2024:S1054-139X(24)00253-2. [PMID: 39078364 DOI: 10.1016/j.jadohealth.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 04/30/2024] [Accepted: 05/21/2024] [Indexed: 07/31/2024]
Abstract
PURPOSE Evidence on whether the immigrant health paradox (i.e., immigrants having better health than natives of nonmigrant background) extends to children and youth is mixed and often based on self-reported survey data. In this study, we use population-wide administrative microdata from Norwegian demographic and health registries to investigate health inequalities between adolescents with foreign-born and native-born parents, paying specific attention to variation across immigrant generations, origin countries, and types of diagnoses. METHODS In this registry-based study, we estimate differences in the likelihood of somatic and mental disorders using logistic regression and population-wide health records for adolescents aged 16-20 years (N = 616,835). RESULTS Child immigrants and native-born children of immigrants have fewer consultations for somatic and psychiatric diagnoses in adolescence compared to natives, while native-born children with mixed parental background have health outcomes more similar to natives. The differences are most pronounced for mental disorders. Differences across immigrant generations persist when stratifying by country of origin and when looking at specific diagnoses. DISCUSSION The findings support the existence of an immigrant health advantage, which we find across various psychiatric and somatic diagnoses and for most immigrant generations. A key task for future research is to explore specific mechanisms underlying these patterns and to address potential inequities in the quality of health care provided to immigrant-background youth.
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Affiliation(s)
| | - Sara Cools
- Institute for Social Research, Oslo, Norway
| | - Are Skeie Hermansen
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway; Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
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Van Natta M. Second-Class Care: How Immigration Law Transforms Clinical Practice in the Safety Net. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465241254390. [PMID: 39066548 DOI: 10.1177/00221465241254390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
This article examines how U.S. immigration law extends into the health care safety net, enacting medical legal violence that diminishes noncitizens' health chances and transforms clinical practices. Drawing on interviews with health care workers in three U.S. states from 2015 to 2020, I ask how federal citizenship-based exclusions within an already stratified health care system shape the clinical trajectories of noncitizens in safety-net institutions. Focusing specifically on cancer care, I find that increasingly anti-immigrant federal policies often reshape clinical practices toward noncitizens with a complex, life-threatening condition as they approach a "specialty care cliff" by (1) creating time penalties that keep many noncitizens in a protracted state of injury and (2) deterring noncitizens from seeking care through threats of immigration enforcement. Through these processes, medical legal violence also creates the potential for moral injury among health care workers, who must adapt clinical practices in response to socio-legal boundaries of belonging.
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Affiliation(s)
- Meredith Van Natta
- Department of Sociology, University of California Merced, Merced, CA, USA
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21
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Wiedmeyer ML, Machado S, Tayyar E, Sierra-Heredia C, Bozorgi Y, Hagos S, Goldenberg S, Lavergne R. How immigration shapes health disadvantages and what healthcare organizations can do to deliver more equitable care. Healthc Manage Forum 2024:8404704241265675. [PMID: 39045719 DOI: 10.1177/08404704241265675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
That immigration is a determinant of health and that immigration systems themselves contribute to structural disadvantage remains under-addressed within healthcare in Canada. This article offers context for how immigration shapes health, and recommendations for how health systems can be better prepared to respond to the diverse needs of immigrants and migrants (together referred to as im/migrants), based on a community-based research project in British Columbia. Findings call attention to the varied and intersecting ways in which immigration status, access to health insurance, language, experiences of trauma and discrimination, lack of support for health system limits access to healthcare, and the roles community-based organizations play in supporting access. Recommendations are intended to help make sure that all health services are accessible to everyone, and move beyond a homogenizing category of "newcomers" into practical, meaningful strategies that attend to diverse and intersecting community needs.
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Affiliation(s)
| | - Stefanie Machado
- Centre for Gender and Sexual Health Equity, Vancouver, BC, Canada
| | - Elmira Tayyar
- Centre for Gender and Sexual Health Equity, Vancouver, BC, Canada
| | | | - Yasmin Bozorgi
- Centre for Gender and Sexual Health Equity, Vancouver, BC, Canada
| | - Selamawit Hagos
- Centre for Gender and Sexual Health Equity, Vancouver, BC, Canada
| | - Shira Goldenberg
- San Diego State, San Diego, California, Unites States of America
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22
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Kåks P, Målqvist M, Tomlinson M, Stansert Katzen L. Empowerment strategies of the Mentor Mother peer support program among mothers who have migrated to Sweden: a photovoice study. BMC Public Health 2024; 24:1912. [PMID: 39014412 PMCID: PMC11253451 DOI: 10.1186/s12889-024-19442-5] [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: 01/30/2024] [Accepted: 07/10/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION A peer support intervention using 'Mentor Mothers' was implemented for mothers who had migrated to Sweden, living in socially disadvantaged communities. The Mentor Mothers had a high degree of freedom to develop strategies for facilitating empowerment of their clients according to perceived needs. This study aimed to investigate which empowerment facilitation strategies that Mentor Mothers perceived to be relevant, feasible and effective. METHODS Photovoice was used to generate qualitative data. Participants took photographs of their work which were then discussed during a focus group discussion and six individual semi-structured interviews. Data were analysed using thematic analysis. RESULTS Four overarching strategies to facilitate empowerment were identified, corresponding to distinctive perceived needs in the target group: (1) Informative support responded to a need for making sense of the external context, by helping mothers navigate society, the process of parenthood and cultural parenting norms. (2) Practical support addressed a need for managing challenges in daily life, by facilitating contacts with welfare services and authorities and to enhance parenting practices. (3) Psychosocial support addressed a need for improved mental wellbeing, by instilling feelings of safety and security in daily life, relationships and in contacts with public institutions. (4) Motivational support responded to a need for finding fulfilling purpose, by promoting social interaction, encouraging civic engagement and sharing the challenges and successes of others to inspire hope. CONCLUSIONS These results highlight various aspects of peer support for empowerment facilitation that future interventions targeting immigrant parents can use in their intervention design.
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Affiliation(s)
- Per Kåks
- Department of Women's and Children's Health, Uppsala University, Uppsala, SE-75 185, Sweden.
| | - Mats Målqvist
- Department of Women's and Children's Health, Uppsala University, Uppsala, SE-75 185, Sweden
| | - Mark Tomlinson
- School of Nursing and Midwifery, Queen's University, Belfast, United Kingdom
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Linnea Stansert Katzen
- Department of Women's and Children's Health, Uppsala University, Uppsala, SE-75 185, Sweden
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Tranby BN, Sia IG, Clark MM, Novotny PJ, Lohr AM, Pardo LS, Patten CA, Iteghete SO, Zeratsky KA, Rieck TM, Molina L, Capetillo GP, Ahmed Y, Dirie H, Wieland ML. Negative mood is associated with sociobehavioral factors contributing to cardiovascular risk in an immigrant population. BMC Public Health 2024; 24:1911. [PMID: 39014369 PMCID: PMC11253367 DOI: 10.1186/s12889-024-19402-z] [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] [Received: 02/06/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND After settling in the United States (US), immigrants often accumulate obesity and cardiovascular risk factors. As mood is often associated with health behaviors in the US population, mood may be an important mediating factor in immigrant populations. METHODS The Healthy Immigrant Community (HIC) study, set in southeast Minnesota, enrolled 475 adult participants in a weight loss intervention designed to reduce cardiovascular risk. Baseline questionnaires assessed mood, nutrition, physical activity, self-efficacy for healthy eating and physical activity, social support, and cohesion. A single-item mood rating of poor or fair was considered "negative", while ratings of good, very good, or excellent were considered "positive". RESULTS Hispanic/Latino (n = 268) and Somali (n = 181) adults enrolled in HIC completed baseline measures and were included in this analysis. Participants endorsing negative mood compared to positive mood had lower healthy eating scores (p = 0.02), lower physical activity levels (p = 0.03), lower confidence in eating a healthy diet (p = 0.001), and felt less of a sense of belonging to their community (p = 0.01). Those endorsing negative mood reported receiving less social support to eat healthy (p = < 0.001) and be physically active (p = 0.01). They also accessed community resources for healthy eating (p = 0.001) and physical activity (p = < 0.01) less frequently than participants endorsing positive mood. CONCLUSIONS On self-report, negative mood was associated with less healthy nutrition, lower confidence in eating healthy, sedentary lifestyle, and perceived lack of belonging to the community. Integrating mood management and self-efficacy strategies may enhance the effectiveness of lifestyle interventions to reduce obesity and cardiovascular risk among immigrants who report negative mood. TRIAL REGISTRATION ClinicalTrials.gov registration: NCT05136339; April 23, 2022.
