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Torres A, Vidales G, Chapa SV, Ruiz P, Brown A, Mercado A. The Psychological Health Symptoms of DACA Recipients: A Systematic Review at the Ten-Year Mark of the Program. J Immigr Minor Health 2024; 26:718-737. [PMID: 38551736 DOI: 10.1007/s10903-024-01585-7] [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: 02/17/2024] [Indexed: 07/31/2024]
Abstract
The purpose of this systematic review was to identify the mental health symptoms endorsed by DACA recipients. This study included qualitative and quantitative original, peer-reviewed articles related to mental health or psychological state or wellbeing of DACA recipients. Articles were abstracted from PsychInfo, PubMed, and GoogleScholar. The results included a total of fifteen articles, which were divided into qualitative and quantitative findings. The qualitative articles had a common theme of endorsement of depressive symptoms and negative affect associated to changes in familial and financial responsibilities and living in a difficult sociopolitical climate in the United States. The quantitative articles identified lower odds or symptom severity of depression and other internalizing symptoms compared to undocumented individuals. This summary review was limited by the ample exclusion of access to health care studies among DACamented individuals, which could have provided a broader picture about the health and accessibility for DACA recipients. Despite the limitations, this review identifies DACA as a policy that allows this group to improve their social function and quality of life compared to undocumented individuals but still endorse high levels of negative affect related to perceived challenging sociopolitical atmospheres.
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Affiliation(s)
- Andy Torres
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W., Edinburg, TX, 78539, USA.
| | - Gonzalo Vidales
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W., Edinburg, TX, 78539, USA
| | - Sandra V Chapa
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W., Edinburg, TX, 78539, USA
| | - Pablo Ruiz
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W., Edinburg, TX, 78539, USA
| | - Aliya Brown
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W., Edinburg, TX, 78539, USA
| | - Alfonso Mercado
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W., Edinburg, TX, 78539, USA
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2
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Molina RL, Beecroft A, Pazos Herencia Y, Bazan M, Wade C, DiMeo A, Sprankle J, Sullivan MM. Pregnancy Care Utilization, Experiences, and Outcomes Among Undocumented Immigrants in the United States: A Scoping Review. Womens Health Issues 2024; 34:370-380. [PMID: 38493075 DOI: 10.1016/j.whi.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Undocumented immigrants face many barriers in accessing pregnancy care, including language differences, implicit and explicit bias, limited or no insurance coverage, and fear about accessing services. With the national spotlight on maternal health inequities, the current literature on undocumented immigrants during pregnancy requires synthesis. OBJECTIVE We aimed to describe the literature on pregnancy care utilization, experiences, and outcomes of undocumented individuals in the United States. METHODS We performed a scoping review of original research studies in the United States that described the undocumented population specifically and examined pregnancy care utilization, experiences, and outcomes. Studies underwent title, abstract, and full-text review by two investigators. Data were extracted and synthesized using descriptive statistics and content analysis. RESULTS A total of 5,940 articles were retrieved and 3,949 remained after de-duplication. After two investigators screened and reviewed the articles, 29 studies met inclusion criteria. The definition of undocumented individuals varied widely across studies. Of the 29 articles, 24 showed that undocumented status and anti-immigrant policies and rhetoric are associated with lower care utilization and worse pregnancy outcomes, while inclusive health care and immigration policies are associated with higher levels of prenatal and postnatal care utilization as well as better pregnancy outcomes. CONCLUSIONS The small, heterogeneous literature on undocumented immigrants and pregnancy care is fraught with inconsistent definitions, precluding comparisons across studies. Despite areas in need of further research, the signal among published studies is that undocumented individuals experience variable access to pregnancy care, heightened fear and stress regarding their status during pregnancy, and worse outcomes compared with other groups, including documented immigrants.
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Affiliation(s)
- Rose L Molina
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | | | | | - Maria Bazan
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Universidad Científica del Sur, Lima, Peru
| | - Carrie Wade
- Countway Library, Harvard Medical School, Boston, Massachusetts
| | - Amanda DiMeo
- Ariadne Labs at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jeffrey Sprankle
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Margaret M Sullivan
- François-Xavier Bagnoud (FXB) Center for Health & Human Rights, Harvard University, Boston, Massachusetts
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3
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Akinlotan MA, Marouf F, Esplin B, Horel S, Bolin JN, Ferdinand AO. The Impact of Immigration Policy Changes on Preterm Birth Rates in Texas: An Examination of Border and Nonborder Regions. Womens Health Issues 2024; 34:361-369. [PMID: 38724342 DOI: 10.1016/j.whi.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 02/29/2024] [Accepted: 03/25/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Our study examined the acute and sustained impact of immigration policy changes announced in January 2017 on preterm birth (PTB) rates among Hispanic and non-Hispanic white women in Texas's border and nonborder regions. METHODS Using Texas birth certificate data for years 2008 through 2020, we used a multiple group interrupted time series approach to explore changes in PTB rates. RESULTS In the nonborder region, the PTB rate among Hispanic women of any race was 8.64% in 2008 and was stable each year before 2017 but increased by .29% (95% CI [.12, .46]) annually between 2017 and 2020. This effect remained statistically significant even when compared with that of non-Hispanic white women (p = .014). In the border areas, the PTB rate among Hispanic women of any race was 11.67% in 2008 and remained stable each year before and after 2017. No significant changes were observed when compared with that of non-Hispanic white women (p = .897). In Texas as a whole, the PTB rate among Hispanic women of any race was 10.16% in 2008 and declined by .07% (95% CI [-.16, -.03]) per year before 2017, but increased by .16% (95% CI [.05, .27]) annually between 2017 and 2020. The observed increase was not statistically significant when compared with that of non-Hispanic white women (p = .326). CONCLUSIONS The January 2017 immigration policies were associated with a sustained increase in PTB among Hispanic women in Texas's nonborder region, suggesting that geography plays an important role in perceptions of immigration enforcement. Future research should examine the impact of immigration policies on maternal and child health, considering geography and sociodemographic factors.
