Perceived Anti-Immigrant Climate, Health Care Discrimination, and Satisfaction with Care Among US Latino Adults

A growing body of evidence has documented the effects of discrimination among Latinos. However, little is known about the impacts a noxious sociopolitical climate can have on their health and health care outcomes. The present study explored the associations between perceived anti-immigrant climate, health care discrimination, and satisfaction with care among US Latino adults. We used data from the 2015 Latino National Health and Immigration Survey (n = 1,284), a nationally representative sample of US Latino adults (ages 18 and older). Key predictors included living in a state whose policies are unfavorable towards immigrants, perceived anti-immigrant climate and/or anti-Hispanic climate, and health care discrimination. Ordered logistic regression models evaluated the associations between these predictors (adjusting for other relevant covariates) and satisfaction with care. Latinos living in state that is unfavorable towards immigrants were less likely to be satisfied with medical care they receive. Also, we found that Latinos living in anti-immigrant and anti-Hispanic climates were less likely to be satisfied with care. In both cases, experiencing health care discrimination significantly reduced the odds of satisfaction with care. Latinos' perception of an anti-immigrant & anti-Hispanic climate and state policies can have detrimental effects on their health and health care outcomes. These results highlight the importance of addressing both community-wide and interpersonal discrimination specific to health care settings, which can have concurrent impacts on the health and well-being of Latino and other minoritized populations.

Social and structural determinants of COVID-19 vaccine uptake among racial and ethnic groups

Latino, Black, American Indian/Alaska Native (AI/AN), and Native Hawaiian or Other Pacific Islander people have the highest hospitalizations and death rates from COVID-19. Social inequalities have exacerbated COVID-19 related health disparities. This study examines social and structural determinants of COVID-19 vaccine uptake. Results from logistic regressions suggest Latino and Black people were less likely to be vaccinated. People that did not have health insurance, a primary care doctor and were unemployed were more than 30% less likely to be vaccinated for COVID-19. Greater perceived health inequalities in one's neighborhood and perceived racial/ethnic discrimination were associated with a decreased odds in being vaccinated. People that suffered the loss of a household member from COVID-19 were three times more likely to have been vaccinated. Establishing policies that will increase access to health insurance and create jobs with living wages may have lasting impacts. Furthermore, collaboration with local and national community organizations can enhance the development of sustainable solutions.

Battling the Hydra: the disparate impact of voter ID requirements in North Dakota

Minority voters have experienced a renewed effort to curtail their access to the ballot box in recent years. Although a host of research has examined the impact of election changes on Black and Latino voters, scholars have dedicated much less attention to the rights of Native Americans, even as they face challenges to voting in states where they comprise a significant portion of the population. Many of these states are likewise increasingly important to national elections. Such laws may impact Native Americans when they intersect with the political geography of living on a reservation, and voting rights advocates have challenged them in places like Montana, Nevada and North Dakota. This paper empirically evaluates how such laws might uniquely impact Native American voters. We draw on North Dakota's voter identification law as a case study, but our analysis has wider implications, since residency is the primary means by which election administration uniquely impacts this group. Drawing on two rich survey datasets collected in 2015 and 2017, we offer descriptive evidence of the barriers individuals may encounter while trying to obtain an ID under North Dakota's law, and find that Native Americans are statistically less likely to have access to an ID than are whites. This gap is largely due to the requirement that an ID has a physical address and attendant difficulties in obtaining such an ID, given the remote nature of reservations. We bring needed attention to the impact of carefully crafted electoral rules on this often-overlooked group.

Racial/Ethnic Group Differences and Sociocultural Factors Associated With Implicit and Explicit Attitudes Toward Undocumented Latino Immigrants

In the context of recent policies aimed at deterring immigration and criminalizing undocumented Latino immigrants, we examined factors predicting implicit and explicit attitudes toward this population. We hypothesized that more positive implicit and explicit attitudes toward undocumented Latino immigrants would be displayed by Latinxs (compared to non-Hispanic Whites) and by individuals having personal connections to undocumented immigrants or a high level of intercultural sensitivity. Latinx (n = 376) and non-Hispanic White (n = 214) college students (70% female, M age = 21) participated in this cross-sectional study and completed two Implicit Association Tests and measures of explicit attitudes, personal connections, and intercultural sensitivity. As predicted, Latinx participants held more positive implicit and explicit attitudes than non-Hispanic White participants. Intercultural sensitivity and personal connections to undocumented immigrants were associated with more positive explicit attitudes. Identifying factors that increase a sense of commonality and cultural sensitivity with undocumented Latino immigrants may be helpful in diminishing the profiling and criminalization of this community.