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Affiliation(s)
- Brianna N Tranby
- Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Irene G Sia
- Rochester Healthy Community Partnership, Rochester, MN, USA
- Division of Public Health, Infectious Diseases, & Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
- Rochester Healthy Community Partnership, Rochester, MN, USA
| | - Paul J Novotny
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Abby M Lohr
- Rochester Healthy Community Partnership, Rochester, MN, USA
- Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Laura Suarez Pardo
- Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Christi A Patten
- Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Sheila O Iteghete
- Rochester Healthy Community Partnership, Rochester, MN, USA
- Community Based Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | | | - Luz Molina
- Rochester Healthy Community Partnership, Rochester, MN, USA
- Community Based Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Yahye Ahmed
- Rochester Healthy Community Partnership, Rochester, MN, USA
- Somali American Social Service Association, Rochester, MN, USA
| | - Hana Dirie
- Rochester Healthy Community Partnership, Rochester, MN, USA
- Community Based Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Mark L Wieland
- Rochester Healthy Community Partnership, Rochester, MN, USA
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA
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LeBrón AMW, Schulz AJ, Gamboa C, Reyes A, Viruell-Fuentes E, Israel BA. Mexican-origin women's individual and collective strategies to access and share health-promoting resources in the context of exclusionary immigration and immigrant policies. BMC Public Health 2024; 24:1757. [PMID: 38956532 PMCID: PMC11218332 DOI: 10.1186/s12889-024-19204-3] [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] [Received: 03/25/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being. METHODS We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014. RESULTS Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network. CONCLUSIONS Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.
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Affiliation(s)
- Alana M W LeBrón
- Department of Health, Society, and Behavior, University of California, Irvine 856 Health Sciences Drive, Suite 3555, Irvine, CA, USA.
- Department of Chicano/Latino Studies, University of California, Irvine, Irvine, CA, USA.
| | - Amy J Schulz
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Cindy Gamboa
- Detroit Hispanic Development Corporation, Detroit, MI, USA
| | - Angela Reyes
- Detroit Hispanic Development Corporation, Detroit, MI, USA
| | - Edna Viruell-Fuentes
- Department of Latina/o Studies, University of Illinois Urbana-Champaign (Deceased), Urbana- Champaign, IL, USA
| | - Barbara A Israel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Chen J, Jang S, Wang MQ. Medicare Payments and ACOs for Dementia Patients Across Race and Social Vulnerability. Am J Geriatr Psychiatry 2024:S1064-7481(24)00381-6. [PMID: 39019696 DOI: 10.1016/j.jagp.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVES This study investigated variations in Medicare payments for Alzheimer's disease and related dementia (ADRD) by race, ethnicity, and neighborhood social vulnerability, together with cost variations by beneficiaries' enrollment in Accountable Care Organizations (ACOs). METHODS We used merged datasets of longitudinal Medicare Beneficiary Summary File (2016-2020), the Social Vulnerability Index (SVI), and the Medicare Shared Savings Program (MSSP) ACO to measure beneficiary-level ACO enrollment at the diagnosis year of ADRD. We analyzed Medicare payments for patients newly diagnosed with ADRD for the year preceding the diagnosis and for the subsequent 3 years. The dataset included 742,175 Medicare fee-for-service (FFS) beneficiaries aged 65 and older with a new diagnosis of ADRD in 2017 who remained in the Medicare FFS plan from 2016 to 2020. RESULTS Among those newly diagnosed, Black and Hispanic patients encountered higher total costs compared to White patients, and ADRD patients living in the most vulnerable areas experienced the highest total costs compared to patients living in other regions. These cost differences persisted over 3 years postdiagnosis. Patients enrolled in ACOs incurred lower costs across all racial and ethnic groups and SVI areas. For ADRD patients living in the areas with the highest vulnerability, the cost differences by ACO enrollment of the total Medicare costs ranged from $4,403.1 to $6,922.7, and beneficiaries' savings ranged from $114.5 to $726.6 over three years post-ADRD diagnosis by patient's race and ethnicity. CONCLUSIONS Black and Hispanic ADRD patients and ADRD patients living in areas with higher social vulnerability would gain more from ACO enrollment compared to their counterparts.
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Affiliation(s)
- Jie Chen
- Department of Health Policy and Management (JC, SJ), School of Public Health, University of Maryland, College Park, MD; The Hospital And Public health interdisciPlinarY research (HAPPY) Lab (JC, SJ, MQW), School of Public Health, University of Maryland, College Park, MD.
| | - Seyeon Jang
- Department of Health Policy and Management (JC, SJ), School of Public Health, University of Maryland, College Park, MD; The Hospital And Public health interdisciPlinarY research (HAPPY) Lab (JC, SJ, MQW), School of Public Health, University of Maryland, College Park, MD
| | - Min Qi Wang
- The Hospital And Public health interdisciPlinarY research (HAPPY) Lab (JC, SJ, MQW), School of Public Health, University of Maryland, College Park, MD; Department of Behavioral and Community Health, School of Public Health (MQW), University of Maryland, College Park, MD
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Eick F, Vallersnes OM, Fjeld HE, Sørbye IK, Valberg M, Dahl C. Perinatal mortality among pregnant undocumented migrants in Norway 1999-2020: A register-based population study. Soc Sci Med 2024; 353:117055. [PMID: 38897075 DOI: 10.1016/j.socscimed.2024.117055] [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: 12/22/2023] [Revised: 04/11/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Irregular legal status is a recognized health risk factor in the context of migration. However, undocumented migrants are rarely included in health surveys and register studies. Adverse perinatal outcomes are especially important because they have long-term consequences and societal risk factors are modifiable. In this study, we compare perinatal outcomes in undocumented migrants to foreign-born and Norwegian-born residents, using a population-based register. METHODS We included women 18-49 years old giving birth to singletons as registered in the Medical Birth Registry of Norway from 1999 to 2020. Women were categorized as 'undocumented migrants' (without an identity number), 'documented migrants' (with an identity number and born abroad), and 'non-migrants' (with an identity number and born in Norway). The main outcome was perinatal mortality, i.e., death of a foetus ≥ gestational week 22, or neonate up to seven days after birth. We used log-binominal regression to estimate the association between legal status and perinatal mortality, adjusting for several maternal pre-gestational and gestational factors. Direct standardization was used to adjust for maternal region of origin. ETHICAL APPROVAL Regional Ethical Committee (REK South East, case number 68329). RESULTS We retrieved information on 5856 undocumented migrant women who gave birth during the study period representing 0.5% of the 1 247 537 births in Norway. Undocumented migrants had a relative risk of 6.17 (95% confidence interval 5.29 ̶7.20) of perinatal mortality compared to non-migrants and a relative risk of 4.17 (95% confidence interval 3.51 ̶4.93) compared to documented migrants. Adjusting for maternal region of origin attenuated the results slightly. CONCLUSION Being undocumented is strongly associated with perinatal mortality in the offspring. Disparities were not explained by maternal origin or maternal health factors, indicating that social determinants of health through delays in receiving adequate care and factors negatively influencing gestational length may be of importance.
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Affiliation(s)
- Frode Eick
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway.
| | - Odd Martin Vallersnes
- Department of General Practice, Institute of Health and Society, University of Oslo, Norway; Oslo Accident and Emergency Outpatient Clinic, Department of Emergency General Practice, City of Oslo Health Agency, Norway
| | - Heidi E Fjeld
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway
| | - Ingvil K Sørbye
- Department of Obstetrics, Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway
| | - Morten Valberg
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway; Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Norway
| | - Cecilie Dahl
- Department of Public Health Science, Institute of Health and Society, University of Oslo, Norway
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Owczarzak J, Monton O, Fuller S, Burlaka J, Kiriazova T, Morozova O, Dumchev K. "Will you need this health at all? Will you be alive?": using the bioecological model of mass trauma to understand HIV care experiences during the war in Ukraine. J Int AIDS Soc 2024; 27 Suppl 3:e26307. [PMID: 39030874 PMCID: PMC11258484 DOI: 10.1002/jia2.26307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/28/2024] [Indexed: 07/22/2024] Open
Abstract
INTRODUCTION Russia's invasion of Ukraine in February 2022 has severely impacted the healthcare system, including the provision of HIV care. The ongoing war is a human-caused mass trauma, a severe ecological and psychosocial disruption that greatly exceeds the coping capacity of the community. The bioecological model of mass trauma builds on Bronfenbrenner's concept of interaction between nested systems to argue that social context determines the impact of life events on the individual and how an individual responds. This paper uses the bioecological model of mass trauma to explore the impact of Russia's aggression against Ukraine and the ongoing war on HIV-positive people who use drugs in Ukraine, a particularly vulnerable population that may be negatively affected by disruptions to social networks, healthcare infrastructure and economic conditions caused by mass trauma. METHODS Data were collected between September and November 2022. A convenience sample of 18 HIV-positive people who use drugs were recruited from community organizations that work with people living with HIV, drug treatment programmes, and HIV clinics through direct recruitment and participant referral. A total of nine men and nine women were recruited; the age ranged from 33 to 62 years old (mean = 46.44). Participants completed a single interview that explored how the war had affected their daily lives and access to HIV care and other medical services; their relationships with healthcare providers and social workers; and medication access, supply and adherence. Data were analysed using the Framework Method for thematic analysis. RESULTS The war had a profound impact on the social, emotional and financial support networks of participants. Changes in social networks, coupled with limited job opportunities and rising prices, intensified financial difficulties for participants. Relocating to different regions of Ukraine, staying at somebody else's home, and losing connections with social workers impacted medication adherence and created lengthy treatment gaps. Participants also experienced a decreased supply of antiretroviral therapy, concerns about accessing medication for opioid use disorder, and overwhelming fears associated with the war, which overshadowed their HIV-related health concerns and negatively impacted medication adherence. CONCLUSIONS Our analysis reveals the complex impact of war on social networks and healthcare access. Maintaining support networks and competent healthcare providers will be essential amid the ongoing war.
