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Dorri AA, Loza O, Bond MA, Ciszek E, Elias-Curry Y, Aguilar S, Fliedner P, Norwood A, Stone AL, Cooper MB, Schick V, Wilkerson JM, Wermuth PP, Yockey RA, Schnarrs P. Understanding the Experiences of Latinx LGBTQ Texans at the Beginning of the COVID-19 Pandemic. JOURNAL OF HOMOSEXUALITY 2024; 71:2424-2448. [PMID: 37552613 DOI: 10.1080/00918369.2023.2241597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Marginalized communities have been disproportionately affected by COVID-19, including both racial/ethnic minority and sexual minority populations. To date, there has been little research examining the impact of the COVID-19 pandemic at the intersections of marginalized identities. Furthermore, available national data on COVID-19 outcomes may obscure our understanding of region-specific outcomes, particularly in the U.S. South. Using an intersectional approach, we explore differences in worries over COVID-19, preventative behaviors, and COVID-19 outcomes in the early months of the pandemic in a diverse sample of LGBTQ people (N = 1076) living in Texas. Our findings indicated that LGBTQ Latinx people in Texas reported more COVID-19 related worries and adverse outcomes than non-Latinx LGBTQ people. These findings are in line with previous research that found that the increased risk to Latinx and LGBTQ populations in public health crises is often overlooked and can be attributed to many factors such as socioeconomic status, occupational propensity, disparities in physical health, and barriers to healthcare access. Furthermore, our findings suggest the necessity of utilizing an intersectional approach when examining the disproportionate burden marginalized communities face in public health crises.
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Affiliation(s)
- Armin A Dorri
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Oralia Loza
- Department of Public Health Sciences, University of Texas at El Paso, El Paso, Texas, USA
| | - Mark A Bond
- New Meridian Corporation, Austin, Texas, USA
| | - Erica Ciszek
- Stan Richards School of Advertising & Public Relations, University of Texas at Austin, Texas, USA
| | - Yona Elias-Curry
- Department of Population Health, University of Texas at Austin, Austin, Texas, USA
| | - Sheridan Aguilar
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Paul Fliedner
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Aliza Norwood
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Amy L Stone
- Department of Sociology & Anthropology, Trinity University, San Antonio, Texas, USA
| | - M Brett Cooper
- Department of Pediatrics, University of Texas Southwestern, Dallas, Texas, USA
| | - Vanessa Schick
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - J Michael Wilkerson
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - Paige P Wermuth
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - Robert A Yockey
- School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas, USA
| | - Phillip Schnarrs
- Department of Population Health, University of Texas at Austin, Austin, Texas, USA
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Young MEDT, Sudhinaraset M, Tafolla S, Nakphong M, Yan Y, Kietzman K. The "disproportionate costs" of immigrant policy on the health of Latinx and Asian immigrants. Soc Sci Med 2024; 353:117034. [PMID: 38905924 DOI: 10.1016/j.socscimed.2024.117034] [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: 01/20/2024] [Revised: 04/23/2024] [Accepted: 05/31/2024] [Indexed: 06/23/2024]
Abstract
There is growing evidence that Asian and Latinx immigrants' health and health care access is shaped by immigrant policies that determine their rights, protections, and access to resources and the extent to which they are targeted by policing or deportation based on citizenship/legal status and other immigration-related social categories. However, there is limited population-based evidence of how immigrants experience the direct consequences of policies, nor of the impact of such consequences on their health. Between 2018 and 2020, we conducted the Research on Immigrant Health and State Policy (RIGHTS) Study, developing a population-based survey of Asian and Latinx immigrants in California (n = 2010) that measured 23 exclusionary experiences under health care and social services, education, labor/employment, and immigration enforcement policies. Applying Ruth Wilson Gilmore's concept of "disproportionate costs," we conducted a latent class analysis (LCA) and regression models of the RIGHTS data to 1) describe patterns of immigrant policy exclusion experienced by Asian and Latinx immigrants and 2) test relationships between patterns of policy exclusion and health care access and health status. LCA analyses identified 6 classes of distinct combinations of policy exclusions. In regression analyses, respondents in the class with cumulative exclusions across all policy sectors had the worst health care access and highest level of psychological distress, but the best self-rated health; while those in the class with employment and enforcement exclusions also had poor health care access. Respondents in the other 3 classes experienced combinations of health and social services exclusions, but these alone were not associated with worse outcomes. Findings show that the consequences of immigrant policies harm health through both cumulative exposure to and intersections of exclusions across policy sectors. Labor/employment and immigration enforcement policies, specifically, likely drive health inequities within immigrant populations. The RIGHTS study highlights the need to measure the cumulative and intersecting "disproportionate costs" of immigrant policy within diverse immigrant populations.
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Affiliation(s)
- Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, 5200 N Lake Road, Merced, CA, 95343, USA.
| | - May Sudhinaraset
- Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
| | - Sharon Tafolla
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, 5200 N Lake Road, Merced, CA, 95343, USA
| | - Michelle Nakphong
- Division of Prevention Science, School of Medicine, University of California, San Francisco. 550 16th St. 3rd Fl., San Francisco, CA, 94158, USA
| | - Yueqi Yan
- Department of Psychological Sciences, School of Social Sciences, Humanities and Arts, University of California, 5200 N Lake Road, Merced, CA, 95343, USA
| | - Kathryn Kietzman
- Center for Health Policy Research, University of California, 10960 Wilshire Blvd #1550, Los Angeles, CA, 90024, USA
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3
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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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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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5
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Potochnick S, Mikkelsen I, Gallo LC, Isasi CR, Gonzalez F, Perreira KM. Immigrant Parent Legal Status and Children's Health in the Hispanic Community Health Study of Latino Youth (SOL Youth). J Immigr Minor Health 2024; 26:461-473. [PMID: 38158543 DOI: 10.1007/s10903-023-01573-3] [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] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
We assess how immigrant parent legal status shapes children's physical and mental health. Using the Hispanic Community Health Study of Latino Youth-a multi-site dataset-we evaluated mean differences in multiple physical and mental health indicators and parents' and children's stress and resilience by parents' (primarily mothers') legal status (N = 1177). We estimated regression models of two overall child health outcomes-allostatic load and any internalized disorder. Average allostatic load was 28% higher (0.36 standard deviations) and average prevalence of any internalizing disorder was 16% points greater for children of foreign-born unauthorized versus US-born parents. Higher levels of socioeconomic and acculturative stress contributed to children of foreign-born unauthorized parents' heightened health risk, while resilience factors-parental health and familial support-protected their health. Children with unauthorized immigrant parents experience both negative physical and mental health outcomes that can have potential long-term costs.
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Affiliation(s)
- Stephanie Potochnick
- Sociology Department, University of North Carolina Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA.
| | - Ian Mikkelsen
- Public Policy Department, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Franklyn Gonzalez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Naseh M, Zeng Y, Ahn E, Cohen F, Rfat M. Mental Health Implications of Family Separation Associated with Migration Policies in the United States: A Systematic Review. Soc Sci Med 2024; 352:116995. [PMID: 38810506 DOI: 10.1016/j.socscimed.2024.116995] [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: 06/15/2023] [Revised: 10/13/2023] [Accepted: 05/16/2024] [Indexed: 05/31/2024]
Abstract
The practice of family separation as a mechanism of oppression has a deep-rooted history in the U.S., manifesting in diverse contexts, including punitive migration policies. This systematic review aimed to provide a rigorous and updated synthesis of the research on family separation as a result of migration policies and its impacts on immigrants' mental health while making a distinction between forced family separation, family separation by constrained choices, and living with the fear of family separation. We systematically searched four bibliographic databases using keywords related to family separation, migration, transnational families, and mental health for peer-reviewed studies published in English on or before January 1st, 2022. Results of the review indicate that family separation or fear of it may result in depression, anxiety, behavioral and emotional issues, sleep disturbances, and stress or distress in affected children. Similarly, impacted parents or caregivers might experience stress or distress, depression, anxiety, and sleep disturbances. Findings call for migration policy changes prioritizing family unity and comprehensive mental health interventions to respond to the pervasive consequences of family separation or fear thereof among immigrants in the U.S.
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Affiliation(s)
- Mitra Naseh
- Brown School, Washington University in St. Louis, St. Louis, 1 Brookings Dr, MO, 63130, USA.
| | - Yingying Zeng
- School of Social Work, University of Georgia, Athens, GA, USA.
| | - Eunhye Ahn
- Brown School, Washington University in St. Louis, St. Louis, 1 Brookings Dr, MO, 63130, USA.
| | - Flora Cohen
- School of Social Work, University of Illinois Urbana-Champaign, IL, USA
| | - Mustafa Rfat
- Brown School, Washington University in St. Louis, St. Louis, 1 Brookings Dr, MO, 63130, USA
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Snyder SA, Kuan KE, Velasco MG, Saadi A. Order Keepers or Immigration Agents? Latine Immigrant Views of Law Enforcement in Healthcare Settings. J Gen Intern Med 2024:10.1007/s11606-024-08767-x. [PMID: 38698296 DOI: 10.1007/s11606-024-08767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/10/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Police and security presence in healthcare settings have grown. There are few studies exploring perceptions of these law enforcement agents among US Latine immigrants, who can be vulnerable to immigration enforcement actions due to past and ongoing criminalization and anti-immigrant policies. OBJECTIVE To explore Latine immigrants' perceptions of law enforcement in healthcare settings. DESIGN Exploratory, semi-structured qualitative interviews asked participants about their perspectives of law enforcement in healthcare settings. PARTICIPANTS English- and Spanish-speaking adult patients (n = 19) from a Federally Qualified Health Center (FQHC) in Los Angeles, CA, serving predominantly low-income Latine immigrants. APPROACH We used the framework method for analysis to establish a codebook and inform our thematic interpretation. KEY RESULTS We identified three themes: (1) perceptions of safety offered by police officers are separated from the role of immigration officers; (2) perceptions of police officers are integrated into broader perceptions of the healthcare system; and (3) lived experiences, including immigration status, influenced valence response to officer uniforms and perceptions of officers. Most participants viewed police officers positively as maintaining order and safety, separating them from federal immigration enforcement actions, and reflecting on local, state, and organizational "sanctuary" or immigrant-friendly policies. Individuals with precarious immigration status more often saw officers as intimidating. Immigration enforcement remained a key concern. CONCLUSIONS Differentiating police and security roles from immigration enforcement in healthcare could improve Latine immigrant trust and access. Future studies should explore perspectives of Latine immigrants in localities without sanctuary laws or organizational immigrant-friendly policies.
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Affiliation(s)
- Sara A Snyder
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Krystal E Kuan
- Departments of Biostatistics, Epidemiology, and Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Margarita G Velasco
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Manalo-Pedro E, Enriquez LE, Nájera JR, Ro A. Anxious Activists? Examining Immigration Policy Threat, Political Engagement, and Anxiety among College Students with Different Self/Parental Immigration Statuses. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465241247541. [PMID: 38682706 DOI: 10.1177/00221465241247541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Restrictive immigration policies harm the mental health of undocumented immigrants and their U.S. citizen family members. As a sociopolitical stressor, threat to family due to immigration policy can heighten anxiety, yet it is unclear whether political engagement helps immigrant-origin students to cope. We used a cross-sectional survey of college students from immigrant families (N = 2,511) to investigate whether anxiety symptomatology was associated with perceived threat to family and if political engagement moderated this relationship. We stratified analyses by self/parental immigration statuses-undocumented students, U.S. citizens with undocumented parents, and U.S. citizens with lawfully present parents-to examine family members' legal vulnerability. Family threat was significantly associated with anxiety; higher levels of political engagement reduced the strength of this relationship. However, this moderation effect was significant only for U.S. citizens with lawfully present parents. These findings emphasize the importance of the family immigration context in shaping individuals' mental health outcomes.