COVID-19 Is Having a Devastating Impact on the Economic Well-being of Latino Families

Latino Americans are more likely than non-Hispanic whites to contract COVID-19 and to face disproportionately high mortality rates when they contract the virus. What has not been well understood is the impact COVID-19 is having on the economic well-being of Latino families. Using the Abriendo Puertas/Latino Decisions National Parent Survey (1195), we asked Latino respondents how the pandemic has impacted their employment, savings, and finances and we also asked them how they have been coping to make ends meet. Using descriptive analysis and ordinal least squares regression, we find that Latinos are experiencing high job loss and business closures. We also find that young parents (18–29-year olds) and those with income levels of $25,000 or lower are experiencing the most economic stress. We also find that Latinos are having difficulty making housing payments and postponing educational and health-related services to make ends meet. We also find that just over half of Latinos have emergency savings under $1000 which is important given that unemployment benefits expired on July 31, 2020. In conclusion, this research finds that Latinos are experiencing economic stressors and are engaging in coping strategies that are deeply concerning and which require explicit attention from policymakers. Given that Latinos took the longest to recover from the Great Recession, policymakers should keep this in mind as we continue to monitor the implications of the recession, ideally looking at mechanisms to reduce the stress for Latino families and encourage policies which target low-income working class Americans and small business owners.

The Impact of Acculturation and Racialization on Self-Rated Health Status Among U.S. Latinos

We investigate the Hispanic paradox by examining the relationship between acculturation and health status of Latinos to understand nuances among this growing heterogeneous population using a 2011 Latino Decisions survey. We find that acculturation remains an important determinant of Latino health; however, this varies based on whether the sample is restricted to immigrants or includes all Latino adults and on the measures of acculturation employed. We find Latino citizens reported better health than non-citizens; however, other acculturation measures, such as language use and time in the U.S. do not have a marked effect. Furthermore, skin color matters only for U.S.-born Latinos. Racialization is therefore important to consider within the context of the Hispanic paradox. Our findings suggest that some of the disadvantages stemming from minority status in the U.S. are more prominent among Latinos who have greater experience with the racial hierarchy of the U.S. and greater acculturation more broadly.

Latinos' Connections to Immigrants: How Knowing a Deportee Impacts Latino Health

This manuscript examines how personally knowing a deportee and/or undocumented immigrant affects the mental health of Latina/o adults. Utilizing a new survey sponsored by the Robert Wood Johnson Foundation Center for Health Policy at the University of New Mexico (n=1,493), we estimate a series of logistic regressions to understand how personal connections to immigrants are affecting the mental health of Latinos using stress process theory. Our modeling approach takes into consideration the socio-political, familial, cultural, and personal contexts that make up the Latina/o experience, which is widely overlooked in data-sets that treat Latinos as a homogeneous ethnic group. Our findings suggest that knowing a deportee increases the odds of having to seek help for mental health problems. The significance of this work has tremendous implications for policy makers, health service providers, and researchers interested in reducing health disparities among minority populations especially under a new administration, which has adopted more punitive immigration policies and enforcement.

The Impact of Punitive Immigrant Laws on the Health of Latina/o Populations

This study examines how anti-immigrant policies affect the physical health of Latina/os in the United States. Merging two unique datasets: sum of anti-immigrant policies by state from 2005-2011 and a 2011 Robert Wood Johnson Center for Health Policy nationally representative sample of Latina/os (n=1,200), we estimate a series of logistic regressions to understand how anti-immigrant legislations are affecting the health of Latina/os. Our modeling approach takes into consideration Latinos' diverse experience, context that is widely overlooked in datasets that treat Latina/os as a homogeneous ethnic group. Our findings suggest that an increase in anti-immigrant laws enacted by a state decreases the probability of respondents reporting optimal health, even when controlling for other relevant factors, such as citizenship status, language of interview, and interethnic variation. The implication and significance of this work has tremendous impacts for scholars, policy makers, health service providers and applied researchers interested in reducing health disparities among minority populations.