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Affiliation(s)
- Jill Owczarzak
- Department of Health, Behavior & SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Olivia Monton
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Shannon Fuller
- Department of Health, Behavior & SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Julia Burlaka
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | | | - Olga Morozova
- Biological Sciences DivisionDepartment of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
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Akinlotan MA, Marouf F, Esplin B, Horel S, Bolin JN, Ferdinand AO. The Impact of Immigration Policy Changes on Preterm Birth Rates in Texas: An Examination of Border and Nonborder Regions. Womens Health Issues 2024; 34:361-369. [PMID: 38724342 DOI: 10.1016/j.whi.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 02/29/2024] [Accepted: 03/25/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Our study examined the acute and sustained impact of immigration policy changes announced in January 2017 on preterm birth (PTB) rates among Hispanic and non-Hispanic white women in Texas's border and nonborder regions. METHODS Using Texas birth certificate data for years 2008 through 2020, we used a multiple group interrupted time series approach to explore changes in PTB rates. RESULTS In the nonborder region, the PTB rate among Hispanic women of any race was 8.64% in 2008 and was stable each year before 2017 but increased by .29% (95% CI [.12, .46]) annually between 2017 and 2020. This effect remained statistically significant even when compared with that of non-Hispanic white women (p = .014). In the border areas, the PTB rate among Hispanic women of any race was 11.67% in 2008 and remained stable each year before and after 2017. No significant changes were observed when compared with that of non-Hispanic white women (p = .897). In Texas as a whole, the PTB rate among Hispanic women of any race was 10.16% in 2008 and declined by .07% (95% CI [-.16, -.03]) per year before 2017, but increased by .16% (95% CI [.05, .27]) annually between 2017 and 2020. The observed increase was not statistically significant when compared with that of non-Hispanic white women (p = .326). CONCLUSIONS The January 2017 immigration policies were associated with a sustained increase in PTB among Hispanic women in Texas's nonborder region, suggesting that geography plays an important role in perceptions of immigration enforcement. Future research should examine the impact of immigration policies on maternal and child health, considering geography and sociodemographic factors.
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Affiliation(s)
- Marvellous A Akinlotan
- School of Dentistry, Texas A&M University, Dallas, Texas; Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas.
| | - Fatma Marouf
- School of Public Health, Texas A&M University, College Station, Texas
| | - Bryn Esplin
- School of Law, Texas A&M University, Fort Worth, Texas
| | - Scott Horel
- Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas; School of Public Health, Texas A&M University, College Station, Texas
| | - Jane N Bolin
- Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas; School of Public Health, Texas A&M University, College Station, Texas; School of Nursing, Texas A&M University, Bryan, Texas
| | - Alva O Ferdinand
- Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas; School of Public Health, Texas A&M University, College Station, Texas
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Martins ALJ, Paes-Sousa R. The paradox of growing technical capacities with low global governance: a review of Voluntary National Reviews' SDG health-related indicators. Global Health 2024; 20:50. [PMID: 38907243 PMCID: PMC11193190 DOI: 10.1186/s12992-024-01051-x] [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] [Received: 05/02/2023] [Accepted: 05/17/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND This study delves into the States' accountability for health-related Sustainable Development Goal (SDG) indicators from 2016 to 2020. An analysis of Voluntary National Reviews (VNR) is employed as an instrument to scrutinize the alignment of States' indicators with the global indicator framework, shedding light on global health governance within the context of the 2030 Agenda and States' strategic prioritization. A curation of 60 health-related indicators from 195 VNRs, produced during the aforementioned period, is organized into thematic groups. RESULTS Our results highlight a concerning discrepancy in the reporting frequency of various health-related themes. The findings reveal a paradoxical coexistence characterized by the concurrent strengthening and diminution of the global health governance articulated in the Agenda's global health governance. This manifests in the increased utilization and consistency of health-related indicators over the study years, coupled with an emphasis on infectious diseases and child and maternal health indicators. Conversely, a discernible governance decline is evidenced by the inadequate representation of health-related indicators in VNRs, notably within the domains of universal health coverage and health system indicators. Furthermore, High-Income States exhibit diminished accountability. CONCLUSIONS The VNRs unveil a paradox wherein burgeoning technical capacity coexists with governance deficits, a phenomenon attributable to both statistical capabilities and political preferences. The prevalent use of proxy indicators in VNRs oversimplifies the presentation of official indicators, thereby compromising the aspirational goal of pioneering statistical innovations for measuring intricate issues in the SDGs. In light of our conceptualization of the 2030 Agenda's global health as a regime complex governance, we advocate for comprehensive investigations into each health regime cluster. This approach aims to unravel disputes, discern patterns, and elucidate States' preferences concerning specific thematic areas. Functioning as an accountability mechanism for the Agenda's governance, VNRs underscore States' adaptability and short-term learning capabilities, offering valuable insights for identifying harmful goal prioritization. The discretionary nature of indicator selection by States in the VNRs, enabled by the Agenda's proposition of a contextual adaptation of the SDGs and a blind eye to the guideline's request to review all SDG indicators, highlights a critical flaw in the VNR as an accountability mechanism.
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Affiliation(s)
- Ana Luisa Jorge Martins
- Health and Social Protection Policies Research Group, René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Av. Augusto de Lima, 1715. Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
| | - Rômulo Paes-Sousa
- Health and Social Protection Policies Research Group, René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Av. Augusto de Lima, 1715. Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
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Soares GH, Haag D, Bastos JL, Mejia G, Jamieson L. Triple Jeopardy in Oral Health: Additive Effects of Immigrant Status, Education, and Neighborhood. JDR Clin Trans Res 2024:23800844241253518. [PMID: 38877725 DOI: 10.1177/23800844241253518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
PURPOSE To estimate the additive effects of parent's nativity status/language spoken at country of birth, education, and area-level socioeconomic status (SES) on untreated dental caries among children aged 5 to 9 y in Australia. METHODS Cross-sectional population-based data were obtained from the 2014 National Child Oral Health Study (N = 12,140). Indicators of social position used to explore additive effects on dental caries included nativity status, language, university degree, and neighborhood socioeconomic level. Multiple-way interactions were examined, and departure from additivity resulting from 2- and 3-way interactions were estimated as relative excess risk due to interaction (RERI). RESULTS Children marginalized across multiple layers of disadvantage had substantially higher frequencies of dental caries compared with children in the most advantaged category. RERI for the 3-way interaction between immigrant status, education, and neighborhood SES was negative (RERI3: -0.14; 95% confidence interval [CI]: -1.68, 1.40). When operationalizing language, education, and neighborhood SES, the joint effect of the 3 marginalized positions was additive (RERI3: 0.43; 95% CI: -2.08, 2.95). CONCLUSION Children marginalized across multiple intersecting axes of disadvantage bear the greatest burden of dental caries, with frequencies surpassing the cumulative effect of each social position alone. Findings emphasize the need to account for intersecting inequities and their oral health effects among children with immigrant backgrounds. KNOWLEDGE TRANSFER STATEMENT Our analysis underscores the necessity for policies and public health strategies targeting dental caries-related inequities to comprehensively account for various indicators of social disadvantage, particularly encompassing language proficiency, educational attainment, and neighborhood socioeconomic status. Within the intricate interplay of these factors, we identify a vulnerable subgroup comprising children with the highest prevalence of dental decay. Therefore, prioritizing this specific demographic should be the focal point of policies and public health initiatives aimed at fostering equitable oral health outcomes.