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Affiliation(s)
| | | | | | - Annie Ro
- University of California, Irvine, CA, USA
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Samari G, Wurtz HM, Desai S, Coleman-Minahan K. Perspectives from the pandemic epicenter: Sexual and reproductive health of immigrant women in New York City. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024. [PMID: 38571367 DOI: 10.1111/psrh.12260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
CONTEXT The United States' response to COVID-19 created a policy, economic, and healthcare provision environment that had implications for the sexual and reproductive health (SRH) of racialized and minoritized communities. Perspectives from heterogenous immigrant communities in New York City, the pandemic epicenter in the United States (US), provides a glimpse into how restrictive social policy environments shape contraception, abortion, pregnancy preferences, and other aspects of SRH for marginalized immigrant communities. METHODS We conducted in-depth interviews in 2020 and 2021 with 44 cisgender immigrant women from different national origins and 19 direct service providers for immigrant communities in New York City to explore how immigrants were forced to adapt their SRH preferences and behaviors to the structural barriers of the COVID-19 pandemic. We coded and analyzed the interviews using a constant comparative approach. RESULTS Pandemic-related fears and structural barriers to healthcare access shaped shifts in contraceptive use and preferences among our participants. Immigrant women weighed their concerns for health and safety and the potential of facing discrimination as part of their contraceptive preferences. Immigrants also described shifts in their pregnancy preferences as rooted in concerns for their health and safety and economic constraints unique to immigrant communities. CONCLUSION Understanding how immigrant women's SRH shifted in response to the structural and policy constraints of the COVID-19 pandemic can reveal how historically marginalized communities will be impacted by an increasingly restrictive reproductive health and immigration policy landscape.
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Affiliation(s)
- Goleen Samari
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Heather M Wurtz
- Anthropology Department, University of Connecticut, Storrs, Connecticut, USA
- Research Program on Global Health & Human Rights, Human Rights Institute, University of Connecticut, Storrs, Connecticut, USA
- Population Studies and Training Center, Brown University, Providence, Rhode Island, USA
| | - Sheila Desai
- Coalition to Expand Contraceptive Access, Oakland, California, USA
| | - Kate Coleman-Minahan
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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10
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Galletly CL, McAuliffe TL, Dickson-Gomez JB, Glasman LR, Ruelas DM. The Relative Influence of Perceived Immigration Laws and Consequences on HIV Testing Among US Latino Immigrants. AIDS Behav 2024; 28:1301-1313. [PMID: 37632603 DOI: 10.1007/s10461-023-04159-0] [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] [Accepted: 08/10/2023] [Indexed: 08/28/2023]
Abstract
The CDC recommends that persons aged 13-64 receive an HIV test at least once in their lifetime and that some groups test annually or more frequently. Nearly one-half of US Latino immigrants have never been tested for HIV. To the extent that immigration-related laws deter documented and undocumented immigrants from engaging in communicable disease control measures, these laws undermine public health efforts. 1750 noncitizen adult, sexually active, Spanish-speaking Latino immigrants across four cities in the US completed a cross-sectional survey assessing perceptions of immigration-related laws and immigration consequences related to HIV testing and diagnosis. Participants were recruited in-person by staff in community settings, through flyers posted in places frequented by Latino immigrants, and by word-of-mouth through snowball sampling. Outcomes were whether participants had ever received an HIV test and whether they tested in the previous 12 months. Multivariable analyses examined the relative contribution of perceived immigration laws and consequences on HIV testing behaviors when considering established predictors of HIV testing. Perceptions of HIV-related immigration laws and immigration consequences was a significant predictor of never having had an HIV test even when considered relative to common predictors of HIV testing. The influence of perceived immigration laws and consequences on testing in the previous 12 months was not significant in multivariable analysis. Perceived HIV-related immigration laws and consequences appear to be a substantial contributor to reluctance to be tested for HIV among Latino immigrants who have never been tested. Effective interventions should be developed to address these.
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Affiliation(s)
- Carol L Galletly
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 1710 East Lafayette Place, Milwaukee, WI, 53202, USA.
| | - Timothy L McAuliffe
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 1710 East Lafayette Place, Milwaukee, WI, 53202, USA
| | - Julia B Dickson-Gomez
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 1710 East Lafayette Place, Milwaukee, WI, 53202, USA
- Institute for Health Equity, Medical College of Wisconsin, Milwaukee, USA
| | - Laura R Glasman
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 1710 East Lafayette Place, Milwaukee, WI, 53202, USA
| | - Dulce M Ruelas
- College of Nursing & Healthcare Professions, Grand Canyon University, Phoenix, USA
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Shramko M, Lucke C, Piescher K. Patterns of Social Determinants of Health and Publicly-Funded Service Access among Children Involved in Educational, Child Welfare, and Social Service Systems. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:521-531. [PMID: 38224389 DOI: 10.1007/s11121-023-01638-7] [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] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
Social determinants of health (SDOH)-conditions in which children live, learn, and play-affect child health and well-being. Publicly funded services in education and child welfare systems are important resources to support child well-being, but cross-system coordination is rare. Leveraging integrated administrative data from 60,287 6th graders enrolled in public schools in Minnesota, we used latent class analysis (LCA) to examine patterns of cross-system SDOH, including educational services and involvement in child welfare. Five classes emerged. The largest class was characterized by a few multi-system SDOH and had low service needs. Two classes had differing patterns of school service use, one with a greater likelihood of special education service use alone and the other characterized by the use of multiple school services. Two classes were characterized by cross-system SDOH/service use (e.g., homelessness, child protection, placement in care, mental health, and special education services). We then assessed whether race/ethnicity predicted class membership and tested educational distal outcomes. American Indian, Black, and Latinx children had higher odds of exposure to both cross-system SDOH classes. Students facing any SDOH, particularly those with greater multi-system SDOH exposure, had worse attendance and academic achievement. Our study indicates that children are navigating complex experiences of SDOH and service needs, with a disproportional likelihood that Black children, Indigenous children, and other children of color (BIPOC) experience SDOH. Identifying patterns of SDOH provides an opportunity for policymakers and practitioners to intervene to promote health equity. By understanding facilitators and barriers to child well-being, the results inform how child-serving systems can strive toward health equity.
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Affiliation(s)
- Maura Shramko
- Center for Advanced Studies in Child Welfare, University of Minnesota, Minneapolis, MN, 55455, USA.
- American Institutes for Research, 10 S. Riverside Plaza, 6th Floor, Chicago, IL, 60606, USA.
| | - Cara Lucke
- Institute of Child Development, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Kristine Piescher
- Center for Advanced Studies in Child Welfare, University of Minnesota, Minneapolis, MN, 55455, USA
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Platt R, Alvarez K, Vasquez MG, Bancalari P, Acosta J, Caicedo MR, Polk S, Wilcox H. Suicide prevention programming across ecological levels: Recommendations from Latinx immigrant origin youth and their parents. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2024; 42:101-115. [PMID: 37616106 PMCID: PMC10891300 DOI: 10.1037/fsh0000835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Latinx immigrant-origin youth (IOY) have unique risks for suicidal thoughts and behaviors. It has been suggested that these risks should be addressed from an ecological perspective, addressing cultural and family context as well as structural and systemic barriers to prevention. This study sought to explore perspectives of immigrant-origin Latinx adolescents and their caregivers on suicide and its prevention, including the potential impact of stressors specific to immigrant status. METHOD Focus groups were conducted in 2018-2019 with Latinx immigrant-origin caregivers (N = 41, 97.5% female) and adolescents (ages = 14-19, N = 56, 50% female). Participants were recruited from community-based organizations in two different cities. A codebook approach to thematic analysis was used to identify themes, which were subsequently mapped onto levels of the Center for Disease Control's Social-Ecological Framework for Violence Prevention. RESULTS Participants identified both contributors to suicidal behavior and potential components of prevention programming across ecological levels. Specific recommendations for suicide prevention included engaging in recreation, parenting education and support, enhancing academic supports for adolescents, and enhancing school-family communication. Structural barriers (e.g., caregiver work schedules) to implementing recommendations were described. DISCUSSION Our results highlight the potential role of access to school and community-based supports as public health-oriented suicide prevention strategies and suggest a need to address barriers faced by immigrant families in accessing these supports alongside addressing barriers to mental health treatment. Policies impacting immigrant families' financial stability and increasing the availability of recreational and academic opportunities may promote mental health and prevent suicidal thoughts and behavior among IOY. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Rheanna Platt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kiara Alvarez
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Pilar Bancalari
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- NYC Administration for Children’s Services, New York, NY
| | - Jennifer Acosta
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
- Maryland Department of Health, Baltimore, MD
| | - Mariana Rincon Caicedo
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Psychology, University of Kansas, Lawrence, KS
| | - Sarah Polk
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Holly Wilcox
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Hodges JC, McKetchnie SM, González A, Hawkins SS. The Impacts of Inclusionary State Immigrant Policies on Psychosocial Outcomes Among Latinx Adolescents. J Am Acad Child Adolesc Psychiatry 2024; 63:355-364. [PMID: 37414094 DOI: 10.1016/j.jaac.2023.05.024] [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: 12/27/2022] [Revised: 04/28/2023] [Accepted: 06/16/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE State-level policies that exclude immigrants, primarily undocumented, from public services and benefits have been found to have negative psychosocial impacts on Latinx adults, regardless of nativity. The effects of inclusionary policies-that is, extending public benefits to all immigrants-remain underexamined, as well as the impacts on adolescents. METHOD We used data from the Youth Risk Behavior Survey from 2009 to 2019 to examine the association between 7 state-level inclusionary policies and bullying victimization, low mood, and suicidality among Latinx adolescents via 2-way fixed-effects log-binomial regression models. RESULTS Banning the use of eVerify in employment was associated with decreased bullying victimization (prevalence ratio [PR] = 0.63, 95% CI: 0.53-0.74), low mood (PR = 0.87, 95% CI: 0.78-0.98), and suicidality (PR = 0.73, 95% CI: 0.62-0.86). Extending public health insurance coverage was associated with decreased bullying victimization (PR = 0.57, 95% CI: 0.49-0.67), and mandating Culturally and Linguistically Appropriate Services (CLAS) training for health care workers was associated with decreased low mood (PR = 0.79, 95% CI: 0.69-0.91). Extending in-state tuition to undocumented students was associated with increased bullying victimization (PR = 1.16, 95% CI: 1.04-1.30), and extending financial aid was associated with increased bullying victimization (PR = 1.54, 95% CI: 1.08-2.19), low mood (PR = 1.23, 95% CI: 1.08-1.40), and suicidality (PR = 1.38, 95% CI: 1.01-1.89). CONCLUSION The relationships between inclusionary state-level policies and Latinx adolescent psychosocial outcomes were mixed. Although most inclusionary policies were associated with improved psychosocial outcomes, Latinx adolescents residing in states with inclusionary policies related to higher education had worse psychosocial outcomes. Results suggest the importance of elucidating the unintended consequences of well-intentioned policies and the importance of continued efforts to reduce anti-immigrant sentiment.