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Affiliation(s)
- Marvellous A Akinlotan
- School of Dentistry, Texas A&M University, Dallas, Texas; Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas.
| | - Fatma Marouf
- School of Public Health, Texas A&M University, College Station, Texas
| | - Bryn Esplin
- School of Law, Texas A&M University, Fort Worth, Texas
| | - Scott Horel
- Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas; School of Public Health, Texas A&M University, College Station, Texas
| | - Jane N Bolin
- Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas; School of Public Health, Texas A&M University, College Station, Texas; School of Nursing, Texas A&M University, Bryan, Texas
| | - Alva O Ferdinand
- Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas; School of Public Health, Texas A&M University, College Station, Texas
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4
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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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5
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Devillanova C, Franco C, Spada A. Downgraded dreams: Labor market outcomes and mental health in undocumented migration. SSM Popul Health 2024; 26:101652. [PMID: 38516529 PMCID: PMC10950686 DOI: 10.1016/j.ssmph.2024.101652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/02/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
Undocumented immigrant workers are particularly exposed to mental health risk factors, including occupational downgrading - i.e. the loss in occupational status upon arrival. This study breaks new ground by examining the relationship between occupational downgrading and mental health among this hard-to-reach population, offering the first-ever investigation of its kind. Leveraging a unique dataset collected by a primary care outpatient clinic in Milan, Italy, which combines medical evaluations with detailed occupational information, we construct a direct measure of occupational downgrading, which adds to the literature. We employ logistic regression models to estimate odds ratios (ORs) for mental and behavioral disorders. The study also offers fresh evidence on the socioeconomic and health status of a sizable sample of undocumented migrants. The study sample consists of 1738 individuals that had their first medical examination in 2017-18. Prevalence of mental health conditions is 5.58%. Data also highlight poor labor market integration: one third of individuals in the sample is employed, mostly in elementary occupations; 66.63% of immigrant workers experienced occupational downgrading. Regression results show that undocumented immigrants who undergo occupational downgrading are at considerably higher risk of mental disorders. ORs range from 1.729 (95% CI 1.071-2.793), when the model only includes individual characteristics determined prior to migration, to 2.659 (CI 1.342-5.271), when it accounts for all the available controls. From a policy perspective, our study underscores the need to consider the broader impact of policies, including restrictive entry and integration policies, on migrant health. Additionally, ensuring access to primary care for all immigrants is crucial for early detection and treatment of mental health conditions.
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Affiliation(s)
- Carlo Devillanova
- Department of Social and Political Sciences and Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Italy
| | - Cristina Franco
- European Commission, Directorate-General for Neighbourhood Policy and Enlargement Negotiations, Belgium
| | - Anna Spada
- On Behalf of Naga, Organizzazione di Volontariato per l’Assistenza Socio-Sanitaria e per i Diritti di Cittadini Stranieri, Rom e Sinti, Italy
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Zapata JP, Hurtado M, Avila AA, John SA, Rodriguez-Diaz CE, de St Aubin E. Factors Influencing Engagement Across the Motivational PrEP Cascade Among Latino SMM: A Mixed-Methods Analysis from the Perspectives of Community Providers and Latino SMM. AIDS Behav 2024:10.1007/s10461-024-04372-5. [PMID: 38780867 DOI: 10.1007/s10461-024-04372-5] [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: 05/07/2024] [Indexed: 05/25/2024]
Abstract
Latino sexual minority men (SMM) are a highly vulnerable population to HIV, and while pre-exposure prophylaxis (PrEP) has emerged as a promising biomedical tool for HIV prevention among them, its utilization remains disproportionately low in this community despite its potential. Understanding the barriers along the PrEP continuum of care, known as the "PrEP cascade," is crucial for effectively implementing PrEP interventions. Therefore, the objective of our study was twofold: first, to explore the stage of Latino SMM in the PrEP cascade by examining disparities in demographics, social factors, and healthcare aspects; second, to gain insights from healthcare providers who have direct clinical experience with our population regarding the challenges faced by Latino SMM in accessing and adhering to PrEP. Based on the study findings, the majority of participants (n = 74; 49%) were in the contemplation stage, and only one in ten Latino SMM (10.6%) were currently adherent to PrEP. Compared to those who were at least second-generation, first-generation status had a positive association (B = 0.699, SE = 0.208, β = 0.351, p < .001) with engagement along the PrEP Contemplation Ladder. Conversely, having at least one parent who did not have legal residency, relative to those whose parents were both U.S. citizens or held legal residency documentation, was found to have a negative association (B = - 0.689, SE = 0.245, β = 0.245, p = .006) with engagement along the PrEP Contemplation Ladder. Additionally, discussing PrEP with a healthcare provider had a positive association (B = 0.374, SE = 0.179, β = 0.185, p = .038) with engagement along the PrEP Contemplation Ladder. Qualitative results from our study suggest that some Latinos who initially agreed to start using PrEP ended up getting lost in the care pipeline and failed to attend their scheduled appointments. Providers also noted that many patients lacked access to a pharmacy where they felt comfortable obtaining their PrEP prescription, leading them to discontinue use after only a few months. These findings emphasize the importance of considering the unique needs, culture, and background of Latinos, including care delivery and provider attitudes that can facilitate progress through the PrEP cascade.
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Affiliation(s)
- Juan Pablo Zapata
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA.
| | - Manuel Hurtado
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA
| | - Andrés Alvarado Avila
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA
| | - Steven A John
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Carlos E Rodriguez-Diaz
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Ed de St Aubin
- Department of Psychology, Marquette University, Milwaukee, WI, USA
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7
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Leszko M, Allen DJ. Caring From a Distance: Experiences of Polish Immigrants in the United States Providing Care to Parents With Dementia Overseas. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad086. [PMID: 37288778 DOI: 10.1093/geronb/gbad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES Aging populations and an increasing number of immigrants in recent years have led to numerous changes in intergenerational relationships. Although many studies have investigated the impact of providing care to a parent with dementia, little is known about the impact of caregiving activities provided from a distance, such as in the case of immigration, and over a long period of time to a person with dementia. Our understanding of how transnational caregiving for a person with dementia affects relationships is also limited. Using the Intergenerational Solidarity Theory as a theoretical framework, this paper examines the experiences of adult children and immigrant caregivers of a parent with dementia living in Poland. METHODS A qualitative, semistructured interview was conducted with 37 caregivers living in the United States while providing transnational care to a parent with Alzheimer's disease or other forms of dementia. The data analysis was based on the thematic analysis strategy. RESULTS Four themes were identified: (1) filial obligations and solidarity, (2) caregivers' contradictory emotions regarding transnational care, (3) financial and emotional exhaustion, and (4) challenges of nursing home dilemmas. DISCUSSION Transnational caregivers represent a unique group who face distinctive challenges related to competing demands and limited resources. This study contributes to a better understanding of their experiences whereas the findings highlight the importance of addressing the mental and physical well-being of immigrant caregivers of individuals with dementia and have important implications for health care professionals and immigration policies. Implications for future research were also identified.