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Affiliation(s)
- G H Soares
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - D Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - J L Bastos
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - G Mejia
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - L Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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Montoya-Williams D, Barreto A, Laguna-Torres A, Worsley D, Wallis K, Peña MM, Palladino L, Salva N, Levine L, Rivera A, Hernandez R, Fuentes-Afflick E, Yun K, Lorch S, Virudachalam S. Philadelphia Latine Immigrant Birthing People's Perspectives on Mitigating the Chilling Effect on Prenatal Care Utilization. Med Care 2024; 62:404-415. [PMID: 38728679 PMCID: PMC11090453 DOI: 10.1097/mlr.0000000000002002] [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: 05/12/2024]
Abstract
RESEARCH DESIGN Community-engaged qualitative study using inductive thematic analysis of semistructured interviews. OBJECTIVE To understand Latine immigrants' recent prenatal care experiences and develop community-informed strategies to mitigate policy-related chilling effects on prenatal care utilization. BACKGROUND Decreased health care utilization among immigrants due to punitive immigration policies (ie, the "chilling effect") has been well-documented among Latine birthing people both pre and postnatally. PATIENTS AND METHODS Currently or recently pregnant immigrant Latine people in greater Philadelphia were recruited from an obstetric clinic, 2 pediatric primary care clinics, and 2 community-based organization client pools. Thematic saturation was achieved with 24 people. Participants' pregnancy narratives and their perspectives on how health care providers and systems could make prenatal care feel safer and more comfortable for immigrants. RESULTS Participants' recommendations for mitigating the chilling effect during the prenatal period included training prenatal health care providers to sensitively initiate discussions about immigrants' rights and reaffirm confidentiality around immigration status. Participants suggested that health care systems should expand sources of information for pregnant immigrants, either by partnering with community organizations to disseminate information or by increasing access to trusted individuals knowledgeable about immigrants' rights to health care. Participants also suggested training non-medical office staff in the use of interpreters. CONCLUSION Immigrant Latine pregnant and birthing people in greater Philadelphia described ongoing fear and confusion regarding the utilization of prenatal care, as well as experiences of discrimination. Participants' suggestions for mitigating immigration-related chilling effects can be translated into potential policy and programmatic interventions which could be implemented locally and evaluated for broader applicability.
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Affiliation(s)
- Diana Montoya-Williams
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- CHOP PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Alejandra Barreto
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alicia Laguna-Torres
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Diana Worsley
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- CHOP PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kate Wallis
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of Developmental-Behavioral Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michelle-Marie Peña
- Department of Pediatrics, Division of Neonatology, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Lauren Palladino
- Division of Emergency Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Nicole Salva
- Department of Obstetrics and Gynecology, Penn Medicine, Philadelphia, PA, USA
| | - Lisa Levine
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Obstetrics and Gynecology, Penn Medicine, Philadelphia, PA, USA
| | | | | | - Elena Fuentes-Afflick
- Division of General Pediatrics University of California, San Francisco, San Francisco, CA
| | - Katherine Yun
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Scott Lorch
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- CHOP PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Senbagam Virudachalam
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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Samari G, Wurtz HM, Abularrage TF, Sharif MZ. Structural gendered racism as conceptualized by immigrant women in the United States. Soc Sci Med 2024; 351 Suppl 1:116396. [PMID: 38825373 PMCID: PMC11149896 DOI: 10.1016/j.socscimed.2023.116396] [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] [Received: 04/20/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 06/04/2024]
Abstract
RATIONALE Immigrants represent a rapidly growing proportion of the population, yet the many ways in which structural inequities, including racism, xenophobia, and sexism, influence their health remains largely understudied. Perspectives from immigrant women can highlight intersectional dimensions of structural gendered racism and the ways in which racial and gender-based systems of structural oppression interact. OBJECTIVE This study aims to show the multilevel manifestations of structural gendered racism in the health experiences of immigrant women living in New York City. METHOD Semi-structured, in-depth interviews were conducted in 2020 and 2021 with 44 cisgender immigrant women from different national origins in New York City to explore how immigrant women experienced structural gendered racism and its pathways to their health. Interviews were thematically analyzed using a constant comparative approach. RESULTS Participants expressed intersectional dimensions of structural gendered racism and the anti-immigrant climate through restrictive immigration policy and issues related to citizenship status, disproportionate immigration enforcement and criminalization, economic exploitation, and gendered interpersonal racism experienced across a range of systems and contexts. Participants weighed their concerns for safety and facing racism as part of their life course and health decisions for themselves and their families. CONCLUSIONS The perspectives and experiences of immigrant women are key to identifying multilevel solutions for the burdens of structural gendered racism, particularly among individuals and communities of non-U.S. national origin. Understanding how racism, sexism, xenophobia, and intersecting systems of oppression impact immigrant women is critical for advancing health equity.
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Affiliation(s)
- Goleen Samari
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
| | - Heather M Wurtz
- Anthropology Department, University of Connecticut, Storrs, CT, USA; Research Program on Global Health & Human Rights, Human Rights Institute, University of Connecticut, Storrs, CT, USA; Population Studies and Training Center, Brown University, Providence, RI, USA
| | - Tara F Abularrage
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Mienah Z Sharif
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles, CA, USA
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Kumar BN, Bhopal A, Blanchet K, Wickramage K, Onarheim KH. Priority setting and migration health policies for European countries. THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100804. [PMID: 39119096 PMCID: PMC11306211 DOI: 10.1016/j.lanepe.2023.100804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/09/2023] [Accepted: 11/16/2023] [Indexed: 08/10/2024]
Abstract
The 2030 Sustainable Development Goals (SDG) agenda has committed to 'ensuring that no one is left behind'. Applying the right to health of non-citizens and international migrants is challenging in today's highly polarized political discourse on migration governance and integration. We explore the role of a priority setting approach to help support better, fairer and more transparent policy making in migration health. A priority setting approach must also incorporate migration health for more efficient and fair allocation of scarce resources. Explicitly recognizing the trade-offs as part of strategic planning, would circumvent ad hoc decision-making during crises, not well-suited for fairness. Discussions surrounding decisions about expanding services to migrants or subgroups of migrants, which services and to whom should be transparent and fair. We conclude that a priority setting approach can help better inform policy making by being more closely aligned with the practical challenges policy makers face towards the progressive realization of migration health.
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Affiliation(s)
- Bernadette N. Kumar
- Division of Health Services Research, Norwegian Institute of Public Health, Norway
| | - Anand Bhopal
- Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Norway
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, USA
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, Faculty of Medicine University of Geneva, Switzerland
| | - Kolitha Wickramage
- Head, Global Migration Health Research & Epidemiology Unit, Migration Health Division, Global Data Institute (GDI), Berlin, Germany
| | - Kristine Husøy Onarheim
- Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Norway
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Wanigaratne S, Shah B, Stukel TA, Lu H, Den Otter-Moore S, Shetty J, Saunders N, Gandhi S, Guttmann A. COVID-19 hospitalization, mortality and pre-mature mortality by a history of immigration in Ontario, Canada: a population-based cohort study. LANCET REGIONAL HEALTH. AMERICAS 2024; 34:100762. [PMID: 38779655 PMCID: PMC11109005 DOI: 10.1016/j.lana.2024.100762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
Background Immigrants in high-income countries experienced inequities in COVID-19 severe outcomes. We examined hospitalization and death throughout the pandemic, and change during the vaccine era, in Ontario, Canada. Methods We conducted a population-based study using linked immigration and health data, following two cohorts for 20 months from January 1, 2020 (pre-vaccine) and September 1, 2021 (vaccine era). We used multivariable Poisson generalized estimating equation regression to estimate adjusted rate ratios (aRR) with 95% confidence intervals (CI), accounting for age, sex and co-morbidities. We calculated age-standardized years of life lost (ASYRs) rates by immigrant category. Findings Of 11,692,387 community-dwelling adults in the pre-vaccine era cohort and 11,878,304 community-dwelling adults in the vaccine era cohort, 21.6% and 21.4% of adults in each era respectively were immigrants. Females accounted for 57.9% and 57.8% of sponsored family, and 68.4% and 67.6% of economic caregivers, in each era respectively. Compared to other Ontarians in the pre-vaccine era cohort, hospitalization rates were highest for refugees (aRR [95% CI] 3.41 [3.39-3.44]) and caregivers (3.13 [3.07-3.18]), followed by sponsored family and other economic immigrants. Compared to other Ontarians, aRRs were highest for immigrants from Central America (5.00 [4.92-5.09]), parts of South Asia (3.95 [3.89-4.01]) and Jamaica (3.56 [3.51-3.61]) with East Asians having lower aRRs. Mortality aRRs were similar to hospitalization aRRs. In the vaccine era, all aRRs were attenuated and most were similar to or lower than other Ontarians, with refugees and a few regions maintaining higher rates. In the pre-vaccine era ASYRs were higher for all immigrant groups. ASYRs dropped in the vaccine era with only refugees continuing to have higher rates. Interpretation Immigrants, particularly refugees, experienced greater premature mortality. aRRs for most immigrant groups dropped substantially after high vaccine coverage was achieved. Vaccine outreach and improvements in the social determinants of health are needed. Funding Canadian Institutes of Health Research, Canada Research Chairs Program.