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Affiliation(s)
- James C Hodges
- School of Social Work, Boston College, Chestnut Hill, Massachusetts.
| | | | - Andrés González
- School of Theology and Ministry, Boston College, Chestnut Hill, Massachusetts
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Moinester M, Stanhope KK. Extending Driver's Licenses to Undocumented Immigrants: Comparing Perinatal Outcomes Following This Policy Shift. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465241230839. [PMID: 38404178 DOI: 10.1177/00221465241230839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Research shows that restrictive immigration policies and practices are associated with poor health, but far less is known about the relationship between inclusive immigration policies and health. Using data from the United States natality files, we estimate associations between state laws granting undocumented immigrants access to driver's licenses and perinatal outcomes among 4,047,067 singleton births to Mexican and Central American immigrant birthing people (2008-2021). Fitting multivariable log binomial and linear models, we find that the implementation of a license law is associated with improvements in low birthweight and mean birthweight. Replicating these analyses among U.S.-born non-Hispanic White birthing people, we find no association between the implementation of a license law and birthweight. These findings support the hypothesis that states' extension of legal rights to immigrants improves the health of the next generation.
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Xiao C, Patrician PA, Montgomery AP, Wang Y, Jablonski R, Markaki A. Filial piety and older adult caregiving among Chinese and Chinese-American families in the United States: a concept analysis. BMC Nurs 2024; 23:115. [PMID: 38347512 PMCID: PMC10863110 DOI: 10.1186/s12912-024-01789-0] [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: 07/20/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The culturally sensitive nursing practice has not embedded filial piety as a cultural value and stance pertaining to caregiving among aging Chinese and Chinese-American (CCA) families in the United States, yet it is critical for healthy aging among CCAs. PURPOSE To understand filial piety when caring for aging CCAs and conceptualize an operational definition and framework. METHODS A systematic search was conducted in CINAHL, PubMed, Scopus, and PsycINFO databases. Analysis of the concept of filial piety among CCAs used Walker and Avant's methods. Twenty-six studies were selected in the final full-text analysis. FINDINGS Synthesis of evidence identified four antecedents: (a) filial obligation as a 'cultural gene', (b) sense of altruism, (c) familial solidarity, and (d) societal expectation of 'birth right'. Attributes included familial material and emotional support, obedience, pious reverence, and societal norms. Consequences were related to caregiver burden, psychological and physical well-being, quality of life, and health equity. CONCLUSION Filial piety is an intrinsic desire to support aging parents and an extrinsic desire to adhere to Chinese societal moral tenets. The proposed operational framework "Caregiving for aging CCAs in the United States" merits further study.
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Affiliation(s)
- Chunhong Xiao
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA.
| | - Patricia A Patrician
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Aoyjai P Montgomery
- University of Alabama at Birmingham School of Public Health, 1665, 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Youhua Wang
- College of State Governance, Southwest University, No. 2 Tianshen Road, Chongqing, 400715, Beibei District, China
| | - Rita Jablonski
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Adelais Markaki
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
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Tang Z, Du S. Revisiting the Immigrant Health Advantage: Self-Reported Health and Smoking Among Sexual Minority Immigrants. J Immigr Minor Health 2024; 26:35-44. [PMID: 37526837 DOI: 10.1007/s10903-023-01527-9] [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] [Accepted: 07/20/2023] [Indexed: 08/02/2023]
Abstract
This study aims to examine how the immigrant health advantage (IHA) may differ by sexual orientation. Using data from the 2015-2019 National Health Interview Survey, we examined general health status (n = 131,635) and smoking behavior (n = 131, 658) for US-born and foreign-born heterosexual and sexual minority adults, as well as how the duration of stay in the U.S. may influence sexual minority immigrants' health. Logistic regression models were adopted to examine the health outcomes of immigration in different immigrant groups divided by sexual orientation. Findings show a weaker immigrant health advantage among sexual minorities than heterosexual persons, which disappears or turns into a disadvantage for several subpopulations (i.e., foreign-born homosexual individuals who stayed for 10-15 or 15 + years in the U.S.). Foreign-born homosexual individuals having stayed in the U.S. for a decade or more have substantially higher odds of reporting poor/fair health and smoking currently than their US-born counterparts. Although immigrants' health advantage overall attenuates over time, sexual minority immigrants' health erodes more with time spent in the U.S. The disparities in immigrants' health advantages suggest a segmented health acculturation (or even marginalization) process and entail higher sexual orientation-based health disparities among immigrants than among US-born individuals, likely reinforcing the preexisting health disparities in the country. The findings call for policies to address the multifaceted barriers to health equity at the intersection of social disadvantages.
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Affiliation(s)
- Zequn Tang
- School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Shichao Du
- Department of Sociology, Fudan University, Shanghai, China.
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17
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Lemon ED, Mera Nieto KS, Serrano Laguna LY, Flores YA, Niño-Suastegui M, Peraza Campos J, Fuentes V, Lozada K, Ling A, Woods-Jaeger B. "I Can Never Feel Safe": Latinx Youth Voices on Psychosocial Impacts of 287(g) in Georgia. HEALTH EDUCATION & BEHAVIOR 2024; 51:71-81. [PMID: 37675769 DOI: 10.1177/10901981231193695] [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: 09/07/2023]
Abstract
Increasingly, immigration policies are understood as structural determinants, rooted in racism, nativism, and ethnocentrism, which raise serious public health concerns for Latinx adolescents' mental health. Our objective was to examine how immigration policy enforcement affects mental health of Latinx youth raised in a county with an aggressive interior immigration enforcement program. From 2009 to 2021, Gwinnett County, GA, led the nation in deportations under the 287(g) program as a "universal enforcement model," where local law enforcement were deputized to detain undocumented immigrants, primarily through traffic violations. From June to July 2022, we followed a participatory action research approach with two groups of Latinx youth who grew up in Gwinnett County. In total, 10 youth took photos related to the research question, and engaged in facilitated dialogue using photovoice guide SHOWED/VENCER for four, 2-hour sessions that were audio-recorded and transcribed. Transcripts were analyzed following grounded theory principles to arrive at a conceptual model codeveloped and validated by youth. Youth described how 287(g) led to policing and deportation in their communities, fueling stereotypes, and discrimination that criminalized Latinx immigrants. Youth linked immigration enforcement policies like 287(g) to exclusionary systems that contributed to fear, marginalization, and loss in their communities, bringing experiences of sadness, grief, isolation, hopelessness, and low self-worth. From youth-driven research, we identified mental health implications of the 287(g) program among Latinx youth. The cascading harms of immigration enforcement policies highlight the need to address these policies and identify immediate strategies to promote Latinx youth mental health.
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18
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Jindal M, Barnert E, Chomilo N, Gilpin Clark S, Cohen A, Crookes DM, Kershaw KN, Kozhimannil KB, Mistry KB, Shlafer RJ, Slopen N, Suglia SF, Nguemeni Tiako MJ, Heard-Garris N. Policy solutions to eliminate racial and ethnic child health disparities in the USA. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:159-174. [PMID: 38242598 PMCID: PMC11163982 DOI: 10.1016/s2352-4642(23)00262-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 08/28/2023] [Accepted: 09/27/2023] [Indexed: 01/21/2024]
Abstract
Societal systems act individually and in combination to create and perpetuate structural racism through both policies and practices at the local, state, and federal levels, which, in turn, generate racial and ethnic health disparities. Both current and historical policy approaches across multiple sectors-including housing, employment, health insurance, immigration, and criminal legal-have the potential to affect child health equity. Such policies must be considered with a focus on structural racism to understand which have the potential to eliminate or at least attenuate disparities. Policy efforts that do not directly address structural racism will not achieve equity and instead worsen gaps and existing disparities in access and quality-thereby continuing to perpetuate a two-tier system dictated by racism. In Paper 2 of this Series, we build on Paper 1's summary of existing disparities in health-care delivery and highlight policies within multiple sectors that can be modified and supported to improve health equity, and, in so doing, improve the health of racially and ethnically minoritised children.
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Affiliation(s)
- Monique Jindal
- Department of Medicine, University of Illinois Chicago School of Medicine, Chicago, IL, USA.
| | - Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA
| | - Nathan Chomilo
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Shawnese Gilpin Clark
- Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alyssa Cohen
- Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Danielle M Crookes
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA; Department of Sociology and Anthropology, College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katy Backes Kozhimannil
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kamila B Mistry
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Office of Extramural Research, Education, and Priority Populations, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, MD, USA
| | - Rebecca J Shlafer
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA; Center on the Developing Child, Harvard University, Boston, MA, USA
| | - Shakira F Suglia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | | | - Nia Heard-Garris
- Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Institute for Policy Research, Northwestern University, Chicago, IL, USA
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19
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Estrada-Mendizabal RJ, Dhaliwal AS, Bertolo AJ, Batai K, Heimark R, Recio-Boiles A, Chipollini J. Prostate Cancer Disparities in Metastatic and Treatment Status for Hispanic Americans Based on Country of Origin Compared to Non-Hispanic Whites Using the National Cancer Database. Clin Genitourin Cancer 2024; 22:e148-e155.e1. [PMID: 37903669 DOI: 10.1016/j.clgc.2023.10.002] [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: 08/12/2023] [Revised: 09/19/2023] [Accepted: 10/02/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION Among Hispanic-American (HA) men, prostatic cancer (PCa) accounts for nearly one-quarter of the total cancer burden. We sought to identify differences in PCa presentation and treatment status for HA subgroups based on country/region of origin. MATERIAL AND METHODS Using the National Cancer Database, we identified patients with histologically confirmed prostate adenocarcinoma with reported race/ethnicity, clinical staging, Gleason score ≥ 6, and PSA level at diagnosis from 2010 to 2016. HAs were divided into 4 subgroups: Mexican, Puerto Ricans, Cubans, and Central/South Americans. Non-Hispanic White (NHW) men were used as a reference group. Statistical analysis was derived from the Kruskal-Wallis test for continuous variables and χ2 test for categorical variables. Models were constructed to evaluate the association of Hispanic country of origin with metastatic presentation and treatment status. RESULTS A total of 428,829 patients were included, with 5625 (1.3%) classified as HA. Within the Hispanic group, 2880 (51.2%) were Mexican, 999 (17.8%) Puerto Rican, 477 (8.5%) Cuban, and 1269 (22.6%) South/Central American. Mexican men presented with higher median PSA, more Gleason 8 to 10 disease, and higher rates of metastatic presentation compared to NHW and other HA subgroups (all, p < .01). Metastatic rates over the study period for Mexican, Puerto Rican, Cuban, and South/Central Americans were 6.4 (±1.2), 5.3 (±3.0), 3.2 (±2.0), and 4.6% (±1.7), respectively (p = .01). Treatment rates were 89.1, 89.6, 92.4, and 89.3% for Mexican, Puerto Rican, Cuban, and South/Central Americans, respectively (p = .19). Mexican men had higher odds of initial metastatic presentation (OR: 1.32; 95%CI: 1.07-1.63, p = .01) but lower odds of receiving treatment (0.68; 0.55-0.85, p < .01). CONCLUSION Men of Mexican origin presented with more advanced PCa when compared to NHW and other Hispanic subgroups. Our results warrant further investigation into potential biological factors affecting Hispanic patients as well as the identification of treatment barriers for this vulnerable population.