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Affiliation(s)
- Magdalena Leszko
- Department of Psychology, University of Szczecin, Szczecin, Poland
| | - Dorota J Allen
- Department of Child Development and Family Studies, Purdue University, Hammond, Indiana, USA
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8
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Poulimeneas D, Koniordou M, Kousi D, Merakou C, Kopsidas I, Tsopela GC, Argyropoulos CD, Themistocleous SC, Shiamakkides G, Constantinou M, Alexandrou A, Noula E, Nearchou A, Salmanton-García J, Stewart FA, Heringer S, Albus K, Álvarez-Barco E, Macken A, Di Marzo R, Luis C, Valle-Simón P, Askling HH, Hellemans M, Spivak O, Davis RJ, Azzini AM, Barta I, Součková L, Jancoriene L, Akova M, Mallon PWG, Olesen OF, Frias-Iniesta J, van Damme P, Tóth K, Cohen-Kandli M, Cox RJ, Husa P, Nauclér P, Marques L, Ochando J, Tacconelli E, Zeitlinger M, Cornely OA, Pana ZD, Zaoutis TE. The Challenges of Vaccine Trial Participation among Underserved and Hard-to-Reach Communities: An Internal Expert Consultation of the VACCELERATE Consortium. Vaccines (Basel) 2023; 11:1784. [PMID: 38140188 PMCID: PMC10747264 DOI: 10.3390/vaccines11121784] [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] [Received: 10/18/2023] [Revised: 11/06/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023] Open
Abstract
Underserved and hard-to-reach population groups are under-represented in vaccine trials. Thus, we aimed to identify the challenges of vaccine trial participation of these groups in member countries of the VACCELERATE network. Seventeen National Coordinators (NC), each representing their respective country (15 European countries, Israel, and Turkey), completed an online survey. From 15 eligible groups, those that were more frequently declared underserved/hard-to-reach in vaccine research were ethnic minorities (76.5%), persons experiencing homelessness (70.6%), illegal workers and refugees (64.7%, each). When prioritization for education on vaccine trials was considered, ethnic groups, migrants, and immigrants (5/17, 29.4%) were the groups most frequently identified by the NC as top targets. The most prominent barriers in vaccine trial participation affecting all groups were low levels of health literacy, reluctance to participate in trials due to engagement level, and low levels of trust in vaccines/vaccinations. This study highlighted population groups considered underserved/hard-to-reach in countries contained within the European region, and the respective barriers these groups face when participating in clinical studies. Our findings aid with the design of tailored interventions (within-and across-countries of the European region) and with the development of strategies to overcome major barriers in phase 2 and phase 3 vaccine trial participation.
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Affiliation(s)
- Dimitrios Poulimeneas
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece; (D.P.); (M.K.); (D.K.); (C.M.); (G.C.T.)
| | - Markela Koniordou
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece; (D.P.); (M.K.); (D.K.); (C.M.); (G.C.T.)
| | - Dimitra Kousi
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece; (D.P.); (M.K.); (D.K.); (C.M.); (G.C.T.)
| | - Christina Merakou
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece; (D.P.); (M.K.); (D.K.); (C.M.); (G.C.T.)
| | - Ioannis Kopsidas
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece; (D.P.); (M.K.); (D.K.); (C.M.); (G.C.T.)
| | - Grammatiki Christina Tsopela
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece; (D.P.); (M.K.); (D.K.); (C.M.); (G.C.T.)
| | - Christos D. Argyropoulos
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (C.D.A.); (S.C.T.); (M.C.); (A.A.); (E.N.); (A.N.); (Z.D.P.)
| | - Sophia C. Themistocleous
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (C.D.A.); (S.C.T.); (M.C.); (A.A.); (E.N.); (A.N.); (Z.D.P.)
| | - George Shiamakkides
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (C.D.A.); (S.C.T.); (M.C.); (A.A.); (E.N.); (A.N.); (Z.D.P.)
| | - Marinos Constantinou
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (C.D.A.); (S.C.T.); (M.C.); (A.A.); (E.N.); (A.N.); (Z.D.P.)
| | - Alexandra Alexandrou
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (C.D.A.); (S.C.T.); (M.C.); (A.A.); (E.N.); (A.N.); (Z.D.P.)
| | - Evgenia Noula
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (C.D.A.); (S.C.T.); (M.C.); (A.A.); (E.N.); (A.N.); (Z.D.P.)
| | - Andria Nearchou
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (C.D.A.); (S.C.T.); (M.C.); (A.A.); (E.N.); (A.N.); (Z.D.P.)
| | - Jon Salmanton-García
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Institute of Translational Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; (J.S.-G.); (S.H.); (O.A.C.)
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 38124 Cologne, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Fiona A. Stewart
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Institute of Translational Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; (J.S.-G.); (S.H.); (O.A.C.)
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 38124 Cologne, Germany
| | - Sarah Heringer
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Institute of Translational Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; (J.S.-G.); (S.H.); (O.A.C.)
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 38124 Cologne, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Kerstin Albus
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Institute of Translational Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; (J.S.-G.); (S.H.); (O.A.C.)
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Elena Álvarez-Barco
- Centre for Experimental Pathogen Host Research, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland; (E.Á.-B.); (A.M.); (P.W.G.M.)
| | - Alan Macken
- Centre for Experimental Pathogen Host Research, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland; (E.Á.-B.); (A.M.); (P.W.G.M.)
| | - Romina Di Marzo
- European Vaccine Initiative (EVI), 69115 Heidelberg, Germany; (R.D.M.); (C.L.); (O.F.O.)
| | - Catarina Luis
- European Vaccine Initiative (EVI), 69115 Heidelberg, Germany; (R.D.M.); (C.L.); (O.F.O.)
| | - Paula Valle-Simón
- Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; (P.V.-S.); (J.F.-I.)
- Servicio Madrileño de Salud, 28046 Madrid, Spain
| | - Helena H. Askling
- Department of Infectious Diseases, Karolinska University Hospital, 17177 Stockholm, Sweden; (H.H.A.); (P.N.)
- Department of Medicine, Division of Infectious Diseases, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Margot Hellemans
- VAXINFECTIO, Centre of Evaluation of Vaccination, Faculty of Medicine and Health Science, Universiteit Antwerpen, 2610 Antwerp, Belgium; (M.H.); (P.v.D.)
| | - Orly Spivak
- Ministry of Health of Israel, Jerusalem 1176, Israel; (O.S.); (M.C.-K.)
| | - Ruth Joanna Davis
- Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy; (R.J.D.); (A.M.A.); (E.T.)
| | - Anna Maria Azzini
- Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy; (R.J.D.); (A.M.A.); (E.T.)
| | - Imre Barta
- National Koranyi Institute for Pulmonology, 1121 Budapest, Hungary (K.T.)
| | - Lenka Součková
- Department of Pharmacology, Faculty of Medicine, Masaryk University, 60177 Brno, Czech Republic; (L.S.); (P.H.)
- University Hospital Brno, 62500 Brno, Czech Republic
- Czech Clinical Research Infrastructure Network (CZECRIN), 62500 Brno, Czech Republic
| | - Ligita Jancoriene
- Institute of Clinical Medicine, Medical Faculty, Vilnius University, 03101 Vilnius, Lithuania;
- Vilnius University Hospital Santaros Klinikos, Medical Faculty, Vilnius University, 03101 Vilnius, Lithuania
| | - Murat Akova
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Haceteppe University, Ankara 06230, Turkey;
| | - Patrick W. G. Mallon
- Centre for Experimental Pathogen Host Research, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland; (E.Á.-B.); (A.M.); (P.W.G.M.)
| | - Ole F. Olesen
- European Vaccine Initiative (EVI), 69115 Heidelberg, Germany; (R.D.M.); (C.L.); (O.F.O.)
| | - Jesus Frias-Iniesta
- Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; (P.V.-S.); (J.F.-I.)