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Affiliation(s)
- Susitha Wanigaratne
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada
| | - Baiju Shah
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Therese A. Stukel
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada
| | | | | | - Janavi Shetty
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada
| | - Natasha Saunders
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | | | - Astrid Guttmann
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Okuyan CB, Bilgili N. Assessment of health perceptions, use of health services and traditional health practices of Afghan immigrants in Türkiye. Glob Health Promot 2024:17579759241243365. [PMID: 38822634 DOI: 10.1177/17579759241243365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
Immigration, as a social determinant of health, encompasses several social and economic transformations. Neglecting to adequately address this issue could potentially worsen pre-existing challenges within health systems and in the management of migration. In the present study, we aim to evaluate the health perceptions, traditional health practices and use of health services of Afghan immigrants. We enrolled 1597 Afghan immigrants over 18 years old in the descriptive cross-sectional research. The mean age of the immigrants was 49.19 ± 1.6 years. The smallest number of points that can be achieved on the health perception scale is 15, while the greatest number is 75. We found that the health perception scale average score is 37.61 ± 7.32. Some factors, such as age 65 and over, female gender, postgraduate education level, good social insurance and economic status, being a public officer, not having any infectious diseases, and having a good Turkish level, have positively affected the health perception levels (p < 0.05). Moreover, we observed that cultural differences, expensive health care, a lack of social insurance, fear and anxiety, lack of language skills, waiting times and traditional health practices were the most common barriers to accessing healthcare services. Considering these issues in the health system, identifying the factors that negatively affect the perception of health and related to the use of health services can help immigrants increase their use of health services and improve their health.
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Affiliation(s)
- Canan Birimoglu Okuyan
- Department of Public Health Nursing, Faculty of Health Sciences, Sakarya University of Applied Sciences, Sakarya, Türkiye
| | - Naile Bilgili
- 2Department of Public Health Nursing, Faculty of Nursing, Gazi University, Ankara, Türkiye
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Abularrage TF, Wurtz HM, Samari G. Responding to structural inequities: Coping strategies among immigrant women during COVID-19. SSM - MENTAL HEALTH 2024; 5:100293. [PMID: 38910842 PMCID: PMC11192517 DOI: 10.1016/j.ssmmh.2023.100293] [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: 06/25/2024] Open
Abstract
Examining coping strategies and resilience among immigrant communities reflects a commitment to working with immigrant communities to understand their needs while also identifying and building upon their strengths. In the United States, the physical, emotional, and economic impacts of the COVID-19 pandemic intersected with existing structural inequities to produce distinct challenges and stressors related to the pandemic, immigration, caregiving responsibilities, and structural xenophobia. Leveraging an understanding of the multilevel effects of stress, this qualitative study explores individual, interpersonal, and community-level coping strategies immigrant women used to respond to, alleviate, or reduce distress related to these compounding stressors. Using semi-structured in-depth interviews conducted in 2020 and 2021 with 44 first- and second-generation cisgender immigrant women from different national origins and 19 direct service providers serving immigrant communities in New York City, data were coded and analyzed using a constant comparative approach. Four central themes were identified: caregiving as a source of strength, leveraging resources, social connections, and community support. While women described a range of coping strategies they used to manage stressors and challenges, perspectives from direct service providers also connect these coping strategies to the harm-generating institutions, policies, and structures that produce and uphold structural oppression and inequities. Accounts from service providers point to the detrimental long-term effects of prolonged coping, underscoring a duality between resilience and vulnerability. Exploring the coping strategies cisgender immigrant women used to ease distress and promote resilience during a period of heightened structural vulnerability is critical to centering the experiences of immigrant women while simultaneously directing attention towards addressing the fundamental causes of cumulative disadvantage and the systems and structures through which it is transmitted.
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Affiliation(s)
- Tara F. Abularrage
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Heather M. Wurtz
- Anthropology Department, University of Connecticut, Storrs, CT, USA
- Research Program on Global Health & Human Rights, Human Rights Institute, University of Connecticut, Storrs, CT, USA
- Population Studies and Training Center, Brown University, Providence, RI, USA
| | - Goleen Samari
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Li D, Gao D, Yamada M, Chen C, Xiang L, Nie H. Healthcare-seeking behavior and spatial variation of internal migrants with chronic diseases: a nationwide empirical study in China. GEOSPATIAL HEALTH 2024; 19. [PMID: 38804697 DOI: 10.4081/gh.2024.1255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/03/2024] [Indexed: 05/29/2024]
Abstract
Individuals migrating with chronic diseases often face substantial health risks, and their patterns of healthcare-seeking behavior are commonly influenced by mobility. However, to our knowledge, no research has used spatial statistics to verify this phenomenon. Utilizing data from the China Migrant Dynamic Survey of 2017, we conducted a geostatistical analysis to identify clusters of chronic disease patients among China's internal migrants. Geographically weighted regressions were utilized to examine the driving factors behind the reasons why treatment was not sought by 711 individuals among a population sample of 9272 migrant people with chronic diseases. The results indicate that there is a spatial correlation in the clustering of internal migrants with chronic diseases in China. The prevalence is highly clustered in Zhejiang and Xinjiang in north-eastern China. Hotspots were found in the northeast (Jilin and Liaoning), the north (Hebei, Beijing, and Tianjin), and the east (Shandong) and also spread into surrounding provinces. The factors that affect the migrants with no treatment were found to be the number of hospital beds per thousand population, the per capita disposable income of medical care, and the number of participants receiving health education per 1000 Chinese population. To rectify this situation, the local government should "adapt measures to local conditions." Popularizing health education and coordinating the deployment of high-quality medical facilities and medical workers are effective measures to encourage migrants to seek reasonable medical treatment.
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Affiliation(s)
- Dan Li
- United Graduate School of Agricultural Science, Tokyo University of Agriculture and Technology.
| | - Dawei Gao
- College of Economics and Management, Zhengzhou University of Light Industry, Henan Province.
| | - Masaaki Yamada
- Division of International Environmental and Agricultural Science, Institute of Agriculture, Tokyo University of Agriculture and Technology.
| | - Chuangbin Chen
- Business School, Shantou University, Shantou City, Guangdong Province.
| | - Liuchun Xiang
- United Graduate School of Agricultural Science, Tokyo University of Agriculture and Technology.
| | - Haisong Nie
- Division of International Environmental and Agricultural Science, Institute of Agriculture, Tokyo University of Agriculture and Technology.