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Affiliation(s)
| | | | | | - Ken Batai
- Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Ronald Heimark
- Department of Surgery, University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - Alejandro Recio-Boiles
- Department of Medicine, University of Arizona, AZ; University of Arizona Cancer Center, Tucson, AZ
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20
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Bao J, Sun L, Nguyen-Hoang P, Momany ET. Exploring the Effect of Anti-immigration Rhetoric on Emergency Department Use by Undocumented Adults. J Immigr Minor Health 2024; 26:110-116. [PMID: 37587245 DOI: 10.1007/s10903-023-01531-z] [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] [Accepted: 07/20/2023] [Indexed: 08/18/2023]
Abstract
An unwelcoming policy climate can create barriers to health care access and produce a 'Chilling Effect' among immigrant communities. For undocumented immigrants, barriers may be unique and have a greater impact. We used administrative emergency department (ED) data from 2015 to 2019 for a Midwestern state provided under a data use agreement with the state hospital association. General linear modelling was used to estimate the impact of anti-immigrant rhetoric on ED visit intensity among non-elderly adults who were likely Hispanic/Latino with undocumented status. Compared to 2015, the average ED visit intensity among adults who were likely Hispanic/Latino with undocumented status was significantly higher during 2016-2019 when anti-immigrant rhetoric was heightened. The magnitude of this change increased over time (0.013, 0.014, 0.021, and 0.020, respectively). Additionally, this change over time was not observed in the comparison groups. Our findings suggest that anti-immigrant rhetoric may alter health care utilization for adults who are likely Hispanic/Latino with undocumented status. Limitations to our findings include the use of only those likely to be Hispanic/Latino, data from only one Midwestern state and the loss of data due to non-classification using the NYU ED algorithm. Further research should focus on validating these findings and investigating these identification methods and anti-immigrant rhetoric effects among other undocumented groups including children and adults of different race or ethnicity such as black, both those that identify as Hispanic/Latino and those that do not. Developing strategies to improve health care access for undocumented Hispanic/Latino adults also warrants future research.
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Affiliation(s)
- Juan Bao
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Leon Sun
- College of Public Health, University of Iowa, Iowa City, IA, USA
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Elizabeth T Momany
- College of Public Health, University of Iowa, Iowa City, IA, USA.
- College of Public Health, 145 N Riverside Drive, College of Public Health Building, Iowa City, IA, 52242, USA.
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López-Hinojosa I, Zhang J, López-Hinojosa K, Baig AA, Tung EL, Martinez-Cardoso A. "We have to lie low … that sort of poisons me more and more": A qualitative study of violent political rhetoric and health implications for Spanish and Chinese speaking immigrants. Soc Sci Med 2024; 341:116504. [PMID: 38134713 DOI: 10.1016/j.socscimed.2023.116504] [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: 05/04/2023] [Revised: 09/01/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND In recent years, the historical legacy of anti-immigrant sentiment in the US has resurfaced, fueled by a new wave of anti-immigrant political rhetoric. Violent political rhetoric, defined as either explicit or metaphorically targeted language to dehumanize targeted groups, can incite discriminatory treatment of immigrants at both interpersonal and institutional levels, shaping their health and healthcare experiences. This qualitative study explores and compares how Spanish- and Chinese-speaking immigrant populations in Chicago make sense of violent political rhetoric against their racial and ethnic identities, utilize coping strategies to maintain their sense of belonging, and experience downstream health consequences. METHODS In 2019, 14 semi-structured focus groups were conducted among immigrants to the U.S. (n = 79). Participants were recruited from four community sites in either Hispanic/Latino or Chinese neighborhoods in Chicago. Focus groups were conducted by racially- and linguistically concordant interviewers in Spanish, Mandarin, or Cantonese. The research team developed a codebook iteratively and analyzed transcripts using grounded theory and the constant comparison method. RESULTS Participants included Chinese (61%) and Spanish-speaking immigrants (39%), with an average age of 61.4 years (sd = 13); the majority were female (62%), unemployed (68%), and attained less than a high school diploma (53%). Self-reported stress due to political rhetoric was more pronounced among Spanish-speaking participants (93%) than Chinese participants (39.6%). Immigrants responded to manifestations of violent political rhetoric in numerous ways including mobilizing the model minority myth with internalized racism, anticipatory stress, and "high effort" coping mechanisms (John Henryism), all with downstream health effects. CONCLUSION Violent political rhetoric is one of the mechanisms by which racism and xenophobia exacerbate a toll on the health of racialized immigrant groups. These processes have implications for both interpersonal and institutional experiences, as well as health and healthcare interactions. We propose a conceptual model that outlines these mechanisms and points to potential areas of intervention to ameliorate immigrant health inequities.
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Affiliation(s)
| | - James Zhang
- University of Chicago, Pritzker School of Medicine, United States
| | | | - Arshiya A Baig
- University of Chicago, Section of General Internal Medicine, United States
| | - Elizabeth L Tung
- University of Chicago, Section of General Internal Medicine, United States
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22
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Timilsina L. Immigration policy shocks and infant health. ECONOMICS AND HUMAN BIOLOGY 2023; 51:101309. [PMID: 37862953 DOI: 10.1016/j.ehb.2023.101309] [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: 03/06/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/22/2023]
Abstract
This paper evaluates the effect of positive and negative immigration policy shocks on infant health outcomes in the U.S. I examine changes in mean birth weight and the incidence of low birth weight (LBW) at the metropolitan statistical area (MSA) level around two major institutional shocks: The 1986 Immigration Reform Act (IRCA), which favored immigrants, and the increase in Immigration and Customs Enforcement (ICE) agency arrests at the start of 2017 which might have put immigrants at greater risk of apprehension. It uses a triple difference approach, comparing birth outcomes of foreign-born mothers with U.S.-born mothers (relative to mothers living in MSAs with a higher and lower concentration of IRCA applications and an increase in ICE arrests) before and after the two immigration policies. I find that in MSAs that had higher IRCA applications, mean birth weight increased, and the incidence of LBW decreased by 3-6 percent for babies born to foreign-born mothers. By contrast, in MSAs that had higher ICE arrests starting in 2017, mean birth weight decreased, and the incidence of LBW increased by 3-7 percent for babies born to foreign-born mothers. The effect of the increase in ICE arrests was more pronounced among mothers who were born in Latin and Central American countries. Sub-sample analysis shows that the incidence of LBW increased by as much as 12 percent for babies born to foreign-born mothers of Hispanic origin.
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Affiliation(s)
- Laxman Timilsina
- Department of Economics, Connecticut College, United States of America.
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23
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Ertanir B, Cobb CL, Unger JB, Celada-Dalton T, West AE, Zeledon I, Perazzo PA, Cano MÁ, Des Rosiers SE, Duque MC, Ozer S, Cruz N, Scaramutti C, Vos SR, Salas-Wright CP, Maldonado-Molina MM, Nehme L, Martinez CR, Zayas LH, Schwartz SJ. Crisis Migration Adverse Childhood Events: A New Category of Youth Adversity for Crisis Migrant Children and Adolescents. Res Child Adolesc Psychopathol 2023; 51:1871-1882. [PMID: 36626084 PMCID: PMC10661744 DOI: 10.1007/s10802-022-01016-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] [Accepted: 12/21/2022] [Indexed: 01/11/2023]
Abstract
The present article proposes an extension of the concept of adverse childhood experiences (ACEs) to apply to crisis migration - where youth and families are fleeing armed conflicts, natural disasters, community violence, government repression, and other large-scale emergencies. We propose that adverse events occurring prior to, during, and following migration can be classified as crisis-migration-related ACEs, and that the developmental logic underlying ACEs can be extended to the new class of crisis-migration-related ACEs. Specifically, greater numbers, severity, and chronicity of crisis-migration-related ACEs would be expected to predict greater impairments in mental and physical health, poorer interpersonal relationships, and less job stability later on. We propose a research agenda centered around definitional clarity, rigorous measurement development, prospective longitudinal studies to establish predictive validity, and collaborations among researchers, practitioners, and policymakers.
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Affiliation(s)
- Beyhan Ertanir
- School of Education, Institute Research and Development, University of Applied Sciences and Arts Northwestern Switzerland, Bahnhofstrasse 6, 5210, Windisch, Switzerland.
| | | | | | | | - Amy E West
- University of Southern California, Los Angeles, United States
| | - Ingrid Zeledon
- University of Southern California, Los Angeles, United States
| | | | | | | | - Maria C Duque
- University of Texas at Austin, Austin, United States
| | | | - Natalie Cruz
- Children's Hospital Los Angeles, Los Angeles, United States
| | | | - Saskia R Vos
- University of Miami (Florida), Miami, United States
| | | | | | - Lea Nehme
- Florida International University, Miami, United States
| | | | - Luis H Zayas
- University of Texas at Austin, Austin, United States
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Lemon ED, Crookes DM, Del Carmen Chacón L, Santiago C, Urbina B, Livingston M, Woods-Jaeger B. Facing a dual threat: Pandemic stress and immigration policy vulnerability on mental health among Latinx immigrant parents. Int J Soc Psychiatry 2023; 69:2139-2147. [PMID: 37691431 DOI: 10.1177/00207640231194480] [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: 09/12/2023]
Abstract
BACKGROUND Exclusionary immigration policies rooted in structural racism threaten the wellbeing of Latinx families, increasing stress, anxiety, depression, and distress among immigrant parents. The COVID-19 pandemic has had devastating and disproportionate impacts on communities of color with unique impacts on Latinx immigrant parents in mixed-status families. AIMS From a syndemic theory lens, we explored the convergence of structural racism and the COVID-19 pandemic to explore if the stress of the COVID-19 pandemic may compound harmful immigration-related policies. METHODS Our community-based participatory research cross-sectional study administered 145 surveys among Latinx immigrant parents in mixed-status families in Georgia. We examined the relationship of pandemic stress and perceived statewide immigration policy vulnerability to depressive, anxiety, and PTSD symptoms. We conducted multiple linear regression analyses to test these relationships and their interaction. RESULTS We found that that greater perceived policy immigration vulnerability and reported pandemic stress were associated with higher symptoms of depression. Increased PTSD symptoms were also associated with immigration policy vulnerability, but not pandemic stress. Tests to assess if pandemic stress strengthened the relationship between policy vulnerability on depressive, anxiety, and PTSD symptoms revealed no statistically significant interactions. CONCLUSION Our findings suggest that stress of the COVID-19 pandemic and longstanding anti-immigrant policies in Georgia were salient for and related to the mental health of these Latinx immigrant parents.