- Servicio Madrileño de Salud, 28046 Madrid, Spain
| | - Pierre van Damme
- VAXINFECTIO, Centre of Evaluation of Vaccination, Faculty of Medicine and Health Science, Universiteit Antwerpen, 2610 Antwerp, Belgium; (M.H.); (P.v.D.)
| | - Krisztina Tóth
- National Koranyi Institute for Pulmonology, 1121 Budapest, Hungary (K.T.)
| | | | - Rebecca Jane Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway;
| | - Petr Husa
- Department of Pharmacology, Faculty of Medicine, Masaryk University, 60177 Brno, Czech Republic; (L.S.); (P.H.)
- University Hospital Brno, 62500 Brno, Czech Republic
- Czech Clinical Research Infrastructure Network (CZECRIN), 62500 Brno, Czech Republic
| | - Pontus Nauclér
- Department of Infectious Diseases, Karolinska University Hospital, 17177 Stockholm, Sweden; (H.H.A.); (P.N.)
- Department of Medicine, Division of Infectious Diseases, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Laura Marques
- Centro Hospitalar Universitário do Porto, 4099-001 Porto, Portugal;
| | - Jordi Ochando
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain;
| | - Evelina Tacconelli
- Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy; (R.J.D.); (A.M.A.); (E.T.)
| | - Markus Zeitlinger
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria;
| | - Oliver A. Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Institute of Translational Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; (J.S.-G.); (S.H.); (O.A.C.)
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 38124 Cologne, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
- Clinical Trials Centre Cologne (ZKS Köln), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Zoi Dorothea Pana
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (C.D.A.); (S.C.T.); (M.C.); (A.A.); (E.N.); (A.N.); (Z.D.P.)
| | - Theoklis E. Zaoutis
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece; (D.P.); (M.K.); (D.K.); (C.M.); (G.C.T.)
- 2nd Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
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9
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Serrano E, Voldal EC, Machado-Aranda D, DeUgarte DA, Kao L, Drake T, Winchell R, Cuschieri J, Krishnadasan A, Talan DA, Siparsky N, Ayoung-Chee P, Self WH, McGonagill P, Mandell KA, Liang MK, Dodwad SJ, Thompson CM, Padilla RM, Fleischman R, Price TP, Jones A, Bernardi K, Garcia L, Evans HL, Sanchez SE, Odom S, Comstock BA, Heagerty PJ, Lawrence SO, Monsell SE, Fannon EE, Kessler LG, Flum DR, Davidson GH. Trial Participation and Outcomes Among English-Speaking and Spanish-Speaking Patients With Appendicitis Randomized to Antibiotics: A Secondary Analysis of the CODA Randomized Clinical Trial. JAMA Surg 2023; 158:901-908. [PMID: 37379001 PMCID: PMC10308294 DOI: 10.1001/jamasurg.2023.2277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/28/2023] [Indexed: 06/29/2023]
Abstract
Importance Spanish-speaking participants are underrepresented in clinical trials, limiting study generalizability and contributing to ongoing health inequity. The Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial intentionally included Spanish-speaking participants. Objective To describe trial participation and compare clinical and patient-reported outcomes among Spanish-speaking and English-speaking participants with acute appendicitis randomized to antibiotics. Design, Setting, and Participants This study is a secondary analysis of the CODA trial, a pragmatic randomized trial comparing antibiotic therapy with appendectomy in adult patients with imaging-confirmed appendicitis enrolled at 25 centers across the US from May 1, 2016, to February 28, 2020. The trial was conducted in English and Spanish. All 776 participants randomized to antibiotics are included in this analysis. The data were analyzed from November 15, 2021, through August 24, 2022. Intervention Randomization to a 10-day course of antibiotics or appendectomy. Main Outcomes and Measures Trial participation, European Quality of Life-5 Dimensions (EQ-5D) questionnaire scores (higher scores indicating a better health status), rate of appendectomy, treatment satisfaction, decisional regret, and days of work missed. Outcomes are also reported for a subset of participants that were recruited from the 5 sites with a large proportion of Spanish-speaking participants. Results Among eligible patients 476 of 1050 Spanish speakers (45%) and 1076 of 3982 of English speakers (27%) consented, comprising the 1552 participants who underwent 1:1 randomization (mean age, 38.0 years; 976 male [63%]). Of the 776 participants randomized to antibiotics, 238 were Spanish speaking (31%). Among Spanish speakers randomized to antibiotics, the rate of appendectomy was 22% (95% CI, 17%-28%) at 30 days and 45% (95% CI, 38%-52%) at 1 year, while in English speakers, these rates were 20% (95% CI, 16%-23%) at 30 days and 42% (95% CI 38%-47%) at 1 year. Mean EQ-5D scores were 0.93 (95% CI, 0.92-0.95) among Spanish speakers and 0.92 (95% CI, 0.91-0.93) among English speakers. Symptom resolution at 30 days was reported by 68% (95% CI, 61%-74%) of Spanish speakers and 69% (95% CI, 64%-73%) of English speakers. Spanish speakers missed 6.69 (95% CI, 5.51-7.87) days of work on average, while English speakers missed 3.76 (95% CI, 3.20-4.32) days. Presentation to the emergency department or urgent care, hospitalization, treatment dissatisfaction, and decisional regret were low for both groups. Conclusions and Relevance A high proportion of Spanish speakers participated in the CODA trial. Clinical and most patient-reported outcomes were similar for English- and Spanish-speaking participants treated with antibiotics. Spanish speakers reported more days of missed work. Trial Registration ClinicalTrials.gov Identifier: NCT02800785.