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El Arab RA, Urbanavice R, Jakavonyte-Akstiniene A, Skvarcevskaja M, Austys D, Briones-Vozmediano E, Rubinat-Arnaldo E, Istomina N. "We want our freedom back, that's our only need": a qualitative study of health and social needs among asylum seekers and undocumented migrants crossing the borders from Belarus to Lithuania. Front Public Health 2024; 12:1371119. [PMID: 38756883 PMCID: PMC11096443 DOI: 10.3389/fpubh.2024.1371119] [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: 01/15/2024] [Accepted: 03/20/2024] [Indexed: 05/18/2024] Open
Abstract
Background The influx of undocumented migrants and asylum seekers into Lithuania, particularly during the COVID-19 pandemic, presents unique public health challenges. This study employs the Social Determinants of Health framework to explore the healthcare and social needs of this vulnerable population. Methods In May 2022, we carried out a qualitative study through semi-structured interviews with asylum seekers across four centers in Lithuania. Employing both purposive and snowball sampling techniques, we selected participants for our investigation. The study comprised 21 interviews-19 conducted in Arabic and 2 in English-with durations ranging between 20 and 40 min each. We audio-recorded all interviews, transcribed them verbatim, and subsequently performed a thematic analysis using Atlas.ti software. This process of design and analysis strictly followed the principles of thematic analysis as outlined by Braun and Clarke, guaranteeing methodological precision and rigor. Findings 21 interviews revealed critical insights into the healthcare access challenges, mental health issues, and social integration barriers faced by the participants. Key themes included 'Healthcare Needs and the Impact of the COVID-19 Pandemic 'and 'Social needs and Aspirations Amidst Pandemic-Induced Uncertainty '. The findings highlight the multifaceted healthcare and social needs of asylum seekers, juxtaposed against significant barriers they face. Access to medical services is hindered by long waiting times and financial constraints, especially for specialized care such as dental services. Communication issues during medical appointments due to language barriers and the lack of gender-specific healthcare, such as access to gynecological services, further exacerbate the challenges. Additionally, the COVID-19 pandemic introduces hurdles such as limited testing, isolation measures, language-specific information barriers, and insufficient social distancing practices. Mental health has emerged as a critical concern, with asylum seekers reporting significant stress and emotional exhaustion due to uncertainty and restrictive living conditions. Social needs extend to delayed asylum application processes, inconsistent language education opportunities, inadequate clothing, and nutrition that lacks cultural sensitivity, and living conditions characterized by overcrowding and insufficient facilities. The restricted freedom of movement within asylum seeking centres severely impacts their psychological well-being, underscoring a deep longing for autonomy and a better life despite the myriad of challenges faced. Discussion The study illustrates the complex interplay between migration, health, and social factors in the context of a global pandemic. It highlights the need for culturally sensitive healthcare services, mental health support, and structured language education programs. Offering educational avenues alongside language courses for children and adults is essential for fostering social inclusion and securing economic prosperity. Addressing the challenge of language barriers is of utmost importance, as these barriers significantly impede undocumented migrants' and asylum seekers employment opportunities and their access to crucial services. The findings emphasized immigration as a health determinant and underscored the importance of inclusive health policies and advocacy for undocumented migrants and asylum seekers' rights and needs. Conclusion There is an urgent need for comprehensive policies and practices that are grounded in the principles of equity, compassion, and human rights. Additionally, advocating for practice adaptations that are culturally sensitive, linguistically inclusive, and responsive to the unique challenges faced by undocumented migrants and asylum seekers. As global migration continues to rise, these findings are crucial for informing public health strategies and social services that cater to the diverse needs of this vulnerable population.
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Affiliation(s)
- Rabie Adel El Arab
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Healthcare Research Group (GRECS), Institute for Biomedical Research (IRBLleida), Lleida, Spain
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania
- Department of Health Management and Informatics, AlMoosa College of Health Sciences, Al Ahsa, Saudi Arabia
| | - Rita Urbanavice
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania
- Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Agne Jakavonyte-Akstiniene
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania
- Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Marija Skvarcevskaja
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania
- Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Donatas Austys
- Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Erica Briones-Vozmediano
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Healthcare Research Group (GRECS), Institute for Biomedical Research (IRBLleida), Lleida, Spain
| | - Esther Rubinat-Arnaldo
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Healthcare Research Group (GRECS), Institute for Biomedical Research (IRBLleida), Lleida, Spain
| | - Natalja Istomina
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania
- Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Premji S, Begum M, Laila K, Jahangir S, Zvric A. The Health and Safety Experiences of Precariously Employed Bangladeshi Immigrant Workers in Toronto During the COVID-19 Pandemic. New Solut 2024; 34:38-51. [PMID: 38483872 PMCID: PMC11003198 DOI: 10.1177/10482911241239263] [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: 04/10/2024]
Abstract
Racialized immigrants in Canada have been disproportionately impacted by the COVID-19 pandemic. Our qualitative, community-based study with South Asian Women and Immigrants' Services examined the impact of the second and third waves of the pandemic on the work and health of precariously employed Bangladeshi immigrant women and men in Toronto. Our study is based on interviews and focus group discussions with 45 workers, all conducted in Bangla, and 11 key informants. Interviews reveal work transitions, an increase in precarity, work in essential sectors, exposures at work, home and in transit, workplace prevention and management gaps, and an inability to take time off, with significant impacts on workers' physical and mental health. We discuss the implications of our findings for prevention, preparedness, and response by workplaces and governments to decrease the risk and reduce the impact of infectious diseases emergencies in the precarious work sector.
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Affiliation(s)
- Stephanie Premji
- School of Labour Studies, McMaster University, Hamilton, ON, Canada
| | - Momtaz Begum
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kishower Laila
- South Asian Women and Immigrants’ Services, Toronto, ON, Canada
| | | | - Adam Zvric
- School of Labour Studies, McMaster University, Hamilton, ON, Canada
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Wahlström E, Wallander F, Stier J. Vacillating between "strange" and "familiar" - representations of children in migrant families and their health in Swedish school health services. Soc Sci Med 2024; 348:116809. [PMID: 38547808 DOI: 10.1016/j.socscimed.2024.116809] [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: 11/29/2023] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 04/29/2024]
Abstract
Representations of migrants influence how they are perceived by others. Hence, how children who have migrated or whose parents have migrated (Children in Migrant Families: CMFs) are represented in clinical practice guidelines (CPGs) for Swedish school health services (SHS) may influence how they are perceived by school nurses. Thus, this study aimed to explore representations of CMFs in school nurses' CPGs. Data consisted of 130 CPGs from municipalities in Sweden. Documents were analyzed using the "What is the Problem Represented to be" (WPR) approach - an analytic strategy for investigating embedded assumptions of "problems". In the analysis, Sarah Ahmed's work on "strangers" and "strangeness" was applied. In the CPGs, the CMFs and their health were repeatedly mentioned in conjunction with the need for particular or additional actions, efforts, or routines when assessing or discussing their health, to a degree beyond what is "usually" provided. This need was motivated by representing the CMFs and their health as being the same, yet different in relation to "Swedish" children in general. Thus, the children were not only represented as different, but they were "foreignized". These representations of difference and foreignness placed the children on a continuum in relation to what is recognized as "familiar" in their health, and constructed elastic boundaries between the strange and the familiar. By illustrating how these boundaries were used for difference-making between "familiar" and "strange", this study showed how CMFs are alternately represented as similar and different, and foreignized while provided with SHS aiming to make them "familiar".
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Affiliation(s)
- Emmie Wahlström
- ChiP research group, School of health, care and social welfare, Mälardalen University, Västerås, 721 23, Sweden; School of health, care and social welfare, Mälardalen University, Västerås, 721 23, Sweden.
| | - Frida Wallander
- ChiP research group, School of health, care and social welfare, Mälardalen University, Västerås, 721 23, Sweden
| | - Jonas Stier
- ChiP research group, School of health, care and social welfare, Mälardalen University, Västerås, 721 23, Sweden; School of health, care and social welfare, Mälardalen University, Västerås, 721 23, Sweden
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McLaren F, Mercado M, Montalva N, Watkins L, Antipichun A, Cheristil J, Rocha-Jiménez T. Ethics in Mental Health Research with Haitian Migrants: Lessons from a Community-Based Study in Santiago, Chile. Ethics Hum Res 2024; 46:16-25. [PMID: 38629226 DOI: 10.1002/eahr.500209] [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: 04/19/2024]
Abstract
Migration research poses several unique challenges and opportunities. Conducting ethical global health practice, especially when studying migrant mental health, is of particular concern. This article explores seven challenges and lessons learned in our mixed-methods study conducted to assess the impact of the migration experience on Haitian migrants' mental health in Santiago, Chile. The primary challenges were recruiting in a highly mobile population, building trust and community participation, overcoming language barriers, safety considerations during the Covid-19 pandemic, mitigating potential negative impacts of research on the community, providing psychological support, and finding meaningful ways to benefit the community. We propose moving toward a better and more ethical migrant research practice by ensuring language accessibility, hiring community members for the study team, working with local institutions and nongovernmental organizations, and maintaining sustainable connections.