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Affiliation(s)
- Emily D Lemon
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Danielle M Crookes
- Department of Health Sciences Bouvé College of Health Sciences and Department of Anthropology and Sociology, College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA
| | - Liliana Del Carmen Chacón
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | | | - Melvin Livingston
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Briana Woods-Jaeger
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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25
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Chen L, Young MEDT, Rodriguez MA, Kietzman K. Immigrants' Enforcement Experiences and Concern about Accessing Public Benefits or Services. J Immigr Minor Health 2023; 25:1077-1084. [PMID: 36859637 PMCID: PMC10509127 DOI: 10.1007/s10903-023-01460-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] [Accepted: 02/10/2023] [Indexed: 03/03/2023]
Abstract
Although exclusionary immigration policies are associated with fear of deportation and avoidance of public benefits, relationships between immigration enforcement policy and public charge policies are largely unknown. Using a California population-based survey of 1103 Asian and Latinx immigrants in 2018, we tested the relationship between immigrants' experiences with law enforcement and their concern about public charge. Direct encounters with various forms of law enforcement, including being asked to show proof of citizenship by law enforcement, staying inside to avoid police or immigration officials, and having known someone who had been deported, were associated with immigrants' avoidance of public benefits due to public charge concerns. Latinx immigrants were more likely to be concerns about public charge than Asians. Intersections among immigration policies deserve further consideration. There is a need to provide accurate and reliable information to immigrant communities about public benefits and advocate for inclusive immigration policies.
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Affiliation(s)
- Lei Chen
- Department of Social Welfare, Luskin School of Public Affairs and Center for Health Policy Research, University of California Los Angeles, Los Angeles, CA, USA
| | - Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California Merced, 5200 Lake Road, Merced, CA, 95343, USA.
| | - Michael A Rodriguez
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Kathryn Kietzman
- Center for Health Policy Research, University of California Los Angeles, Los Angeles, CA, USA
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26
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Arteaga I, Wilde PE. Measuring Food Security in the United States for More Than 25 years: History, Methods, Findings, and Opportunities. J Acad Nutr Diet 2023; 123:S5-S19. [PMID: 36669754 DOI: 10.1016/j.jand.2023.01.007] [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: 08/22/2022] [Revised: 11/29/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Abstract
This article sets the stage for the "25 Years of Food Security Measurement: Answered Questions and Further Research" conference, with support from the Economic Research Service of the US Department of Agriculture, by providing some history of federal food security measurement, summarizing notable findings, and reviewing selected special topics in analysis methods. The federal government uses food security surveys to monitor national progress toward reducing food insecurity and to evaluate federal nutrition assistance programs. For the monitoring purpose, there is a tension between focus (on a single authoritative measurement approach) and breadth (encompassing multiple tools or instruments suitable for diverse populations, contexts, and applications). For the program evaluation purpose, challenges include coordination with study designs capable of real causal estimation in the face of strong self-selection effects and tailored reference periods in survey questions that match the timing of program participation. Some analysis methods treat the food security survey items as distinct experiences of hardship, whereas others treat the food security survey items as windows on an underlying latent variable, a food insecurity score. The severity of food-related hardship may be assessed quantitatively by the number of distinct hardships reported, by the estimated value of a latent food insecurity score, or by the frequency of occurrence for sentinel hardships. Ongoing work investigates statistical approaches that are sufficiently simple for policy application and yet sufficiently flexible to accurately match the empirical survey evidence.
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Affiliation(s)
- Irma Arteaga
- Truman School of Government and Public Affairs, University of Missouri, Columbia, Missouri.
| | - Parke E Wilde
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
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Cadiz MP, Santos CE, Tibbe TD. A Longitudinal Mediation Analysis of the Interrelations among Exclusionary Immigration Policy, Ethnic Identity, and Self-Esteem of Latinx Early Adolescents. J Youth Adolesc 2023; 52:2045-2060. [PMID: 37328609 PMCID: PMC10371921 DOI: 10.1007/s10964-023-01801-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: 08/19/2022] [Accepted: 05/29/2023] [Indexed: 06/18/2023]
Abstract
Little is known about how exclusionary immigration laws affect ethnic identity and self-esteem among Latinx middle school students. Arizona's SB 1070, which required local officers to verify the legal status of detained individuals, garnered national attention for its impact on immigrant and Latinx communities. This study tested a longitudinal parallel multiple mediation model where perceptions of the effects of an exclusionary immigration law (Arizona's SB 1070) on self-esteem were mediated by dimensions of ethnic identity (ethnic centrality, ethnic private regard, ethnic public regard). Data were collected from a two-wave survey of 891 early adolescents ranging in age from 10 to 14 years (M = 12.09 years; SD = 0.99), a majority (71%) of whom were of Mexican descent. Analyses revealed an indirect effect of T1 perceptions of this law on T2 self-esteem (7 months later), holding T1 measures constant, with T2 ethnic centrality, private regard, and public regard acting as mediators. Perceived effects of this exclusionary law led to increased self-esteem through increased dimensions of ethnic identity. Results reveal how ethnic identity functions as a multidimensional construct in the process through which exclusionary immigration policy may impact the self-esteem of Latinx early adolescents.
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Affiliation(s)
- Madonna P Cadiz
- Department of Social Welfare, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Carlos E Santos
- Department of Social Welfare, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tristan D Tibbe
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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28
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Diaz C, Nwadiuko J, Saadi A, Patler C. Advancing Research To Address The Health Impacts Of Structural Racism In US Immigration Prisons. Health Aff (Millwood) 2023; 42:1448-1455. [PMID: 37782876 DOI: 10.1377/hlthaff.2023.00479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
The US is the world leader in imprisoning immigrants. Its mass immigration detention system emerged as an extension of mass incarceration, rooted in a legacy of racist US immigration and criminal laws. Immigration policy is a structural determinant of health that negatively affects the health of imprisoned immigrants, their families, and their communities. The systemic harms of "detention facilities," which we refer to as "immigration prisons," have been extensively documented, yet incrementalist reforms have failed to result in improved outcomes for immigrants. We argue that ending the practice of immigrant imprisonment is the most effective solution to mitigating its harms. Community-based programs are safer and less expensive than imprisonment, while also being effective at ensuring compliance with government requirements. We identify several priorities for researchers and policy makers to tackle the health inequities resulting from this structurally racist system. These include applying a critical, intersectional lens to studying the policies and practices that drive imprisonment, engaging affected communities in research and policy development, and creating an accountable and transparent system of data collection and release to inform health interventions. The reliance of the US on immigrant imprisonment is a policy choice with immense social and economic costs; dismantling it is critical to advancing health equity.
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Affiliation(s)
- Chanelle Diaz
- Chanelle Diaz , NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York
| | - Joseph Nwadiuko
- Joseph Nwadiuko, University of California Los Angeles, Los Angeles, California
| | - Altaf Saadi
- Altaf Saadi, Massachusetts General Hospital and Harvard University, Boston, Massachusetts
| | - Caitlin Patler
- Caitlin Patler, University of California Berkeley, Berkeley, California
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29
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Camargo JT, Barral RL, Kerling EH, Saavedra L, Carlson SE, Gajewski BJ, Ramírez M. Prenatal Care Utilization Challenges and Facilitators for a Growing Latino Community in the Midwest. Matern Child Health J 2023; 27:1811-1822. [PMID: 37369811 DOI: 10.1007/s10995-023-03733-1] [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] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Latina women are less likely to start prenatal care in the first trimester and to attend the recommended amount of prenatal visits compared to their non-Latina white counterparts. OBJECTIVES This study aimed to assess challenges and facilitators to first-trimester prenatal care (FTPNC) and prenatal care utilization (PNCU) in a Midwestern urban area with a growing immigrant Latino community. METHODS This study used a mixed-method approach based on the Theoretical Domains Framework. Nine semi-structured interviews were conducted with healthcare professionals that worked in birth centers, clinics, or hospitals that provided prenatal care (PNC) services for Latina women. Eight focus groups and quantitative surveys were conducted with Latina women and their supporters in Kansas City metropolitan area. RESULTS FTPNC was challenged by women's immigrant status, lack of healthcare coverage due to immigrant status, and complexity of Medicaid application. PNCU was challenged by the cost of PNC when diagnosed with gestational diabetes, lack of healthcare coverage, PNC literacy, late access to gynecologists/obstetricians, inadequate interpretation services, transportation, and mental health distress. Meanwhile, FTPNC was facilitated by social support and connectedness. PNCU was facilitated by Spanish-proficient providers and interpreters, effective nonverbal communication and education techniques, and pregnancy prevention access and education. CONCLUSIONS FOR PRACTICE Results from this study highlight important targets to improve PNC for Latina women. Participants called for various types of support to address identified challenges, ranging from information on social media about PNC services to broader efforts such as building trust from the community toward PNC providers and making PNC services affordable for women with gestational diabetes.
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Affiliation(s)
- Juliana Teruel Camargo
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
- Minority Health and Health Disparities Population Lab, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Romina L Barral
- Division of Adolescent Medicine, School of Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Elizabeth H Kerling
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Lillian Saavedra
- JUNTOS Center for Advancing Latino Health, Department of Population Health, School of Medicine, University of Kansas Medical Center, 4125 Rainbow Blvd Mail Stop 1076, Kansas City, KS, 66160, USA
| | - Susan E Carlson
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Byron J Gajewski
- Department of Biostatistics & Data Science, School of Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Mariana Ramírez
- JUNTOS Center for Advancing Latino Health, Department of Population Health, School of Medicine, University of Kansas Medical Center, 4125 Rainbow Blvd Mail Stop 1076, Kansas City, KS, 66160, USA.
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30
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Slopen N, Umaña-Taylor AJ, Shonkoff JP, Carle AC, Hatzenbuehler ML. State-Level Anti-Immigrant Sentiment and Policies and Health Risks in US Latino Children. Pediatrics 2023; 152:e2022057581. [PMID: 37581234 PMCID: PMC10565791 DOI: 10.1542/peds.2022-057581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Although systemic inequities, broadly defined, are associated with health disparities in adults, there is a dearth of research linking contextual measures of exclusionary policies or prejudicial attitudes to health impairments in children, particularly among Latino populations. In this study, we examined a composite measure of systemic inequities in relation to the cooccurrence of multiple health problems in Latino children in the United States. METHODS Participants included 17 855 Latino children aged 3 to 17 years from the National Survey of Children's Health (2016-2020). We measured state-level systemic inequities using a factor score that combined an index of exclusionary state policies toward immigrants and aggregated survey data on prejudicial attitudes toward immigrants and Latino individuals. Caregivers reported on 3 categories of child health problems: common health difficulties in the past year, current chronic physical health conditions, and current mental health conditions. For each category, we constructed a variable reflecting 0, 1, or 2 or more conditions. RESULTS In models adjusted for sociodemographic covariates, interpersonal discrimination, and state-level income inequality, systemic inequities were associated with 1.13 times the odds of a chronic physical health condition (95% confidence interval: 1.02-1.25) and 1.24 times the odds of 2 or more mental health conditions (95% confidence interval: 1.06-1.45). CONCLUSIONS Latino children residing in states with higher levels of systemic inequity are more likely to experience mental health or chronic physical health conditions relative to those in states with lower levels of systemic inequity.