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Affiliation(s)
- Elina Serrano
- University of Washington, Seattle
- Fred Hutch Cancer Center, Seattle, Washington
| | - Emily C. Voldal
- University of Washington, Seattle
- Fred Hutch Cancer Center, Seattle, Washington
| | | | | | - Lillian Kao
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston
| | | | | | - Joseph Cuschieri
- Harborview Medical Center, UW Medicine, Seattle, Washington
- University of California, San Francisco, San Francisco
| | | | - David A. Talan
- Olive View–UCLA Medical Center, Los Angeles, California
- Ronald Reagan UCLA Medical Center, Los Angeles, California
| | | | - Patricia Ayoung-Chee
- Bellevue Hospital Center, NYU School of Medicine, New York, New York
- Tisch Hospital, NYU Langone Medical Center, New York, New York
- Morehouse School of Medicine, Atlanta GA
| | - Wesley H. Self
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | - Mike K. Liang
- Lyndon B. Johnson General Hospital, University of Texas, Houston
- University of Houston, HCA Healthcare, Kingwood, Kingwood, Texas
| | - Shan-Jahan Dodwad
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston
| | - Callie M. Thompson
- Vanderbilt University Medical Center, Nashville, Tennessee
- University of Utah, Salt Lake City
| | | | | | | | - Alan Jones
- The University of Mississippi Medical Center, Jackson
| | - Karla Bernardi
- Lyndon B. Johnson General Hospital, University of Texas, Houston
| | - Luis Garcia
- University of Iowa Hospitals and Clinics, Iowa City
| | - Heather L. Evans
- Harborview Medical Center, UW Medicine, Seattle, Washington
- The Medical University of South Carolina, Charleston
| | | | - Stephen Odom
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
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10
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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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11
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Goldstein EV, Wilson FA. Hispanic Immigrants and Suicide: Overcoming Data Challenges in an Anti-immigrant Climate. AJPM FOCUS 2022; 1:100038. [PMID: 37791237 PMCID: PMC10546600 DOI: 10.1016/j.focus.2022.100038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Affiliation(s)
- Evan V. Goldstein
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah
| | - Fernando A. Wilson
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah
- Department of Economics, University of Utah, Salt Lake City, Utah
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, Utah
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12
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Ruhnke SA, Wilson FA, Stimpson JP. Using machine learning to impute legal status of immigrants in the National Health Interview Survey. MethodsX 2022; 9:101848. [PMID: 36160111 PMCID: PMC9490167 DOI: 10.1016/j.mex.2022.101848] [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] [Received: 06/23/2022] [Accepted: 08/30/2022] [Indexed: 11/27/2022] Open
Abstract
We describe a novel machine learning method of imputing legal status for immigrants using nationally representative survey data from the Survey of Income and Program Participation (SIPP) and the National Health Interview Survey (NHIS). K-nearest Neighbor (KNN) classifier and Random Forest (RF) Algorithm machine learning were described as novel imputation methods compared to established regression-based imputation. After validating the imputation methods using sensitivity, specificity, positive predictive value (PPV) and accuracy statistics, the Random Forest Algorithm was more accurate in identifying undocumented immigrants and minimized bias in both socio-demographic variables included in the imputation, and unobserved health variables relative to regression-based imputation and KNN.We developed a new machine learning method of imputing legal status for immigrants that can be used with nationally representative, publicly available data. Our findings indicate that using machine learning to impute legal status of immigrants, specifically the Random Forest Algorithm, was more accurate in identifying undocumented immigrants and minimized bias relative to other imputation methods.
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Affiliation(s)
- Simon A Ruhnke
- Berliner Institut für empirische Integrations- und Migrationsforschung/BIM, Berlin, Germany
| | - Fernando A Wilson
- University of Utah, Matheson Center for Health Care Studies, Salt Lake City, UT
| | - Jim P Stimpson
- Drexel University, Department of Health Management and Policy, PA, USA
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13
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Rockler BE, Grutzmacher SK, Garcia J, Smit E. The role of SNAP and WIC participation and racialized legal status in U.S. farmworker health. PLoS One 2022; 17:e0272911. [PMID: 35976916 PMCID: PMC9385050 DOI: 10.1371/journal.pone.0272911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Policies that restrict access to and use of the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) by legal status may disproportionately disadvantage particular racial and ethnic groups. While immigrant legal status, race, and ethnicity are recognized as independent social determinants of health, studies examining the extent to which legal status structures racial and ethnic health disparities are limited. Research is needed to identify factors that mitigate disparate health outcomes, such as SNAP and WIC. Methods Cross-sectional data from the 2009/2010 National Agricultural Workers Survey (N = 3,961) were analyzed. Chi-square tests and logistic regressions examined associations among self-reported health, race, ethnicity, legal status, and SNAP/WIC participation. Results Farmworkers reporting excellent or good health were more likely to be non-Hispanic White, U.S. citizen, aged 18–25, single, male, educated beyond primary school, living above the poverty level, without chronic health conditions, and located in the Midwest. Hispanic farmworkers had lower odds of reporting excellent or good health (OR 0.27, 95% CI 0.12–0.62). Among SNAP/WIC participants, Hispanic farmworkers had higher odds of reporting excellent or good health (OR 6.74, 95% CI 1.54–29.57) compared to non-Hispanic White farmworkers. There was no significant association between self-reported health and legal status. Discussion This study complements the extant literature showing racial and ethnic health disparities among the U.S. farmworker population. Results provide valuable insight on the health-protective potential of programs like SNAP and WIC, particularly among Hispanic farmworkers, who may be both less likely to be eligible and more hesitant to participate. These findings underscore the need to expand U.S. farmworkers’ eligibility and participation in SNAP and WIC.
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Affiliation(s)
- Briana E. Rockler
- Department of Public Health and Environmental Studies, College of Arts and Sciences, University of Wisconsin–Eau Claire, Eau Claire, Wisconsin, United States of America
- * E-mail:
| | - Stephanie K. Grutzmacher
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Jonathan Garcia
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Ellen Smit
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
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14
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Sudhinaraset M, Ling I, Gao L, Chavarin J, Gee GC. The association between Deferred Action for Childhood Arrivals, health access, and mental health: the role of discrimination, medical mistrust, and stigma. ETHNICITY & HEALTH 2022; 27:1075-1087. [PMID: 33276705 DOI: 10.1080/13557858.2020.1850647] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 11/09/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE There are approximately 11 million undocumented immigrants in the US, including 1.3 million young adults who are eligible for the Deferred Action for Childhood Arrivals (DACA) program. It is unclear how DACA influences engagement in healthcare or depressive symptoms, and the role of discrimination, medical mistrust, and stigma in healthcare settings. This study assesses the association of DACA on undocumented young adults' engagement with health care and depressive symptoms. DESIGN We conducted an internet-based survey examining the health-related experiences of undocumented Latino and Asians and Pacific Islander (API) young adults in California (n = 218) between June and August 2017. Multivariable logistic regressions were conducted to assess the influence of DACA, discrimination, medical mistrust, and stigma on healthcare engagement and depressive symptoms. RESULTS Approximately 78% of respondents had a gap in healthcare, and about 31% reported high levels of depressive symptoms. Controlling for demographic characteristics, compared to those without DACA, DACA-recipients had lower odds of reporting gaps in healthcare engagement (aOR = 0.270, p < 0.05) and depressive symptoms (aOR = 0.115, p < 0.01). Those facing discrimination, medical mistrust, and stigma in healthcare settings were less likely to have a healthcare visit and more likely to have higher depressive symptoms. CONCLUSIONS DACA is a potential strategy to improve healthcare access and address the mental health of undocumented populations. In particular, issues of discrimination, stigma by healthcare providers, and medical mistrust need to be addressed.
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Affiliation(s)
- May Sudhinaraset
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA
- School of Medicine, University of California, San Francisco, CA, USA
| | - Irving Ling
- School of Medicine, University of California, San Francisco, CA, USA
| | - Leiwen Gao
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | | | - Gilbert C Gee
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA
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15
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Ruhnke SA, Reynolds MM, Wilson FA, Stimpson JP. A healthy migrant effect? Estimating health outcomes of the undocumented immigrant population in the United States using machine learning. Soc Sci Med 2022; 307:115177. [PMID: 35785643 DOI: 10.1016/j.socscimed.2022.115177] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022]
Abstract
This paper investigated whether the commonly observed immigrant health advantage persists among undocumented immigrants in the U.S. and provides nationally representative evidence on the health of this vulnerable population. Data were derived from pooled cross-sections of the National Health Interview Survey (NHIS, 2000-2018). The legal status of foreign-born NHIS respondents is imputed using a non-parametric machine learning model built based on information from the 2004, 2008 and 2014 cohorts of the Survey of Income and Program Participation (SIPP). Multivariate logistic regression analysis indicated that, despite exposure to numerous additional risk factors, the undocumented population experienced a more pronounced Healthy Migrant Effect, with lower odds of reporting fair or poor self-rated health, any physician-diagnosed chronic conditions or being obese. The observed patterns in undocumented health outcomes may be related to the additional challenges and exclusionary policies associated with undocumented migration that could in turn lead to a more pronounced selection of healthy and resilient individuals.
