"We Cannot Let Them Die": Undocumented Immigrants and Media Framing of Health Deservingness in the United States

Picturing the populations who could benefit from health insurance access expansions: An analysis of US health insurance television ads airing in 2018

Efforts to expand access to health insurance in the United States are key to addressing health inequities and ensuring that all individuals have access to health care during the coronavirus disease 2019 pandemic. Yet, attempts to expand public insurance programs, including Medicaid, continue to face opposition in state and federal policymaking. Limited policy success raises questions about the health insurance information environment and the extent that available information signals both available resources and the need for policy reform. In this study, we explore one way that consumers and policymakers learn about health insurance-television advertisements-and analyze content in ads that could contribute to an understanding of who needs health insurance or who deserves to benefit from policies to expand insurance access. Specifically, we implement a content analysis of health insurance ads airing throughout 2018 on broadcast television or national cable, focusing on the depictions of people in those ads. Our findings indicate that individuals depicted in ads for Medicaid plans differ from those in ads for non-Medicaid plans. Groups that comprise large populations of current Medicaid enrollees, children and pregnant people, were more likely to appear in ads for non-Medicaid plans than in ads for Medicaid plans. This has implications for potential enrollees' understanding of who is eligible as well as the general public's and policymakers' perspectives on who should be targeted for current or future policies.

Partnering with immigrant families to promote language justice and equity in education

Despite US federal legislation mandates institutions to provide meaningful access and participation to students and families in educational settings, culturally and linguistically diverse (CLD) families and caregivers of children in special education experience cultural and linguistic barriers. A Community Advisory Team (CAT) of parents, advocates, community interpreters and translators, researchers, and teachers explored CLD families' experiences and advocacy efforts. Critical bifocality and circuits of dispossession, privilege, and resistance informed the documentation of inequities and resistance to understand the linkages of structural arrangements of power. Focus groups with families (n = 21) speakers of Spanish, Portuguese, and Cantonese were conducted. Findings indicate perceived discrimination, poor and inadequate interpretation and translation services impact children's access to special education services, hinder family's communication with schools and reduce the perceptions of schools as trustworthy institutions. Families advocate relentlessly for their children and recommend schools listen to families and hire culturally and linguistically competent interpreters and translators. Community psychologists can make significant contributions to promote language justice in education settings through participatory approaches to inquiry that value CLD families' knowledge and expertise.

The Language of Immigration Coverage: The Arizona Republic and Media's Role in the Production of Social Illegality

Recently, several mainstream media organizations have moved away from using "illegal immigrant" in their immigration coverage. While this shift in immigration coverage is positive, seemingly positive language may still be exclusionary, particularly if the content of stories remains the same. We investigate whether newspaper articles that describe immigrants as "illegal" are more negative in content than articles that present immigrants as "undocumented" by analyzing 1,616 newspaper articles and letters to the editor in The Arizona Republic between 2000 and 2016, a critical period of immigration legislative activity in Arizona. We find that The Arizona Republic inundated readers with negative news coverage and that this coverage is baked into the content of stories and transcends the use of either term, "illegal" or "undocumented." We then draw on letters to the editor and original interview data to consider how social forces outside of the media may influence coverage.

“Divide, Divert, & Conquer” Deconstructing the Presidential Framing of White Supremacy in the COVID-19 Era

Based on the analysis of President Donald J. Trump’s social media, along with excerpts from his speeches and press releases, this study sheds light on the framing of white supremacy during the first months of the COVID-19 pandemic in the United States. Our findings reveal that the triad of divide, divert, and conquer was crucial to Trump’s communications strategy. We argue that racist nativism—or racialized national threats to American security—is key to comprehending the external divisiveness in this strategy. When Trump bitterly cast China as the cause of America’s pandemic fallout and Mexico as the source of other key American problems (i.e., crime and low-paid jobs for U.S.-born Americans), he sowed clear racialized divisions between the United States (U.S.). and these two nations. We further argue that nativist racism—or the framing of descendants from those nations as incapable of ever being American—is key to comprehending the internal divisiveness in the former President’s pandemic rhetoric. Trump’s framing of China and Mexico as enemies of America further found its culprits in Asian and Latino Americans who were portrayed as COVID-19 carriers. Trump’s narrative was ultimately geared to diverting attention from his administration’s mishandling of COVID-19, the dismal structural conditions faced by detained and undocumented Latinos, and the anti-Asian bias faced by some of his Asian American constituents. In the conclusions, this article makes a call for countering white supremacy by developing comparative approaches that pay more attention to how different racisms play out for different groups.

Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community

South Florida agricultural regions, home to Latinx immigrant farmworkers, report higher rates of late-stage breast cancer diagnosis than national, state, and county-level averages. We conducted a community-based qualitative study on the needs, health knowledge gaps, barriers to breast cancer screening, and the role of community health workers (CHWs) in supporting the community's access to early detection services. We conducted three CHW focus groups (FGs) (n = 25) and in-depth interviews (n = 15), two FGs (n = 18) and in-depth interviews (n = 3) with farmworker community members, and informal interviews with cancer clinicians (n = 7). Using a grounded theory approach, five core themes regarding the community's barriers to accessing health care services emerged: (a) lack of information; (b) social and economic barriers; (c) cultural factors; (d) fears and mistrust; and (e) psychosocial concerns. Findings yield implications for community health practice, the potential impact of CHWs, and the production of breast cancer education to improve health equity along with the care continuum.