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Affiliation(s)
- Natalie Slopen
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Center on the Developing Child
| | | | - Jack P. Shonkoff
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Center on the Developing Child
- Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts
- Harvard Medical School and Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Adam C. Carle
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
- Department of Psychology University of Cincinnati College of Arts and Sciences
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31
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Ettinger de Cuba S, Miller DP, Raifman J, Cutts DB, Bovell-Ammon A, Frank DA, Jones DK. Reduced health care utilization among young children of immigrants after Donald Trump's election and proposed public charge rule. HEALTH AFFAIRS SCHOLAR 2023; 1:qxad023. [PMID: 38756243 PMCID: PMC10986243 DOI: 10.1093/haschl/qxad023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/31/2023] [Accepted: 06/10/2023] [Indexed: 05/18/2024]
Abstract
Widespread fear among immigrants from hostile 2016 presidential campaign rhetoric decreased social and health care service enrollment (chilling effect). Health care utilization effects among immigrant families with young children are unknown. We examined whether former President Trump's election had chilling effects on well-child visit (WCV) schedule adherence, hospitalizations, and emergency department (ED) visits among children of immigrant vs US-born mothers in 3 US cities. Cross-sectional surveys of children <4 years receiving care in hospitals were linked to 2015-2018 electronic health records. We applied difference-in-difference analysis with a 12-month pre/post-election study period. Trump's election was associated with a 5-percentage-point decrease (-0.05; 95% CI: -0.08, -0.02) in WCV adherence for children of immigrant vs US-born mothers with no difference in hospitalizations or ED visits. Secondary analyses extending the treatment period to a leaked draft of proposed changes to public charge rules also showed significantly decreased WCV adherence among children of immigrant vs US-born mothers. Findings indicate likely missed opportunities for American Academy of Pediatrics-recommended early childhood vaccinations, health and developmental screenings, and family support. Policies and rhetoric promoting immigrant inclusion create a more just and equitable society for all US children.
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Affiliation(s)
- Stephanie Ettinger de Cuba
- Health Law, Policy & Management, Boston University School of Public Health and Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, United States
| | - Daniel P Miller
- Human Behavior, Research, and Policy, Boston University School of Social Work, Boston, MA, United States
| | - Julia Raifman
- Health Law, Policy & Management, Boston University School of Public Health, Boston, MA 02118, United States
| | - Diana B Cutts
- Pediatrics, Hennepin Healthcare and University of Minnesota School of Medicine, MN, United States
| | - Allison Bovell-Ammon
- Pediatrics, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Deborah A Frank
- Pediatrics, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - David K Jones
- Health Law, Policy & Management, Boston University School of Public Health, Boston, MA 02118, United States
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32
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Hodges J, Calvo R. Telehealth for All? Assessing Remote Service Delivery for Latinx Immigrants. HEALTH & SOCIAL WORK 2023:7194690. [PMID: 37308313 DOI: 10.1093/hsw/hlad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/30/2022] [Accepted: 09/22/2022] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic spurred a widespread shift to remotely delivered health services. Telehealth has shown promise in making healthcare more accessible. Little research has looked at the effects of this change on access to healthcare for Latinx immigrants. This qualitative study explored the shift to remote services during the COVID-19 pandemic in a new immigrant destination. Authors interviewed 23 service providers to assess if telehealth increased access to healthcare for Latinx immigrants. Results showed that telehealth improved access to services overall. Still, barriers to care remained. Immigrants experienced (a) limited access to technology and low digital literacy, (b) lack of privacy during the provision of services, (c) inability to utilize certain digital platforms due to confidentiality regulations, and (d) decreased quality of services. Findings suggest that telehealth is a promising modality to decrease healthcare disparities, but providers need to thoughtfully address barriers unique to Latinx immigrants to ensure their full participation.
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Affiliation(s)
- James Hodges
- LCSW, is a doctoral candidate School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Rocío Calvo
- PhD, is professor, School of Social Work, Boston College, Chestnut Hill, MA, USA
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33
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Yu SH, Kodish T, Bear L, O’Neill JC, Asarnow JR, Goldston D, Cheng KK, Wang X, Vargas SM, Lau AS. Leader and Provider Perspectives on Implementing Safe Alternatives for Teens and Youth - Acute (SAFETY-A) in Public School Districts Serving Racial/ethnic Minoritized Youth. SCHOOL MENTAL HEALTH 2023; 15:583-599. [PMID: 37622166 PMCID: PMC10449380 DOI: 10.1007/s12310-023-09572-3] [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] [Accepted: 01/31/2023] [Indexed: 02/26/2023]
Abstract
Racial/ethnic minoritized (REM) youth represent a high-risk group for suicide, yet there are striking disparities in their use of mental health services (MHS) even after risk is identified in schools. Prior research suggests that school-based risk assessments and hospitalization encounters can be negatively experienced by REM youth and families, thus deterring likelihood of seeking follow-up care. The Safe Alternatives for Teens and Youth-Acute (SAFETY-A) is a brief, strengths-based, cognitive-behavioral family intervention demonstrated to increase linkage to MHS when implemented in emergency departments. With its focus on strengths and family engagement, SAFETY-A may cultivate a positive therapeutic encounter suited to addressing disparities in MHS by enhancing trust and family collaboration, if appropriately adapted for schools. Thirty-seven school district leaders and frontline school MHS providers from districts serving primarily socioeconomically disadvantaged REM communities participated in key informant interviews and focus groups. First, interviews were conducted to understand usual care processes for responding to students with suicidal thoughts and behaviors, and perspectives on the strengths and disadvantages of current practices. An as-is process analysis was used to describe current practices spanning risk assessment, crisis intervention, and follow-up. Second, focus groups were conducted to solicit perceptions of the fit of SAFETY-A for these school contexts. Thematic analysis of the interviews and focus groups was used to identify multilevel facilitators and barriers to SAFETY-A implementation, and potential tailoring variables for implementation strategies across school districts.
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Affiliation(s)
- Stephanie H. Yu
- Department of Psychology, University of California, Los Angeles, CA
| | - Tamar Kodish
- Department of Psychology, University of California, Los Angeles, CA
| | | | - J. Conor O’Neill
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Joan R. Asarnow
- Department of Psychiatry, Child, and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - David Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Karli K. Cheng
- Department of Neurology, Phoenix Children’s Hospital, Phoenix, AZ
| | - Xinran Wang
- Department of Psychology, University of California, Los Angeles, CA
- Department of Psychology and Human Development, Vanderbilt University, TN
| | - Sylvanna M. Vargas
- Department of Psychology, University of California, Los Angeles, CA
- Department of Psychiatry, Child, and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Anna S. Lau
- Department of Psychology, University of California, Los Angeles, CA
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34
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Tuohy B, Jatres J. Researching Those in the Shadows: Undocumented Immigrants, Vulnerability, and the Significance of Research. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2023; 23:106-109. [PMID: 37220350 DOI: 10.1080/15265161.2023.2204053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Brian Tuohy
- Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University
| | - Jillian Jatres
- Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University
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35
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Saadi A, Morales B, Chen L, Sudhinaraset M. Understanding the function of social capital among Mexican and Chinese immigrants in Southern California: A qualitative study. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 3:100247. [PMID: 38469391 PMCID: PMC10927253 DOI: 10.1016/j.ssmqr.2023.100247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Affiliation(s)
- Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Brenda Morales
- Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA, USA
| | - Lei Chen
- Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA, USA
| | - May Sudhinaraset
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
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Allen R, Pacas JD, Martens Z. Immigrant Legal Status among Essential Frontline Workers in the United States during the COVID-19 Pandemic Era. INTERNATIONAL MIGRATION REVIEW 2023; 57:521-556. [PMID: 38603280 PMCID: PMC9614593 DOI: 10.1177/01979183221127277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Emerging evidence suggests that the COVID-19 pandemic has extracted a substantial toll on immigrant communities in the United States, due in part to increased potential risk of exposure for immigrants to COVID-19 in the workplace. In this article, we use federal guidance on which industries in the United States were designated essential during the COVID-19 pandemic, information about the ability to work remotely, and data from the 2019 American Community Survey to estimate the distribution of essential frontline workers by nativity and immigrant legal status. Central to our analysis is a proxy measure of working in the primary or secondary sector of the segmented labor market. Our results indicate that a larger proportion of foreign-born workers are essential frontline workers compared to native-born workers and that 70 percent of unauthorized immigrant workers are essential frontline workers. Disparities in essential frontline worker status are most pronounced for unauthorized immigrant workers and native-born workers in the secondary sector of the labor market. These results suggest that larger proportions of foreign-born workers, and especially unauthorized immigrant workers, face greater risk of potential exposure to COVID-19 in the workplace than native-born workers. Social determinants of health such as lack of access to health insurance and living in overcrowded housing indicate that unauthorized immigrant essential frontline workers may be more vulnerable to poor health outcomes related to COVID-19 than other groups of essential frontline workers. These findings help to provide a plausible explanation for why COVID-19 mortality rates for immigrants are higher than mortality rates for native-born residents.
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Affiliation(s)
- Ryan Allen
- University of Minnesota Twin
Cities, USA
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37
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Lieberman JT, Valdez CR, Pintor JK, Weisz P, Carroll-Scott A, Wagner K, Martinez-Donate AP. "It felt like hitting rock bottom": A qualitative exploration of the mental health impacts of immigration enforcement and discrimination on US-citizen, Mexican children. LATINO STUDIES 2023:1-25. [PMID: 37358960 PMCID: PMC10184077 DOI: 10.1057/s41276-023-00415-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 06/28/2023]
Abstract
Latino immigrant families in the United States were disproportionately affected by intensified interior immigration enforcement under the Trump administration. US-citizen children are victimized by policies targeting their immigrant parents; research is sparse regarding how these polices affect children who experience parental deportation and children who are at risk for parental deportation. Additionally, anti-immigrant rhetoric can result in increased discrimination that also threatens children's psychological health. This qualitative study (N = 22) explores children's lived experiences of discrimination, parental deportation or threat of parental deportation, and perceived impacts on mental health. Interviews conducted from 2019 to 2020 revealed that children who are directly affected by or at risk for parental deportation experience detrimental impacts to their psychological well-being. Children experience discrimination as Latinos and children of immigrants, which is also detrimental to their mental/emotional health. Incorporating children's perspectives is critical to informing public health interventions. Findings demonstrate the need for family-friendly immigration reform.
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De Trinidad Young ME, Tafolla S, Saadi A, Sudhinaraset M, Chen L, Pourat N. Beyond "Chilling Effects": Latinx and Asian Immigrants' Experiences With Enforcement and Barriers to Health Care. Med Care 2023; 61:306-313. [PMID: 36939228 PMCID: PMC10079615 DOI: 10.1097/mlr.0000000000001839] [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: 03/21/2023]
Abstract
OBJECTIVES Immigration enforcement policies are associated with immigrants' barriers to health care. Current evidence suggests that enforcement creates a "chilling effect" in which immigrants avoid care due to fear of encountering enforcement. Yet, there has been little examination of the impact of immigrants' direct encounters with enforcement on health care access. We examined some of the first population-level data on Asian and Latinx immigrants' encounters with law and immigration enforcement and assessed associations with health care access. METHODS We analyzed the 2018 and 2019 Research on Immigrant Health and State Policy survey in which Asian and Latinx immigrants in California (n=1681) reported on 7 enforcement experiences (eg, racial profiling and deportation). We examined the associations between measures of individual and cumulative enforcement experiences and the usual sources of care and delay in care. RESULTS Latinx, compared with Asian respondents, reported the highest levels of enforcement experiences. Almost all individual enforcement experiences were associated with delaying care for both groups. Each additional cumulative experience was associated with a delay in care for both groups (OR=1.30, 95% CI 1.10-1.50). There were no associations with the usual source of care. CONCLUSION Findings confirm that Latinx immigrants experience high levels of encounters with the enforcement system and highlight new data on Asian immigrants' enforcement encounters. Direct experiences with enforcement have a negative relationship with health care access. Findings have implications for health systems to address the needs of immigrants affected by enforcement and for changes to health and immigration policy to ensure immigrants' access to care.