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Affiliation(s)
- Simon A Ruhnke
- Berliner Institut für Empirische Integrations- und Migrationsforschung/BIM, Berlin, Germany
| | - Megan M Reynolds
- University of Utah, Department of Sociology, Salt Lake City, UT, USA
| | - Fernando A Wilson
- University of Utah, Matheson Center for Health Care Studies, Salt Lake City, UT, USA
| | - Jim P Stimpson
- Drexel University, Department of Health Management and Policy, Philadelphia, PA, USA.
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16
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Galvan T, Rusch D, Rodríguez MMD, Garcini LM. Familias Divididas [divided families]: Transnational family separation and undocumented Latinx immigrant health. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:513-522. [PMID: 35201788 PMCID: PMC9870454 DOI: 10.1037/fam0000975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Undocumented Latinx immigrants (ULIs) comprise a large segment of the U.S. population, yet they remain at high risk for diminished health outcomes due to increased exposure to adverse experiences and context. Transnational family separation and the distress that accompanies it is an example of a common adverse experience that is chronic and that impacts the lives of many ULIs. However, despite how chronic and central transnationalism is to the lives of ULIs, little is known about its relation to the health outcomes of ULIs. To that end, this study examined the relation between distress due to transnational family separation and the physical and mental health of ULIs. To do so, the study utilized respondent-driven sampling and path analysis methodologies to cross-sectionally examine how distress from transnational separation was related to the physical and mental health of ULIs (n = 229). Results revealed that as distress from transnational family separation increased so too did participant's depressive (β = .25, p < .001), anxiety (β = .18, p = .006), and physical symptoms (β = .24, p < .0001). Distress from transnational family separation was also more strongly related to physical and depressive symptoms than to anxiety symptoms. Considering these results, important systemic changes to our approach to healthcare delivery and access among ULIs communities are needed to promote the well-being of this at-risk population. Recommendations for doing so are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Thania Galvan
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago
- Department of Psychiatry, National Crime Victims Treatment and Research Center, Medical University of South Carolina
| | - Dana Rusch
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago
| | | | - Luz M. Garcini
- Center for Research to Advance Community Health, Joe R. and Teresa Lozano Long School of Medicine, The University of Texas Health Science Center at San Antonio
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, The University of Texas Health Science Center at San Antonio
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17
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Guillot-Wright S, Farr NM, Cherryhomes E. A community-led mobile health clinic to improve structural and social determinants of health among (im)migrant workers. Int J Equity Health 2022; 21:58. [PMID: 35501912 PMCID: PMC9059448 DOI: 10.1186/s12939-022-01630-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community-led interventions that address structural and social determinants of health are lacking among (im)migrant workers, especially seafood workers. This lack of medical attention is especially alarming given their high rate of injury and death. METHODS Community-based participatory research (CBPR), a relational model that values the participants as equal partners in research, dissemination, and implementation, guided the interviews and mobile clinic. Seafood workers were engaged throughout data collection, analysis, and interpretation and played a significant role in moving the findings from research into actionable change. RESULTS To address the lack of healthcare options for (im)migrants, and at the request of the seafood workers participating in the ongoing CBPR study, we successfully implemented and treated workers in our mobile clinic. DISCUSSION Many of these individuals had not been seen by a healthcare provider in years, highlighting the importance of community trust and rapport building when addressing interconnected health and safety issues. CONCLUSIONS Although CBPR and free (mobile) health clinics are in and of themselves not novel concepts, when applied to high-risk occupational settings with under-reached populations (e.g., (im)migrant workers), they have the ability to improve health and prevent injury. This intervention adds to the growing literature detailing the potential benefits of using CBPR, and meeting people where they are, especially with historically marginalized populations.
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Affiliation(s)
- Shannon Guillot-Wright
- Department of Family Medicine; Center for Violence Prevention, University of Texas Medical Branch, Galveston, TX, USA.
| | - N Miles Farr
- Internal Medicine; Community Engagement and Education, University of Texas Medical Branch, Galveston, TX, USA
| | - Ellie Cherryhomes
- Department of Family Medicine; Center for Violence Prevention, University of Texas Medical Branch, Galveston, TX, USA
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18
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Garcini LM, Galvan T, Peña JM, Chen N, Klonoff E. Effectiveness of Respondent-Driven Sampling for Conducting Health Studies Among Undocumented Immigrants at a Time of Heightened Immigration Enforcement. J Immigr Minor Health 2022; 24:102-110. [PMID: 33136244 PMCID: PMC8088441 DOI: 10.1007/s10903-020-01112-4] [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: 10/15/2020] [Indexed: 02/03/2023]
Abstract
This paper assessed the effectiveness of Respondent Driven Sampling (RDS) in recruiting undocumented Latinx immigrants for a prevalence health study at a time of heightened immigration enforcement. RDS was used to collect and analyze data from clinical interviews with 254 undocumented Latinx immigrant adults, enabling inference to a population of 22,000. 45% of the sample reported having a chronic medical condition. The desired sample size was achieved and exceeded with three initial recruits and 10 waves of recruitment across 9 weeks. There was substantial cross-group mixing for recruitment in terms of sex and recency of immigration, which facilitated the emergence of diversity within recruitment chains. Primary factors that contributed to effective recruitment were location, flexibility, on-site childcare, and detailed explanation of the recruitment process. RDS is an effective recruitment method to study the health of undocumented Latinx immigrants, which is essential to informing intervention and policy.
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Affiliation(s)
- Luz M. Garcini
- Center for Research to Advance Community Health (ReACH) and Department of Medicine, Long School of Medicine, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, Texas, USA
| | - Thania Galvan
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Juan M. Peña
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Nellie Chen
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
| | - Elizabeth Klonoff
- College of Graduate Studies, University of Central Florida, Orlando, Florida, USA
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Abstract
Associations between social determinants of health (SDOH), demographic factors including preferred language, and SARS-CoV-2 detection are not clear. We conducted a retrospective cohort study among those seeking testing for SARS-CoV-2 at a multi-site, urban community health center. Logistic regression and exact matching methods were used to identify independent predictors of SARS-CoV-2 detection among demographic, SDOH, and neighborhood-level variables. Of 1,361 included individuals, SARS-CoV-2 was detected among 266 (19.5%). Logistic regression demonstrated that SARS-CoV-2 detection was less likely in White participants relative to Hispanic participants (adjusted odds ratio [aOR] 0.18, 95% confidence interval [CI] 0.05–0.46). and more likely in patients who prefer Spanish relative to those that prefer English (aOR 2.04, 95% CI 1.43–2.96). No observed SDOH predicted SARS-CoV-2 detection in adjusted models. A robustness analysis using a matched subset of the study sample produced findings similar to those in the main analysis. Preferring to receive care in Spanish is an independent predictor of SARS-CoV-2 detection in a community health center cohort.