Fear by Association: Perceptions of Anti-Immigrant Policy and Health Outcomes

The United States is experiencing a renewed period of immigration and immigrant policy activity as well as heightened enforcement of such policies. This intensified activity can affect various aspects of immigrant health, including mental health. We use the Robert Wood Johnson Foundation 2015 Latino National Health and Immigration Survey (n = 1,493) to examine the relationship between immigration and immigrant policy and Latino health and well-being. We estimate a series of categorical regression models and find that there are negative health consequences associated with Latinos' perceptions of living in states with unfavorable anti-immigration laws, including reporting poor health and problems with mental health. This article builds on the work of public health scholars who have found a link between this heightened policy environment and the mental health of immigrants, yet expands on this research by finding that the health consequences associated with immigration policy extend to Latinos broadly, not just immigrants. These findings are relevant to scholars of immigration and health policy as well as policy makers who should consider these negative effects on the immigrant community during their decision-making process.

Latina/o or Mexicana/o?: The Relationship between Socially Assigned Race and Experiences with Discrimination

Discrimination based on one's racial or ethnic background is one of the oldest and most perverse practices in the United States. While much of this research has relied on self-reported racial categories, a growing body of research is attempting to measure race through socially-assigned race. Socially-assigned or ascribed race measures how individuals feel they are classified by other people. This paper draws on the socially assigned race literature and explores the impact of socially assigned race on experiences with discrimination using a 2011 nationally representative sample of Latina/os (n=1,200). While much of the current research on Latina/os has been focused on the aggregation across national origin group members, this paper marks a deviation by using socially-assigned race and national origin to understand how being ascribed as Mexican is associated with experiences of discrimination. We find evidence that being ascribed as Mexican increases the likelihood of experiencing discrimination relative to being ascribed as White or Latina/o. Furthermore, we find that being miss-classified as Mexican (ascribed as Mexican, but not of Mexican origin) is associated with a higher likelihood of experiencing discrimination compared to being ascribed as white, ascribed as Latina/o, and correctly ascribed as Mexican. We provide evidence that socially assigned race is a valuable complement to self-identified race/ethnicity for scholars interested in assessing the impact of race/ethnicity on a wide range of outcomes.

Taking a Closer Look at Group Identity: The Link Between Theory and Measurement of Group Consciousness and Linked Fate

Scholarship in the area of group identity has expanded our understanding of how group consciousness and linked fate operate among racial and ethnic minority populations in the United States. What is yet to be tested is whether the measures employed adequately capture the multi-dimensional theoretical constructs associated with group consciousness across racial and ethnic populations. To address this question we make use of the 2004 National Political Study (n=3,339) and apply principle components analysis and exploratory factor analysis to assess whether measures used for both group consciousness and linked fate are interchangeable, as well as whether these measures are directly comparable across racial and ethnic populations. We find that the multidimensional approach to measuring group consciousness is a sound strategy when applied to African Americans, as the dimensions fit the African American experience more powerfully than is the case for Non-Hispanic Whites, Hispanics, and Asian populations. Our analysis suggests that scholars interesting in exploring group identity among the African-African population have fewer analytical concerns in this regard than those working with other populations where the underlying components associated with group consciousness appear to be operating differently.

Civic engagement and political participation among American Indians and Alaska natives in the US

Within the growing literature seeking to understand civic and political engagement among racial and ethnic minorities, our understanding of political behavior among American Indian and Alaska Native's (AI/AN) remains limited. We use the Current Population Survey Civic Engagement and Voting and Registration supplements (2006-2012) to compare AI/AN voter registration, voting, and overall civic engagement to other racial and ethnic groups and to assess whether factors that predict higher levels of civic engagement vary across these populations. We find a few key socio-economic status indicators that predict civic and political engagement uniquely for AI/ANs, but they are not consistently significant across all years or all types of political participation. We find marital status, age, household size, education, and veteran status to be important in predicting civic engagement for AI/ANs. However, for voting and registration, we find that family income, age, marital status, household size, and residential stability to be important contributors. Although we find AI/ANs are less likely to register and vote compared to non-Hispanic whites, we find that the difference is not statistically significant in congressional years, which may suggest that AI/ANs are engaged in local politics and vote for representatives that will represent their tribal interests in national politics.