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Affiliation(s)
- Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA 95343, USA
| | - Sharon Tafolla
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA 95343, USA
| | - Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School; 100 Cambridge St, Suite 2000, Boston, MA 02114, USA
| | - May Sudhinaraset
- Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA
| | - Lei Chen
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, 337 Charles E Young Dr E, Los Angeles, CA 90095
| | - Nadereh Pourat
- Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA
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De Jesus M, Warnock B, Moumni Z, Sougui ZH, Pourtau L. The impact of social capital and social environmental factors on mental health and flourishing: the experiences of asylum-seekers in France. Confl Health 2023; 17:18. [PMID: 37029423 PMCID: PMC10081295 DOI: 10.1186/s13031-023-00517-w] [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: 09/21/2022] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND There is growing interest on how social capital and related social environmental factors impact overall population health and well-being. The nature of asylum-seekers' social environment alters once they migrate to a new context and these changes influence their mental health and well-being. However, there is limited scholarship on how these social environmental factors impact the mental health, well-being, and capacity to flourish of asylum-seekers. METHODS The aim of the study, therefore, was to examine how specific social environmental factors-social networks, social support, and social cohesion at various levels (micro, meso, and macro)-influence the mental health, well-being, and capacity to flourish of asylum-seekers in France. In collaboration with a community-based organization, we used a qualitative research design to conduct 120 semi-structured interviews with asylum-seekers in France. RESULTS The emerging salient themes depicted how the asylum-seekers' usual informal social networks comprised of family and friends had been disrupted since they migrated to France, which impacted their mental health and well-being. Conversely, staying connected with their informal transnational social networks via social media and developing ties with new local informal and formal social networks allowed them to receive different forms of social support, and buffered some of the negative mental health consequences. However, the lack of social cohesion due to a lack of belonging, marginalization, and current harmful migration-related policies impeded asylum-seekers' capacity to flourish. CONCLUSION While social support derived from social networks buffered some negative impacts on mental health and well-being, the overall lack of social cohesion ultimately impeded asylum-seekers' capacity to flourish within their host communities, which was further exacerbated by harmful migration policies of exclusion within France. Introducing more inclusive policies related to the governance of migration and an intersectoral approach that views health in all policies is key to promoting social cohesion and flourishing among asylum-seekers in France.
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Affiliation(s)
- Maria De Jesus
- Collegium de Lyon, Université de Lyon, Lyon, France.
- School of International Service, American University, 4400 Massachusetts Ave, NW, Washington, DC, 20016, USA.
- Center on Health, Risk, and Society, American University, Washington, DC, USA.
| | - Bronwyn Warnock
- School of International Service, American University, 4400 Massachusetts Ave, NW, Washington, DC, 20016, USA
| | - Zoubida Moumni
- Psychologie de la Santé, Université Lumière Lyon 2, 69365, Lyon, France
| | - Zara Hassan Sougui
- Santé Publique, Université Claude Bernard Lyon 1, 69100, Villeurbanne, France
| | - Lionel Pourtau
- Pôle Recherche et Innovation, Habitat et Humanisme, 69300, Caluire et Cuire, France
- LEIRIS, Université Paul Valéry Montpellier 3, 34090, Montpellier, France
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Raffa BJ, Swartz JJ, Ranapurwala SI, Zhao C, Cholera R. Immigration Policy and the Health of Latina Mothers and Their Infants. J Immigr Minor Health 2023:10.1007/s10903-023-01476-3. [PMID: 37020058 DOI: 10.1007/s10903-023-01476-3] [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: 03/16/2023] [Indexed: 04/07/2023]
Abstract
Restrictive immigration policies may adversely affect the health of Latina mothers and their infants. We hypothesized that undocumented Latina mothers and their US born children would have worse birth outcomes and healthcare utilization following the November 2016 election. We used a controlled interrupted time series to estimate the impact of the 2016 presidential election on low birth weight (LBW), preterm birth, maternal depression, well child visit attendance, cancelled visits, and emergency department (ED) visits among infants born to Latina mothers on emergency Medicaid, a proxy for undocumented immigration status. There was a 5.8% (95% CI: -0.99%, 12.5%) increase in LBW and 4.6% (95% CI: -1.8%, 10.9%) increase in preterm births immediately after the 2016 election compared to controls. While these findings were not statistically significant at p < 0.05, the majority of our data suggest worsened birth outcomes among undocumented Latina mothers after the election, consistent with larger prior studies. There was no difference in well child or ED visits. While restrictive policies may have contributed to worse birth outcomes among undocumented Latina mothers, our findings suggest that Latino families still attend infants' scheduled visits.
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Affiliation(s)
- Brittany J Raffa
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Jonas J Swartz
- Division of Women's Community and Population Health, Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
| | - Shabbar I Ranapurwala
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Congwen Zhao
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Rushina Cholera
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Duke Margolis Center for Health Policy, Duke University, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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LEBRÓN ALANAM, TORRES IVYR, KLINE NOLAN, LOPEZ WILLIAMD, DE TRINIDAD YOUNG MARIA, NOVAK NICOLE. Immigration and Immigrant Policies, Health, and Health Equity in the United States. Milbank Q 2023; 101:119-152. [PMID: 37096601 PMCID: PMC10126972 DOI: 10.1111/1468-0009.12636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 10/17/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points There is growing attention to the role of immigration and immigrant policies in shaping the health and well-being of immigrants of color. The early 21st century in the United States has seen several important achievements in inclusionary policies, practices, and ideologies toward immigrants, largely at subnational levels (e.g., states, counties, cities/towns). National policies or practices that are inclusionary toward immigrants are often at the discretion of the political parties in power. Early in the 21st century, the United States has implemented several exclusionary immigration and immigrant policies, contributing to record deportations and detentions and worsening inequities in the social drivers of health.
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Affiliation(s)
- ALANA M.W. LEBRÓN
- Program in Public HealthUniversity of California, Irvine
- University of California, Irvine
| | - IVY R. TORRES
- Program in Public HealthUniversity of California, Irvine
| | - NOLAN KLINE
- University of North Texas, Health Science Center at Fort Worth
| | - WILLIAM D. LOPEZ
- University of Michigan School of Public Health and Poverty Solutions
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Soto S, Yoder AM, Aceves B, Nuño T, Sepulveda R, Rosales CB. Determining Regional Differences in Barriers to Accessing Health Care Among Farmworkers Using the National Agricultural Workers Survey. J Immigr Minor Health 2023; 25:324-330. [PMID: 36319879 PMCID: PMC9988993 DOI: 10.1007/s10903-022-01406-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 12/31/2022]
Abstract
Farmworkers are an essential workforce in the U.S. We assessed the regions in the National Agricultural Workers Survey on the difficulty of accessing health care among farmworkers in the U.S. The study included 9577 farmworkers. Farmworkers in all regions were more likely to report having difficulty accessing health care because it was too expensive. The overall odds ratio for difficulty accessing health care was lower in the MW after adjusting. Farmworkers employed in the SE had greater difficulty accessing health care because of language barriers. Farmworkers employed in CA had difficulty accessing health care in the U.S. because it was too expensive or far away. Results follow previous studies on barriers to access health care among the farmworker population. Understanding regional disparities in the presence of barriers to accessing health care among farmworkers is an essential step to improving equitable health care access in the U.S.
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Affiliation(s)
- Sheila Soto
- Division of Public Health Practice & Translational Research, Mel and Enid Zuckerman, College of Public Health, University of Arizona, Phoenix, AZ, USA.
| | - Aaron Meck Yoder
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Benjamin Aceves
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Tomas Nuño
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Refugio Sepulveda
- Division of Public Health Practice & Translational Research, Mel and Enid Zuckerman, College of Public Health, University of Arizona, Phoenix, AZ, USA
| | - Cecilia Ballesteros Rosales
- Division of Public Health Practice & Translational Research, Mel and Enid Zuckerman, College of Public Health, University of Arizona, Phoenix, AZ, USA
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Stafford AM, Tanna A, Bueno KM, Nagy GA, Felsman IC, de Marchi S, Cholera R, Evans K, Posada E, Gonzalez-Guarda R. Documentation Status and Self-Rated Physical Health Among Latinx Young Adult Immigrants: the Mediating Roles of Immigration and Healthcare Stress. J Racial Ethn Health Disparities 2023; 10:761-774. [PMID: 35175583 PMCID: PMC8853124 DOI: 10.1007/s40615-022-01264-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 01/14/2023]
Abstract
Previous research has demonstrated that undocumented Latinx immigrants in the USA report worse physical health outcomes than documented immigrants. Some studies suggest that immigration-related stress and healthcare related-stress may explain this relationship, but none have tested it empirically. The purpose of this study was to determine if immigration-related stress and healthcare-related stress in the USA explain the relationship between documentation status and physical health among Latinx immigrants in North Carolina. The conceptual model was tested utilizing baseline data from a longitudinal, observational, community-engaged research study of young adult (18-44 years) Latinx immigrants residing in North Carolina (N = 391). Structural equation modeling was used to determine relationships among documentation status, healthcare, and immigration stress in the past six months, and self-rated physical health. Goodness-of-fit measures indicated that data fit the model well (RMSEA = .008; CFI = 1.0; TLI = .999; SRMR = .02; CD = .157). Undocumented individuals were more likely to experience immigration stress than their documented counterparts ([Formula: see text] = - 0.37, p < 0.001). Both immigration stress ([Formula: see text] = - 0.22, p < 0.01) and healthcare stress ([Formula: see text] = - 0.14, p < 0.05) were negatively related to physical health. Additionally, immigration stress was positively related to healthcare stress ([Formula: see text] = 0.72, p < 0.001). Results demonstrate that documentation status is an important social determinant of health. Passage of inclusive immigration and healthcare policies may lessen the stress experienced by Latinx immigrants and subsequently improve physical health.