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20
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Torres A, Kenemore J, Benham G. A Comparison of Psychological Stress and Sleep Problems in Undocumented Students, DACA Recipients, and U.S. Citizens. J Immigr Minor Health 2021; 24:928-936. [PMID: 34822050 DOI: 10.1007/s10903-021-01315-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/28/2022]
Abstract
Amidst the uncertainty of a shifting political landscape, our study examined stress and sleep problems experienced by both Deferred Action for Childhood Arrivals (DACA) undergraduates and non-DACA undocumented immigrants in an undergraduate population, in relation to students who were US citizens. We surveyed 969 students (93% Hispanic; 69% female) in 2017 or 2019 using established measures of stress, sleep quality, and insomnia. Collapsed across years, undocumented students reported significantly greater stress than citizens and DACA students, but DACA students did not differ from citizens. No differences were found in sleep for either quality or insomnia. Additionally, DACA student stress was significantly higher in 2019 than 2017, rising to a level similar to that of undocumented students and that differed significantly from citizens. Undocumented students appear to experience greater stress than students who are U.S. citizens, but these differences do not extend to sleep quality or insomnia.
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Affiliation(s)
- Andy Torres
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W. University Dr., Edinburg, TX, 78539, USA
| | - Jordan Kenemore
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W. University Dr., Edinburg, TX, 78539, USA
| | - Grant Benham
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W. University Dr., Edinburg, TX, 78539, USA.
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21
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Agadjanian V, Oh B, Menjívar C. (Il)legality and psychosocial well-being: Central Asian migrant women in Russia. JOURNAL OF ETHNIC AND MIGRATION STUDIES 2021; 48:53-73. [PMID: 35431605 PMCID: PMC9007543 DOI: 10.1080/1369183x.2021.1872373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
Legal status has shown far-reaching consequences for international migrants' incorporation trajectories and outcomes in Western contexts. In dialogue with the extant research, we examine the implications of legal status for subjective well-being of Central Asian migrant women in the Russian Federation. Using survey data collected through respondent-driven sampling in two large cities, we compare migrants with regularized and irregular legal statuses on several interrelated yet distinct dimensions of subjective well-being. We find that, regardless of other factors, regularized status has a strong positive association with migrants' perception of their rights and freedoms but not with their feeling of being respected in society. Regularized status is positively associated with self-efficacy and negatively with depression. Yet, no net legal status difference is found in migrants' views on their relations with other migrants or on treatment of migrants by native-borns. The findings are situated within the cross-national scholarship on the ramifications of racialized immigrant (il)legality and its implications for membership and belonging.
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22
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Samari G, Sharif MZ, Alcalá HE. Racial and Citizenship Disparities in Health Care Among Middle Eastern Americans. Med Care 2020; 58:974-980. [PMID: 32947512 PMCID: PMC7572888 DOI: 10.1097/mlr.0000000000001423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess differences in health access and utilization among Middle Eastern American adults by White racial identity and citizenship. METHODS Data from the 2011 to 2018 National Health Interview Surveys (N=1013) and survey-weighted logistic regression analyses compare Middle Eastern immigrants by race and citizenship on access and utilization of health care in the United States. RESULTS White respondents had 71% lower odds of delaying care [adjusted odds ratio (AOR)=0.34; 95% confidence interval (CI)=0.13, 0.71] and 84% lower odds of being rejected by a doctor as a new patient (AOR=0.16; 95% CI=0.03, 0.88) compared to non-White respondents. US citizens had higher odds of visiting the doctor in the past 12 months compared with noncitizens (AOR=1.76; 95% CI=1.25, 2.76). CONCLUSION Middle Eastern immigrants who do not identify as White and who are not US citizens are significantly less likely to access and utilize health care compared with those who identify as White and are US citizens. POLICY IMPLICATIONS This study shows that racial and citizenship disparities persist among Middle Eastern Americans at a national-level, playing a critical role in access to and use of health care.
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Affiliation(s)
- Goleen Samari
- Department of Population & Family Health, Mailman
School of Public Health, Columbia University
| | - Mienah Zulfacar Sharif
- Center for the Study of Racism, Social Justice, and Health,
University of California Los Angeles
| | - Héctor E. Alcalá
- Department of Family, Population and Preventative Medicine,
Stony Brook University
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23
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Richardson DM, Andrea SB, Ziring A, Robinson C, Messer LC. Pregnancy Outcomes and Documentation Status Among Latina Women: A Systematic Review. Health Equity 2020; 4:158-182. [PMID: 32440614 PMCID: PMC7241052 DOI: 10.1089/heq.2019.0126] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The impression that Latinas experience paradoxically good pregnancy outcomes in the United States persists, despite evidence showing that these outcomes are not enjoyed by all Latina subgroups. We conducted this systematic literature review to examine the relationship between documentation status and pregnancy outcomes among Latinas. Methods: This review synthesizes empirical evidence on this relationship; examines how these studies define and operationalize documentation status; and makes recommendations of how a more comprehensive methodological approach can guide public health research on the impact of documentation status on Latina immigrants to the United States. We searched the literature within PubMed, Web of Science, Academic Search Premier, and Google Scholar in 2017 for relevant studies. Results: Based on stringent inclusion criteria, we retained nine studies for analysis. Conclusion: We found that evidence for the impact of documentation status on pregnancy outcomes among Latinas is not conclusive. We believe the divergence in our findings is, in part, due to variation in: conceptualization of how documentation status impacts pregnancy outcomes, sample populations, definitions of exposures and outcomes, and contextual factors included in models. Specific analytic challenges around sampling, measurement, and data analysis are identified. Suggestions for future research are offered regarding measurement of documentation status. Findings highlight the need for increased attention to documentation as an influence on Latina pregnancy outcomes.