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Affiliation(s)
| | - Mercedes Mercado
- PhD student in psychology at the Universidad Diego Portales in Santiago, Chile
| | - Nicolás Montalva
- Associate professor at the Society and Health Research Center (CISS) at the School of Psychology of the Humanities and Social Sciences Faculty, Universidad Mayor, Santiago de Chile, a principal investigator of the Millennium Nucleus in Sociomedicine (SocioMed), Santiago de Chile, and a guest researcher at BirthRites Lise Meitner Research Group at the Max Planck Institute for Evolutionary Anthropology, Germany
| | - Loreto Watkins
- Researcher at the Universidad Diego Portales and at the Millennium Nucleus in Sociomedicine (SocioMed), Santiago, Chile
| | - Andy Antipichun
- Student in training of the Millennium Nucleus in Sociomedicine (SocioMed), Santiago, Chile
| | - Judeline Cheristil
- Member of the Haitian community and the field coordinator of the mentioned project affiliated with the ANID 11200486 project
| | - Teresita Rocha-Jiménez
- Associate professor at the Society and Health Research Center (CISS) at the School of Psychology of the Humanities and Social Sciences Faculty at Universidad Mayor, Santiago de Chile and a principal investigator of the Millennium Nucleus in Sociomedicine (SocioMed), Santiago de Chile
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Akalın N. Immigrant-blind care: How immigrants experience the "inclusive" health system as they access care. Soc Sci Med 2024; 348:116822. [PMID: 38569290 DOI: 10.1016/j.socscimed.2024.116822] [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: 05/17/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024]
Abstract
A growing body of scholarship examines the varying impact of legal status and race on accessing healthcare. However, a notable gap persists in comprehending the supplementary mechanisms that hinder immigrants' pathway to seek care. Drawing on ethnographic observations in various clinical settings and in-depth interviews with 28 healthcare professionals and 12 documented Haitian immigrants in a city in Upstate New York, between 2019 and 2021, I demonstrate the tension between the conceptualization and implementation of inclusive care practices by healthcare providers. I argue that the mere expansion and adoption of inclusive discourse among providers do not inherently ensure equity and the removal of barriers to healthcare access. This work contributes to the social study of medicine and race and ethnic studies by introducing the innovative concept of "immigrant-blind." Through this concept, the research sheds light on how providers' conceptualization of inclusivity proclaims medical encounters to be devoid of stratifications and rationalizes their practices which mask the profound impact of immigration status and immigration on immigrant health. Furthermore, these practices reinforce existing divisions within care settings and medical encounters, where immigration laws and enforcement practices operate and further exacerbate stratifications. By examining providers' uninformed implementation of culturally competent care practices, the findings reveal that providers stigmatize and essentialize immigrants during medical encounters. This highlights the imperative for a more nuanced and informed approach to healthcare provision, where genuine inclusivity is upheld, and barriers to access are dismantled to foster equitable and dignified healthcare experiences for all.
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Zeidan A, Cortes J, Marcovitch H, Chicas R, Smith RN, Stevens A, Zambrana E, Anand S. "Caminando Con Riesgo": perceptions of occupational injury, workplace safety and workers rights among Spanish-speaking hospitalized patients. Front Public Health 2024; 12:1347534. [PMID: 38716243 PMCID: PMC11074346 DOI: 10.3389/fpubh.2024.1347534] [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: 12/01/2023] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Occupational health disparities are well documented among immigrant populations and occupational injury remains a high cause of morbidity and mortality among immigrant populations. There are several factors that contribute to the high prevalence of work-related injury among this population and those without legal status are more likely to experience abusive labor practices that can lead to injury. While the work-related injuries and experiences of Spanish-speaking workers have been explored previously, there is a paucity of literature documenting injury among hospitalized patients. Additionally, there are few documented hospital-based occupational injury prevention programs and no programs that implement workers rights information. The purpose of this study was to further explore the context of work related injuries primarily experienced by Spanish speaking patients and knowledge of their rights in the workplace. Methods This was a semi-structured qualitative interview study with Spanish speaking patients admitted to the hospital for work related injuries. The study team member conducting interviews was bilingual and trained in qualitative methodology. An interview guide was utilized for all interviews and was developed with an immigrant workers rights organization and study team expertise, and factors documented in the literature. Participants were asked about the type and context of the injury sustained, access and perceptions of workplace safety, and knowledge of participants rights as workers. All interviews were conducted in Spanish, recorded, transcribed in Spanish and then translated into English. A codebook was developed and refined iteratively and two independent coders coded all English transcripts using Dedoose. Interviews were conducted until thematic saturation was reached and data was analyzed using a thematic analysis approach. Results A total of eight interviews were completed. All participants reported working in hazardous conditions that resulted in an injury. Participants expressed a relative acceptance that their workplace environment was dangerous and acknowledged that injuries were common, essentially normalizing the risk of injury. There were varying reports of access to and utilization of safety information and equipment and employer engagement in safety was perceived as a facilitator to safety. Most participants did have some familiarity with Occupational Safety and Health Administration (OSHA) inspections but were not as familiar with OSHA procedures and their rights as workers. Discussion We identified several themes related to workplace injury among Spanish speaking patients, many of which raise concerns about access to workplace safety, re-injury and long-term recovery. The context around immigration is particularly important to consider and may lead to unique risk factors for injury, recovery, and re-injury both in the workplace and beyond the workplace, suggesting that perhaps immigration status alone may serve as a predisposition to injury. Thus, it is critical to understand the context around work related injuries in this population considering the tremendous impact of employment on one's health and financial stability. Further research on this topic is warranted, specifically the exploration of multiple intersecting layers of exposure to injury among immigrant populations. Future work should focus on hospital-based strategies for injury prevention and know your rights education tailored to Spanish speaking populations.
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Affiliation(s)
- Amy Zeidan
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Juliana Cortes
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | | | - Roxana Chicas
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Randi N. Smith
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States
| | | | | | - Shelly Anand
- Sur Legal Collaborative, Atlanta, GA,United States
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Wong J, Lao C, Dino G, Donyaei R, Lui R, Huynh J. Vaccine Hesitancy among Immigrants: A Narrative Review of Challenges, Opportunities, and Lessons Learned. Vaccines (Basel) 2024; 12:445. [PMID: 38793696 PMCID: PMC11126062 DOI: 10.3390/vaccines12050445] [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: 03/08/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/26/2024] Open
Abstract
(1) Background: Vaccination reluctance is a major worldwide public health concern as it poses threats of disease outbreaks and strains on healthcare systems. While some studies have examined vaccine uptake within specific countries, few provide an overview of the barriers and trends among migrant groups. To fill this knowledge gap, this narrative review analyzes immunization patterns and vaccine hesitancy among immigrant populations. (2) Methods: Four researchers independently evaluated the quality and bias risk of the 18 identified articles using validated critical appraisal tools. (3) Results: Most studies focused on vaccine hesitancy among migrants in the United States and Canada, with a higher COVID-19 vaccine reluctance than native-born residents. Contributing factors to this hesitancy include demographics, cultural views, obstacles to healthcare access, financial hardship, and distrust in health policies. Additionally, immigrants in North America and Europe face unfair vaccine challenges due to misinformation, safety concerns, personal perspectives, language barriers, immigration status, and restricted healthcare access. (4) Conclusions: Tailored vaccine education programs and outreach campaigns sensitive to immigrants' diversity should be developed to address this issue. It is also important to investigate community-specific obstacles and assess the long-term sustainability of current efforts to promote vaccination among marginalized migrant groups. Further research into global immunization disparities among immigrant populations is crucial.
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Affiliation(s)
- Jason Wong
- College of Pharmacy, Western University of Health Sciences, 309 E. Second St., Pomona, CA 91766, USA; (C.L.); (G.D.); (R.D.); (R.L.); (J.H.)
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Hernandez M, Perry GH. Latiné immigrant heterogeneity: Striking health differences among Cuban refugee/migration waves to the United States. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.17.24305856. [PMID: 38699377 PMCID: PMC11065033 DOI: 10.1101/2024.04.17.24305856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Latiné people differ markedly in our lived experiences in ways that are underappreciated. Meanwhile, variations in social experiences are known to be associated with differential health outcomes. We test whether immigration history is associated with health differences among U.S.-based Cuban refugees. Cubans from the circum-1980 Mariel Boatlift migration wave reported significantly higher instances of disability than Early Cuban Exiles, Freedom Flight refugees, and Special Period refugees. We also interviewed Miami-based Cubans. Participants described heightened discrimination in 1980s Cuba and U.S., which we hypothesize contributed to higher instances of disability refugees of that era. By understanding how differential social experiences shape health, we aim to provide a nuanced understanding of the social determinants of health and the ways adverse experiences can be combated.