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Affiliation(s)
| | - Aneri Tanna
- Trinity College of Arts and Sciences, Duke University, Box 90046, Durham, NC 27710 USA
| | - Karina Moreno Bueno
- Trinity College of Arts and Sciences, Duke University, Box 90046, Durham, NC 27710 USA
| | - Gabriela A. Nagy
- Duke University School of Nursing, 307 Trent Dr. DUMC 3322, Durham, NC 27710 USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2213 Elba St, Durham, NC 27705 USA
| | - Irene Crabtree Felsman
- Duke University School of Nursing, 307 Trent Dr. DUMC 3322, Durham, NC 27710 USA
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710 USA
| | - Scott de Marchi
- Department of Political Science, Duke University, 140 Science Dr, Durham, NC 27708 USA
| | - Rushina Cholera
- Department of Pediatrics, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC 27707 USA
| | - Kate Evans
- Duke University School of Law, 210 Science Dr, Durham, NC 27708 USA
| | - Eliazar Posada
- El Centro Hispano Inc, 2000 Chapel Hill Rd, Durham, NC 27707 USA
| | - Rosa Gonzalez-Guarda
- Duke University School of Nursing, 307 Trent Dr. DUMC 3322, Durham, NC 27710 USA
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Caballero E, Minnis A, Parmar D, Zerofsky M, Comfort M, Raymond-Flesch M. Labeling in a Latinx Community: Public Health Implications for Youth and Role in Community Narratives. RESEARCH SQUARE 2023:rs.3.rs-2626181. [PMID: 36993344 PMCID: PMC10055544 DOI: 10.21203/rs.3.rs-2626181/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Background Youth of color are disproportionately subjected to negative formal and informal labels by parents, peers, and teachers. This study examined the consequences of such labels on health-protective behaviors, wellbeing, peer networks and school engagement. Methods In-depth interviews were conducted with 39 adolescents and 20 mothers from a predominantly Latinx and immigrant agricultural community in California. Teams of coders completed iterative rounds of thematic coding to identify and refine key themes. Results Dichotomous labeling of "good" and "bad" was pervasive. Youth labeled as "bad" experienced limited educational opportunities, exclusion from peers, and community disengagement. Additionally, preservation of "good kid" labels compromised health protective-behaviors including foregoing contraception. Participants pushed back on negative labeling when it was applied to close family or community acquaintances. Discussion Targeted interventions that foster social belonging and connection rather than exclusion may facilitate health protective behaviors and have positive implications for future trajectories among youth.
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Durning JD, Moriarty H. Access and Use of Preventive Health Care by Adolescents in Immigrant Families: An Integrative Review. J Transcult Nurs 2023; 34:157-165. [PMID: 36680438 DOI: 10.1177/10436596221149691] [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: 01/22/2023] Open
Abstract
INTRODUCTION More than 25% of American adolescents live in immigrant families. This cohort of adolescents is a minority group with amplified health challenges. The purpose of this study was to provide an integrative review of quantitative research on the access and use of primary and preventive health care by adolescents in immigrant families. METHOD Searches yielded 460 reports, 54 of them satisfied criteria for full-text review, and four publications met inclusion criteria. RESULTS Research, albeit very limited, revealed that adolescents in immigrant families have poor access to and use of preventive health care. DISCUSSION Lack of primary health care may prevent identification of health risks in immigrant adolescents and lead them to perceive that preventive health care is unnecessary. Researchers are challenged to develop and test health promotion interventions tailored for these adolescents. Study recruitment outside of high schools, the typical setting, is critical to advance knowledge and improve access for this vulnerable population.
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Affiliation(s)
- Jennifer Dean Durning
- Villanova University, PA, USA.,Massachusetts General Hospital Institute of Health Professions, Boston, USA
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46
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Peña JM, Schwartz MR, Hernandez-Vallant A, Sanchez GR. Social and structural determinants of COVID-19 vaccine uptake among racial and ethnic groups. J Behav Med 2023; 46:129-139. [PMID: 36652085 PMCID: PMC9846662 DOI: 10.1007/s10865-023-00393-y] [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: 09/01/2021] [Accepted: 01/04/2023] [Indexed: 01/19/2023]
Abstract
Latino, Black, American Indian/Alaska Native (AI/AN), and Native Hawaiian or Other Pacific Islander people have the highest hospitalizations and death rates from COVID-19. Social inequalities have exacerbated COVID-19 related health disparities. This study examines social and structural determinants of COVID-19 vaccine uptake. Results from logistic regressions suggest Latino and Black people were less likely to be vaccinated. People that did not have health insurance, a primary care doctor and were unemployed were more than 30% less likely to be vaccinated for COVID-19. Greater perceived health inequalities in one's neighborhood and perceived racial/ethnic discrimination were associated with a decreased odds in being vaccinated. People that suffered the loss of a household member from COVID-19 were three times more likely to have been vaccinated. Establishing policies that will increase access to health insurance and create jobs with living wages may have lasting impacts. Furthermore, collaboration with local and national community organizations can enhance the development of sustainable solutions.
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Affiliation(s)
- Juan M. Peña
- Department of Psychology Albuquerque, The University of New Mexico, 2001 Redondo S Dr, Albuquerque, 87106 NM USA ,Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA
| | - Matthew R. Schwartz
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Department of Internal Medicine, The University of New Mexico, Albuquerque, NM USA
| | - Alexandra Hernandez-Vallant
- Department of Psychology Albuquerque, The University of New Mexico, 2001 Redondo S Dr, Albuquerque, 87106 NM USA ,Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Center of Alcohol, The University of New Mexico, Substance Use, and Addictions, Albuquerque, NM USA
| | - Gabriel R. Sanchez
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Department of Political Science, The University of New Mexico, Albuquerque, NM USA
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Crookes DM, Lemon ED, Sainz M, Del Carmen Chacón L, Urbina BM, Woods-Jaeger B. Immigration Enforcement Climate in Georgia and the Mental Health of Latinx Immigrants. J Health Care Poor Underserved 2023; 34:798-809. [PMID: 37464531 PMCID: PMC10880083 DOI: 10.1353/hpu.2023.0041] [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: 07/20/2023]
Abstract
INTRODUCTION Immigrant-related social policies and immigration enforcement contribute to a sociopolitical environment that affects immigrants' health. This exploratory study in six metro-Atlanta counties examined associations among immigrants' perceived vulnerability to harmful immigrant-related social policies and county-level 287(g) agreements (which facilitate cooperation between local law enforcement and federal immigration authorities), county-level immigration enforcement levels (arrests, community arrests, detainers, and removals), and immigrants' mental health. METHODS Using data from a 2020 study among Latinx parents who were undocumented or members of mixed-status families (N = 140), we merged data on individuals' perceived policy vulnerability and depressive and anxiety symptoms with county 287(g) status and immigration enforcement levels. RESULTS Perceived policy vulnerability was not associated with county-level 287(g) status or immigration enforcement levels. Greater policy vulnerability and Immigration and Customs Enforcement arrests were associated with higher depressive and anxiety symptoms, but 287(g) status was associated with lower depressive and anxiety symptoms. CONCLUSION Perceived policy vulnerability, 287(g) status, and immigration enforcement levels do not always align and can have different associations with mental health.
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Maness P, Tumin D, Cholera R, Collier DN, Bonilla-Hernandez L, Lazorick S. Ethnicity and trends in pediatric specialty care clinic attendance at an academic medical center in the rural southeastern US. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001816. [PMID: 37053141 PMCID: PMC10101378 DOI: 10.1371/journal.pgph.0001816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/20/2023] [Indexed: 04/14/2023]
Abstract
Following the 2016 US Presidential election, immigration enforcement became more aggressive, with variation by state and region depending on local policies and sentiment. Increases in enforcement created an environment of risk for decreased use of health care services among especially among Latino families. of Hispanic ethnicity and/or from Latin American origin (as a group subsequently referred to as Latino). For Latino children with chronic health conditions, avoidance of routine health care can result in significant negative health consequences such as disease progression, avoidable use of acute health care services, and overall increased costs of care. To investigate for changes in visit attendance during the periods before and since increased immigration enforcement, we extracted data on children followed by subspecialty clinics of one healthcare system in the US state of North Carolina during 2015-2019. For each patient, we calculated the proportion of cancelled visits and no-show visits out of all scheduled visits during the 2016-2019 follow-up period. We compared patient characteristics (at the 2015 baseline) according to whether they cancelled or did not show to any visits in subsequent years by clinic and patient factors, including ethnicity. Data were analyzed using multinomial logistic regression of attendance at each visit, including an interaction between visit year and patient ethnicity. Among 852 children 1 to 17 years of age (111 of Latino ethnicity), visit no-show was more common among Latino patients, compared to non-Latino White patients; while visit cancellation was more common among non-Latino White patients, compared to Latino patients. There was no significant interaction between ethnicity and trends in visit no-show or cancellation. Although differences in pediatric specialty clinic visit attendance by patient ethnicity were seen at study baseline, changing immigration policy and negative rhetoric did not appear to impact use of pediatric subspecialty care.
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Affiliation(s)
- Philip Maness
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Rushina Cholera
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - David N Collier
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Luisa Bonilla-Hernandez
- Pediatrics Residency Program, Vidant Medical Center and East Carolina University, Greenville, North Carolina, United States of America
| | - Suzanne Lazorick
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
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Wang SS, Glied S, Babcock C, Chaudry A. Changes in the Public Charge Rule and Health of Mothers and Infants Enrolled in New York State’s Medicaid Program, 2014‒2019. Am J Public Health 2022; 112:1747-1756. [DOI: 10.2105/ajph.2022.307066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives. To examine the effect of the January 2017 leak of the federal government’s intent to broaden the public charge rule (making participation in some public programs a barrier to citizenship) on immigrant mothers and newborns in New York State. Methods. We used New York State Medicaid data (2014–2019) to measure the effects of the rule leak (January 2017) on Medicaid enrollment, health care utilization, and severe maternal morbidity among women who joined Medicaid during their pregnancies and on the birth weight of their newborns. We repeated our analyses using simulated measures of citizenship status. Results. We observed an immediate statewide delay in prenatal Medicaid enrollment by immigrant mothers (odds ratio = 1.49). Using predicted citizenship, we observed significantly larger declines in birth weight (−56 grams) among infants of immigrant mothers. Conclusions. Leak of the public charge rule was associated with a significant delay in prenatal Medicaid enrollment among immigrant women and a significant decrease in birth weight among their newborns. Local public health officials should consider expanding health access and outreach programs to immigrant communities during times of pervasive antiimmigrant sentiment. (Am J Public Health. 2022; 112(12):1747–1756. https://doi.org/10.2105/AJPH.2022.307066 )
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Affiliation(s)
- Scarlett Sijia Wang
- The authors were affiliated with the Wagner School of Public Service at New York University, New York, NY, at the completion of the article
| | - Sherry Glied
- The authors were affiliated with the Wagner School of Public Service at New York University, New York, NY, at the completion of the article
| | - Claudia Babcock
- The authors were affiliated with the Wagner School of Public Service at New York University, New York, NY, at the completion of the article
| | - Ajay Chaudry
- The authors were affiliated with the Wagner School of Public Service at New York University, New York, NY, at the completion of the article
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Kiehne E, Hafen Q. State and local integrationist policies and the physical and psychological health of undocumented immigrants. Curr Opin Psychol 2022; 48:101453. [PMID: 36174328 DOI: 10.1016/j.copsyc.2022.101453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 01/28/2023]
Abstract
Protracted daily preoccupation with the federal immigration policing infrastructure, restrictive policy, and antagonistic rhetoric take a substantial toll on the psychological and physical health of undocumented immigrants and their families. A growing network of states and municipalities are adopting policies to promote immigrant wellbeing through integration. Recent advances in research suggest subfederal healthcare access, sanctuary, and ID policies increase access to healthcare and health resources and decrease fear and stress. However, health impacts of these policies are modulated by national socio-political forces that spur misinformation, distrust, and fear. To help overcome this, states and municipalities should layer integrationist actions. Critically, more policy impact research is needed to support understanding, uptake, and renewal of state and local policymaking promoting immigrant health.
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