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Young MEDT, Perez-Lua F, Sarnoff H, Plancarte V, Goldman-Mellor S, Payán DD. Working around safety net exclusions during the COVID-19 pandemic: A qualitative study of rural Latinx immigrants. Soc Sci Med 2022; 311:115352. [PMID: 36126474 PMCID: PMC9444313 DOI: 10.1016/j.socscimed.2022.115352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 06/07/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022]
Abstract
Rural Latinx immigrants experienced disproportionately negative health and economic impacts during the COVID-19 pandemic. They contended with the pandemic at the intersection of legal status exclusions from the safety net and long-standing barriers to health care in rural regions. Yet, little is known about how rural Latinx immigrants navigated such exclusions. In this qualitative study, we examined how legal status stratification in rural contexts influenced Latinx immigrant families' access to the safety net. We conducted interviews with first- and second-generation Latinx immigrants (n = 39) and service providers (n = 20) in four rural California communities between July 2020 and April 2021. We examined personal and organizational strategies used to obtain economic, health, and other forms of support. We found that Latinx families navigated a limited safety net with significant exclusions. In response, they enacted short-term strategies and practices - workarounds - that met immediate, short-term needs. Workarounds, however, were enacted through individual efforts, allowing little recourse beyond immediate personal agency. Some took the form of strategic practices within the safety net, such as leveraging resources that did not require legal status verification; in other cases, they took the form of families opting to avoid the safety net altogether.
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Affiliation(s)
- Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA, 95343, USA.
| | - Fabiola Perez-Lua
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA, 95343, USA
| | - Hannah Sarnoff
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA, 95343, USA
| | | | - Sidra Goldman-Mellor
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA, 95343, USA
| | - Denise Diaz Payán
- Department of Health, Society and Behavior, Program in Public Health, University of California, Irvine, CA, 92697, USA
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Cordato D, Blair C, Thomas P, Firtko A, Miller M, Edwards LS, Thomas J, Balabanski AH, Dos Santos A, Lin L, Hodgkinson S, Cappelen-Smith C, Beran RG, McDougall A, Parsons M. Cerebrovascular Disease Profiles of Culturally and Linguistically Diverse Communities in South Western Sydney and New South Wales. Cerebrovasc Dis 2022; 51:744-754. [PMID: 35551130 DOI: 10.1159/000524242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/15/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Culturally and linguistically diverse (CALD) communities are growing globally. Understanding patterns of cerebrovascular disease in CALD communities may improve health outcomes through culturally specific interventions. We compared rates of transient ischaemic attack (TIA)/stroke (ischaemic stroke, intracerebral haemorrhage) and stroke risk factor prevalence in overseas and Australian-born people in South Western Sydney (SWS) and New South Wales (NSW). METHODS This was a 10-year retrospective analysis (2011-2020) of SWS and NSW age-standardized rates per 100,000 person-years of TIA/stroke. Data were extracted from Health Information Exchange and Secure Analytics for Population Health Research and Intelligence systems. Rates of hypertension, type 2 diabetes mellitus (T2DM), atrial fibrillation (AF), smoking, and obesity were also calculated. RESULTS The SWS and NSW age-standardized rate of TIA/stroke for people born in Australia was 100 per 100,000 person-years (100/100,000/year). In SWS, 56.6% of people were overseas-born compared to 29.8% for NSW. The age-standardized rate of TIA/stroke for Polynesian-born people was more than double that of Australian-born people (p < 0.001). Hypertension (33 [SWS] vs. 27/100,000/year [NSW]) and T2DM (36 [SWS] vs. 26/100,000/year [NSW]) were the most common risk factors with rates >50/100,000/year (hypertension) and >80/100,000/year (T2DM) for people born in Polynesia, Melanesia, and Central America. Rates of T2DM, AF, and obesity for Polynesian-born people were over threefold greater than people born in Australia. DISCUSSION/CONCLUSION Greater rates of TIA/stroke were observed in specific CALD communities, with increased rates of cerebrovascular risk factors. Culturally specific, targeted interventions may bridge health inequalities in cerebrovascular disease.
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Affiliation(s)
- Dennis Cordato
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Christopher Blair
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia, .,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia, .,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia, .,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia,
| | - Peter Thomas
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Angela Firtko
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Megan Miller
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Leon Stephen Edwards
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - James Thomas
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Anna H Balabanski
- Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Neuroscience, Monash University, Clayton, Victoria, Australia.,Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.,Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
| | - Angela Dos Santos
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Neuroscience, Monash University, Clayton, Victoria, Australia.,Department of Neurology, Alfred Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Longting Lin
- South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Suzanne Hodgkinson
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Cecilia Cappelen-Smith
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Roy G Beran
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,School of Medicine, Griffith University, Broadbeach, Queensland, Australia.,Sechenov Moscow First State University, Moscow, Russian Federation
| | - Alan McDougall
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Mark Parsons
- Department of Neurology and Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.,South Western Sydney Stroke and Research Group, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Sydney Brain Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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Maxwell AE, Young S, Crespi CM, Vega RR, Cayetano RT, Bastani R. Social determinants of health in the Mixtec and Zapotec community in Ventura County, California. Int J Equity Health 2015; 14:16. [PMID: 25643835 PMCID: PMC4320817 DOI: 10.1186/s12939-015-0148-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 01/21/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION There are an estimated 165,000 indigenous Mexicans living in California, including Mixtec and Zapotec immigrant farm workers. Because many of these immigrants speak only their native non-written languages, there is little information about the needs of this community. An academic-community partnership research team developed a survey to assess basic needs that are known to be social determinants of health in the Mixtec and Zapotec community in Ventura County. METHODS In summer 2013, Spanish-Mixteco and Spanish-Zapoteco bilingual promotoras conducted surveys in Spanish, Mixteco and Zapoteco in the greater Oxnard area in Ventura County, California to assess the following basic needs: ability of adults and children to obtain health services; household needs regarding work opportunities, food, housing, transportation, safety and education; and discrimination. Independent variables included respondent characteristics such as age, gender, marital status, living part of the year in another city, and household characteristics such as Spanish spoken in the household, number of household members and number of health care providers/agencies used. Several sets of analyses examined the relationship between basic needs and independent variables. RESULTS Respondents (N = 989) reported insufficient employment opportunities (74%), food for the family (59%) or housing (48%), lack of transportation (59%), and discrimination or bullying (34%). Most reported access to medical care for children (90%), but only 57% of respondents were able to get health care for themselves. CONCLUSIONS Many basic needs in the Mixtec and Zapotec community in Ventura County are unmet. It will require many different resources and services to address the needs of this community and to overcome longstanding inequities that are experienced by immigrant farm workers. Our findings will guide the development of future health programs and will serve as a baseline to evaluate the impact of services to improve the health conditions in this community.
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Sandra Young
- Mixteco/Indigena Community Organizing Project, PO Box 20543, Oxnard, CA, 93034, USA.
| | - Catherine M Crespi
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Roena Rabelo Vega
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Reggie T Cayetano
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
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