A Latent Class Analysis of Attitudes Towards Asylum Seeker Access to Health Care

In the past decade there has been an increase in focus on the concept of deservingness and how it plays out in debates around health care for migrant populations with precarious legal status. This study uses latent class analysis to identify subtypes of attitudes regarding asylum seeker access to health care and endorsement of support for asylum seeker access to care among 4066 employees of health care institutions in Montreal and Toronto, Canada. Authors identified four classes of attitudes towards asylum seeker access to care named 'Favorable,' 'Opposed,' 'Ambivalent/Reactive,' and 'Unconcerned/Status quo'. The odds of endorsing access to health care depended on the individual's class membership of asylum seeker attitude. Although there are segments of the population that overwhelmingly endorse, or reject, asylum seeker access to care, there are important variants in opinions and beliefs. Interventions are needed to engage professionals more ambivalent or opposed to asylum seeker access to care.

Visualizing Health Equity: Qualitative Perspectives on the Value and Limits of Equity Images

BACKGROUND

Health educators and advocacy groups often use side-by-side visual images to communicate about equity and to distinguish it from equality. Despite the near-ubiquity of these images, little is known about how they are understood by different audiences.

AIMS

To assess the effectiveness of an image commonly used to communicate about health equity.

METHOD

In 167 interviews with health stakeholders in Greater Cleveland, Ohio, in 2018 to 2019, a commonly used health equity image was shown to participants, who were asked to interpret its meaning. Interviewees included 21 health professionals, 21 clinicians, 22 metro-wide decision makers, 24 community leaders, and 79 community members.

RESULTS

About two thirds of our socioeconomically, racial/ethnically, educationally, and professionally diverse sample said the equity image helped clarify the distinction between "equality" and "equity." Yet less than one third offered an interpretation consistent with the image's goals of foregrounding not only injustice but also a need for systemic change. Patterns of misinterpretation were especially common among two groups: ideological conservatives and those of lower socioeconomic status. Conservatives were most likely to object to the image's message.

CONCLUSIONS

Equity images are widely used by public health educators and advocates, yet they do not consistently communicate the message that achieving equity requires systemic change. In this moment of both public health crisis and urgent concern about systemic racism, new visual tools for communicating this crucial message are needed.

Resisting the racialization of medical deservingness: How Latinx nurses produce symbolic resources for Latinx immigrants in clinical encounters

This paper investigates how Latinx nurses resisted the racialization of medical un-deservingness against co-ethnic immigrants in everyday clinical encounters. Drawing on 26 in-depth interviews and dialoguing with the literature on minority professionals, we find that, as a form of racialized equity work, Latinx nurses produced certain symbolic resources, specifically the interactional signals to counteract Latinx patients' internalization of un-deservingness and other medical staff's open hostility towards these "undeserving illegals." Latinx nurses hybridized neoliberal norms (self-sufficiency and responsibility) and social justice values (including healthcare as a universal right and compassion for members of the community): they emphasized Latinx immigrants' efforts at "becoming" self-sufficient and clinically responsible, debunked the relevance of citizenship to a right to healthcare, and highlighted their communal bonds with co-ethnic patients. Meanwhile, accentuating these communal bonds revealed hefty loads of previously self-censored healthcare needs among Latinx patients, which compelled Latinx nurses to reassert some professional boundaries. Whereas some Latinx nurses were able to engage in "moralized boundary-drawing," others experienced setting professional boundaries as "demoralizing boundary-drawing," which resulted in burnout, disillusionment, or internalized racism. Our findings indicate that the path to de-racializing medical deservingness needs to be multi-tiered. Latinx nurses' racialized equity work of generating symbolic resources for Latinx immigrants is only sustainable if supported by non-Latinx colleagues' cross-ethnic equity work. Furthermore, everyday resistance in clinical encounters is necessarily incomplete unless state-level policy initiatives transform the currency of symbolic capital for medical deservingness.

[Perceptions regarding health rights for migrants in Chile: Twitter data analysis]

Objetivo

Describir las distintas percepciones de los derechos de salud para la población migrante en Chile publicadas en Twitter a propósito del primer trasplante hepático realizado en el país a una mujer migrante haitiana en septiembre del año 2018.

Método

Estudio cualitativo, análisis de caso. El caso corresponde a la primera mujer migrante receptora de un trasplante hepático de urgencia en Chile. Se recogieron opiniones vertidas en Twitter respecto a este caso entre el 29 de septiembre y el 17 de noviembre de 2018 (n = 339). Se realizó un análisis temático utilizando el software NVivo12 con códigos delineados según el objetivo.

Resultados

Según las percepciones planteadas en Twitter, el derecho de acceso a servicios de salud de la población migrante en Chile debiera ser limitado, y otorgar prioridad a los nacionales. Estas opiniones conviven con visualizar a la salud como un derecho humano. Aparecen también sentimientos de racismo y discriminación hacia este grupo.

Conclusiones

En Chile conviven distintas percepciones de cuál debiera ser la concesión de derechos de acceso a servicios de salud de las personas inmigrantes. Esto puede generar no solo un recrudecimiento de la estigmatización y la vulnerabilidad que enfrenta este grupo, sino también una barrera para la implementación de la política, agudizando aún más la presencia de inequidades en salud.

Transnational Mother Blame: Protecting and Caring in a Globalized Context

Mexican women in both the United States and Mexico face uneven landscapes of benefits and discourses as they negotiate family members' health. Building on two decades of ethnographic research, I explore how Mexican mothers navigate social and medical services, food provision, food preparation and health, and describe some of the ways that governments in each country abdicate responsibility for shaping structural constraints on citizens' health. Transnational "mother blame" is a pattern that builds on tropes about the simultaneous responsibility and incapacity of women to ensure their family's health, while offering new articulations of responsibility in neoliberal, globalized, transnational contexts in which flexible care arrangements are both necessary and denigrated.