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Affiliation(s)
- Dawn M Richardson
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Sarah B Andrea
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Amber Ziring
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Cassandra Robinson
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Lynne C Messer
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
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24
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Ortega AN, Pintor JK, Langellier BA, Bustamante AV, Young MEDT, Prelip ML, Alberto CK, Wallace SP. Cardiovascular disease behavioral risk factors among Latinos by citizenship and documentation status. BMC Public Health 2020; 20:629. [PMID: 32375729 PMCID: PMC7204048 DOI: 10.1186/s12889-020-08783-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 04/27/2020] [Indexed: 02/02/2023] Open
Abstract
Background Studies have observed that recent Latino immigrants tend to have a physical health advantage compared to immigrants who have been in the US for many years or Latinos who are born in the United States. An explanation of this phenomenon is that recent immigrants have positive health behaviors that protect them from chronic disease risk. This study aims to determine if trends in positive cardiovascular disease (CVD) risk behaviors extend to Latino immigrants in California according to citizenship and documentation status. Methods We examined CVD behavioral risk factors by citizenship/documentation statuses among Latinos and non-Latino US-born whites in the 2011–2015 waves of the California Health Interview Survey. Adjusted multivariable logistic regressions estimated the odds for CVD behavioral risk factors, and analyses were stratified by sex. Results In adjusted analyses, using US-born Latinos as the reference group, undocumented Latino immigrants had the lowest odds of current smoking, binge drinking, and frequency of fast food consumption. There were no differences across the groups for fruit/vegetable intake and walking for leisure. Among those with high blood pressure, undocumented immigrants were least likely to be on medication. Undocumented immigrant women had better patterns of CVD behavioral risk factors on some measures compared with other Latino citizenship and documentation groups. Conclusions This study observes that the healthy Latino immigrant advantage seems to apply to undocumented female immigrants, but it does not necessarily extend to undocumented male immigrants who had similar behavioral risk profiles to US-born Latinos.
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Affiliation(s)
- Alexander N Ortega
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
| | | | - Brent A Langellier
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | | | | | - Michael L Prelip
- Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA
| | - Cinthya K Alberto
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Steven P Wallace
- Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA
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25
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Ornelas IJ, Yamanis TJ, Ruiz RA. The Health of Undocumented Latinx Immigrants: What We Know and Future Directions. Annu Rev Public Health 2020; 41:289-308. [PMID: 32237989 PMCID: PMC9246400 DOI: 10.1146/annurev-publhealth-040119-094211] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Undocumented Latinx immigrants experience unique factors prior to migration, during migration, and after migration that shape their health. Our review summarizes the limited but growing literature highlighting how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect the mental and physical health of undocumented Latinx immigrants. We also discuss how policies and social ties can promote their health. We focus on areas of particular concern, including health care, mental health, and HIV. Future research should use interdisciplinary approaches and intersectional frameworks to understand and address health inequities. Conducting research with undocumented Latinx immigrant communities requires community engagement, assurance of confidentiality, and creative recruitment and retention strategies. Recommendations for public health practice include investing in community health centers and organizations to ensure access to health and social services; presenting results with sufficient contextualization to interpret their generalizability; and advocating for federal-, state-, and local-level policy changes that reduce the negative health consequences associated with being undocumented.
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Affiliation(s)
- India J Ornelas
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
| | - Thespina J Yamanis
- School of International Service, American University, Washington, DC 20016-8071, USA;
| | - Raymond A Ruiz
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
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26
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Wagner JK. Ethical and Legal Considerations for the Inclusion of Underserved and Underrepresented Immigrant Populations in Precision Health and Genomic Research in the United States. Ethn Dis 2019; 29:641-650. [PMID: 31889769 DOI: 10.18865/ed.29.s3.641] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
There has been growing recognition of the importance of diversity and inclusion of underrepresented minority populations, including immigrants, in genomic research and precision medicine. Achieving diversity has been difficult and has led some scholars to question whether the law is a help or a threat to the inclusion of underserved and underrepresented immigrant populations. In this commentary, I provide an overview of some of the many relevant legal issues affecting the inclusion of immigrants in genomic research and precision health initiatives, such as the All of Us SM Research Program. Development of research recruitment, retention, and data collection plans without also considering the legal and sociopolitical context within which such efforts are to be carried out is risky. Advancing health policy with a goal of eliminating health disparities (or, at a minimum, ensuring that health disparities are not exacerbated by genomic or precision health technologies) requires us to acknowledge the negative effects that immigration policy and criminal justice policy have on the involvement of immigrants in such research and on their health directly. I conclude that it is not a question of whether the law is a help or a threat but, rather, whether we collectively will prioritize authentic diversity and inclusion policies and also insist on compliance with the laws intended to ensure the human right of every individual - regardless of immigration status or national origin - to share in the advancement of science.
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Affiliation(s)
- Jennifer K Wagner
- Center for Translational Bioethics & Health Care Policy, Geisinger; Danville, PA
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27
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Saadi A, Cheffers ML, Taira B, Trotzky-Sirr R, Parmar P, Samra S, Morrison JL, Shah S, Schneberk T. Building Immigration-Informed, Cross-Sector Coalitions: Findings from the Los Angeles County Health Equity for Immigrants Summit. Health Equity 2019; 3:431-435. [PMID: 31448353 PMCID: PMC6707036 DOI: 10.1089/heq.2019.0048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
In December 2017, the Los Angeles County Office of Immigrant Affairs and Board of Supervisors, alongside local health care and legal providers, convened the Health Equity for Immigrants and Families Summit to advance a vision for immigrant health. We describe the four critical concepts identified by stakeholders to address the varied needs of immigrants in an increasingly anti-immigrant political environment: (1) Recognizing immigration status as a modifiable social determinant of health; (2) Adopting the concept of “Immigration-Informed Care” within health care institutions; (3) Establishing immigration-focused medical-legal partnerships; and (4) Building coordinated systems based on knowledge of local stakeholders, policies, and funding mechanisms.
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Affiliation(s)
- Altaf Saadi
- National Clinician Scholars Program, University of California, Los Angeles, Los Angeles, California
| | - Mary L Cheffers
- Department of Emergency Medicine, LAC+USC Medical Center, Los Angeles, California
| | - Breena Taira
- Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, California
| | - Rebecca Trotzky-Sirr
- Department of Emergency Medicine, LAC+USC Medical Center, Los Angeles, California
| | - Parveen Parmar
- Department of Emergency Medicine, LAC+USC Medical Center, Los Angeles, California
| | - Shamsher Samra
- Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California
| | - Janina L Morrison
- Primary Care Internal Medicine, The Wellness Center, LAC+USC Medical Center, Los Angeles, California
| | - Sural Shah
- Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, California.,Division of Internal Medicine-Pediatrics, University of California Los Angeles, Los Angeles, California
| | - Todd Schneberk
- Department of Emergency Medicine, LAC+USC Medical Center, Los Angeles, California
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28
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Distel LML, Egbert AH, Bohnert AM, Santiago CD. Chronic Stress and Food Insecurity: Examining Key Environmental Family Factors Related to Body Mass Index Among Low-Income Mexican-Origin Youth. FAMILY & COMMUNITY HEALTH 2019; 42:213-220. [PMID: 31107732 DOI: 10.1097/fch.0000000000000228] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Low-income children of Mexican immigrants are at high risk for obesity. Drawing on a sample of 104 Mexican American children (Mage = 8.39 years; 61% female), this longitudinal study considered relations between food insecurity and chronic stress (ie, parent report and hair cortisol measurement) on body mass index (BMI) and examined whether stress moderated associations between food insecurity and BMI. Analyses revealed that undocumented status was associated with food insecurity and chronic stress but not when accounting for poverty. Food insecurity was only associated with higher BMI for children with the highest hair cortisol. Results suggest that chronic stress may impact body weight among food-insecure children.
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Affiliation(s)
- Laura M L Distel
- Department of Psychology, Loyola University Chicago, Chicago, Illinois
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