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Affiliation(s)
- M Hernandez
- Department of Anthropology, Penn State University; University Park, PA 16802, United States
| | - G H Perry
- Department of Anthropology, Penn State University; University Park, PA 16802, United States
- Department of Biology, Penn State University; University Park, PA 16802, United States
- Huck Institutes of the Life Sciences, Penn State University; University Park, PA 16802, United States
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46
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Wirtz AL, Stevenson M, Guillén JR, Ortiz J, Barriga Talero MÁ, Page KR, López JJ, Ramirez Correa JF, Martínez Porras D, Luque Núñez R, Fernández-Niño JA, Spiegel PB. Persistent Food Insecurity and Material Hardships: A Latent Class Analysis of Experiences among Venezuelan Refugees and Migrants in Urban Colombia. Nutrients 2024; 16:1060. [PMID: 38613093 PMCID: PMC11013044 DOI: 10.3390/nu16071060] [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] [Received: 02/28/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
The causes and conditions of displacement often increase the vulnerability of migrant and refugee populations to food insecurity, alongside other material hardships. We aimed to examine the multidimensional aspects and patterns of food insecurity and other material hardships in a cross-sectional sample of 6221 Venezuelan refugees and migrants in urban Colombia using a latent class analysis. Using multinomial and logistic regression models, we investigated the demographic and migratory experiences associated with identified classes and how class membership is associated with multiple health outcomes among Venezuelan refugees and migrants, respectively. Approximately two thirds of the sample was comprised cisgender women, and the participants had a median age of 32 years (IQR: 26-41). Four heterogeneous classes of food insecurity and material hardships emerged: Class 1-low food insecurity and material hardship; Class 2-high food insecurity and material hardship; Class 3-high income hardship with insufficient food intake; and Class 4-income hardship with food affordability challenges. Class 2 reflected the most severe food insecurity and material hardships and had the highest class membership; Venezuelans with an irregular migration status were almost 1.5 times more likely to belong to this class. Food insecurity and material hardship class membership was independently associated with self-rated health, mental health symptoms, and recent violence victimization and marginally associated with infectious disease outcomes (laboratory-confirmed HIV and/or syphilis infection). Social safety nets, social protection, and other interventions that reduce and prevent material hardships and food insecurity among refugees and migrants, alongside the host community, may improve public health, support development, and reduce healthcare costs. In the long term, regularization and social policies for migrants aimed at enhancing refugees' and migrants' social and economic inclusion may contribute to improving food security in this population.
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Affiliation(s)
- Andrea L. Wirtz
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.S.); (K.R.P.)
- Department of International Health, Center for Humanitarian Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Megan Stevenson
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.S.); (K.R.P.)
| | - José Rafael Guillén
- Red Somos, Bogotá 111321, Colombia; (J.R.G.); (J.O.); (M.Á.B.T.); (J.J.L.); (J.F.R.C.); (D.M.P.)
| | - Jennifer Ortiz
- Red Somos, Bogotá 111321, Colombia; (J.R.G.); (J.O.); (M.Á.B.T.); (J.J.L.); (J.F.R.C.); (D.M.P.)
| | | | - Kathleen R. Page
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.S.); (K.R.P.)
- Department of International Health, Center for Humanitarian Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA;
- Department of Infectious Disease, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Jhon Jairo López
- Red Somos, Bogotá 111321, Colombia; (J.R.G.); (J.O.); (M.Á.B.T.); (J.J.L.); (J.F.R.C.); (D.M.P.)
| | | | - Damary Martínez Porras
- Red Somos, Bogotá 111321, Colombia; (J.R.G.); (J.O.); (M.Á.B.T.); (J.J.L.); (J.F.R.C.); (D.M.P.)
| | | | | | - Paul B. Spiegel
- Department of International Health, Center for Humanitarian Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA;
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Lee CS, Sirin SR, Choi E, Sin EJ. Meta-Analysis of Acculturation and Suicide-Related Outcomes: A Test of the Immigrant Paradox. J Racial Ethn Health Disparities 2024; 11:913-927. [PMID: 36943654 DOI: 10.1007/s40615-023-01572-y] [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: 11/15/2022] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This meta-analysis aimed to systematically test the relation between acculturation and suicide-related outcomes among immigrants, with attention to key methodological (i.e., measure of suicide-related outcome, measure of acculturation) and demographic (i.e., race, gender, age, geographic region, publication year) moderators. METHOD We conducted a meta-analysis of 72 independent samples from 50 studies (38 peer-reviewed articles, 12 dissertations) representing more than 1.4 million immigrants. Participants' age ranged from 11.20 to 74.70 years (M = 29.96, SD = 15.07). Random effects models were used for both main and moderation analyses. RESULTS We found significant positive associations between acculturation and suicidal ideation, but not suicide attempts and deaths. We also found a significant and positive effect of acculturation on suicide-related outcomes when acculturation was measured by psychological scales, but not by generation status, length of residence in the host country, and proficiency in the host country's language. More acculturated Latinx immigrants were at higher risk for suicide-related outcomes, whereas a reverse pattern was found among Asian immigrants. Meta-regressions revealed that the moderating effects of participants' age and publication year were also significant. CONCLUSION Our results show partial support for the immigrant paradox but suggest that the relation between acculturation and suicide-related outcomes is complex and multifaceted. We discuss the implications of our findings and recommendations for research and prevention.
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Affiliation(s)
- Christina Seowoo Lee
- Department of Applied Psychology, New York University, 246 Greene St, New York, NY, 10004, USA.
| | - Selcuk R Sirin
- Department of Applied Psychology, New York University, 246 Greene St, New York, NY, 10004, USA
| | - Elysia Choi
- Department of Applied Psychology, New York University, 246 Greene St, New York, NY, 10004, USA
| | - Esther J Sin
- Department of Applied Psychology, New York University, 246 Greene St, New York, NY, 10004, USA
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Bala A, Pierce J, Pierce K, Song S. Advocacy and Policy: A Focus on Migrant Youth. Child Adolesc Psychiatr Clin N Am 2024; 33:163-180. [PMID: 38395503 DOI: 10.1016/j.chc.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Mental health challenges experienced by migrant children are shaped by multiple factors within the health care system and society at large. It is essential for health care providers to recognize the profound impact of these influences on child well-being. By actively engaging in advocacy and policy initiatives, health care providers can address structural barriers, social inequalities, and stigma that perpetuate mental health disparities. Through their advocacy efforts, providers can contribute to creating an inclusive society that upholds children's rights and ensures equitable access to mental health support and services.
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Affiliation(s)
- Abishek Bala
- Central Michigan University, 1000 Houghton Avenue, Saginaw, MI 48602, USA.
| | - Jessica Pierce
- University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5277, USA
| | - Karen Pierce
- Northwestern University Department of Psychiatry, 2634 N Dayton ST, Chicago, Il 60614, USA
| | - Suzan Song
- Boston Children's Hospital, 1 Brookline Place, Suite 552, Boston, MA 02445, USA
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Burns SD, Baker EH, Sheehan CM, Markides KS. Disability Among Older Immigrants in the United States: Exploring Differences by Region of Origin and Gender. Int J Aging Hum Dev 2024; 98:329-351. [PMID: 37593800 DOI: 10.1177/00914150231196093] [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: 08/19/2023]
Abstract
Rapid aging in American society will be disproportionately concentrated among the foreign-born. Immigrants in the United States (U.S.) are a heterogeneous population, yet little is known regarding their differences in disability later in life by region of origin. We use data from the National Health Interview Survey on respondents ages 60+ (n = 313,072) and employ gender-specific logistic models to predict reports of any activity of daily living (ADL) disability. After accounting for socioeconomic factors, compared to their U.S.-born non-Hispanic (NH) White counterparts, the odds of reporting ADL disability were higher among U.S.-born respondents that are Hispanic, NH Black, and NH Multiracial as well as respondents with Mexican, Puerto Rican, Cuban, Russian/former Soviet, Middle Eastern, East Asian, and South Asian origins. Also, Dominican, African, and Southeast Asian women-and European men-reported high odds of ADL disability. Our results highlight heterogeneity in the disability profiles of foreign-born older adults in the U.S..
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Affiliation(s)
- Shane D Burns
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth H Baker
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Connor M Sheehan
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Kyriakos S Markides
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, Galveston, TX, USA
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Gray C, Porter G, Lobo R, Crawford G. Development and evaluation of health education resources for culturally and linguistically diverse populations: a systematic review. HEALTH EDUCATION RESEARCH 2024; 39:102-118. [PMID: 36994771 DOI: 10.1093/her/cyad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/13/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
People from culturally and linguistically diverse (CaLD) backgrounds in Australia generally experience poorer health outcomes, explained in part by low levels of health literacy. We conducted a systematic review to examine the development and evaluation of health education resources designed for CaLD populations. Five electronic databases were searched for English language, peer-reviewed studies published between 1980 and 2020. Thirty-four studies met the inclusion criteria. Twenty-four different health education resources were described and broadly categorized into four types: media campaigns (n = 10), text-based materials (n = 5), films (n = 8) and radio (n = 1). Studies were assessed against domains adapted from a health literacy guideline incorporating: need, collaboration, audience, health literacy, theory, test and process and impact evaluation. All but one study met the majority of the domains. All studies reported positive evaluation outcomes; this may be due to studies involving community early in resource design and including health literacy considerations in their design. Reporting resource design and evaluation against standard practice controls is recommended to build a more robust evidence base for developing effective health education resources for use by audiences from CaLD backgrounds.
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Affiliation(s)
- Corie Gray
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Georgia Porter
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Roanna Lobo
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Gemma Crawford
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
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