The Enhanced Self-Reported Health Outcome Observed in Hispanics/Latinos Who are Socially-Assigned as White is Dependent on Nativity

A growing body of research seeks to conceptualize race as a multi-dimensional construct, attempting to move beyond a dummy variable approach to study social disparities. This research uses 'socially-assigned race', 'ascribed race', or 'what race others think you are' as opposed to self-identified race to assess self-rated health status among a representative study of the Latino population (n = 1,200). Our analysis shows how important the lived experience of Latinos and Hispanics (as measured by ascribed race and a host of control variables, including nativity and national origin) is on self-reported health. Using a series of logistic regressions, we find support for the 'white advantage' in Latino health status that is suggested in the literature, but this finding is sensitive to nativity, citizenship, and national origin. This research informs the study of racial and ethnic disparities, providing a detailed explanation for the 'white health advantage' finding within the socially-assigned race and health disparities literature.

RACE AS LIVED EXPERIENCE: The Impact of Multi-Dimensional Measures of Race/Ethnicity on the Self-Reported Health Status of Latinos

A growing body of social science research has sought to conceptualize race as a multidimensional concept in which context, societal relations, and institutional dynamics are key components. Utilizing a specially designed survey, we develop and use multiple measures of race (skin color, ascribed race, and discrimination experiences) to capture race as "lived experience" and assess their impact on Latinos' self-rated health status. We model these measures of race as a lived experience to test the explanatory power of race, both independently and as an integrated scale with categorical regression, scaling, and dimensional analyses. Our analyses show that our multiple measures of race have significant and negative effects on Latinos' self-reported health. Skin color is a dominant factor that impacts self-reported health both directly and indirectly. We then advocate for the utilization of multiple measures of race, adding to those used in our analysis, and their application to other health and social outcomes. Our analysis provides important contributions across a wide range of health, illness, social, and political outcomes for communities of color.

Stuck between a rock and a hard place: The relationship between Latino/a's personal connections to immigrants and issue salience and presidential approval

The Obama administration has simultaneously marketed the prospect of providing undocumented immigrants a pathway to citizenship through comprehensive immigration reform and overseen mass deportations of mostly Latino immigrants. While it is clear that immigration policy was highly influential to Latino voters in 2012, it remains unclear how this political hypocrisy is being interpreted by Latino voters. As deportations have risen steadily during the Obama administration, there has been little research on how deportations and personal connections to undocumented immigrants have influenced the political attitudes of the Latino/a electorate. Using a nationally representative survey of 800 registered Latino/a voters administered in 2013, we explore the relationships between personal connections to undocumented immigrants and issue salience among Latinos as well as Latinos' views of President Obama. This study finds that registered Latino voters who know deportees and undocumented immigrants are more likely to report that they think the President and Congress should act on immigration policy versus all other policies. Moreover, Latino voters who know someone who is undocumented are less likely to have favorable views towards President Obama. This study has implications for our collective knowledge of how direct and indirect connections to policy outcomes influences the political behavior of the highly influential Latino/a electorate and how political and policy outcomes will be influenced in the future when a much higher proportion of the electorate have such connections.

Tough times, tough choices: the impact of the rising medical costs on the U.S. Latino electorate's health care-seeking behaviors

Utilizing a survey of Latino registered voters conducted in Spring 2009, we focus our attention on the impact of the rapidly rising costs of health care on the health-seeking behavior of Latino registered voters, and the impact of high medical costs on their economic status. We find that a third of Latinos used up all or most of their savings and a quarter of Latinos skipped a recommended test or treatment due to high medical costs, rates that are particularly high given that our sample is of Latino registered voters. Furthermore having health insurance is not statistically related to preventing economic hardship due to medical costs for Latinos. Our results suggest that the expansion of insurance coverage alone will not insulate the Latino community from being faced with economic difficulties unless the reform policy directly addresses individual costs of care.

“The Politics of the HealthCare Reform Debate: Public Support of Including Undocumented Immigrants and Their Children in Reform Efforts in the U.S.”

Although U.S. immigration and health care policies appear to be highly correlated, scholarship has yet to gauge the public's views toward providing undocumented immigrants with health coverage at the state level. We analyze support for including undocumented immigrants in health care reform in New Mexico. Utilizing an original public opinion survey of New Mexico adults, we find that individuals are more supportive of the state providing health care to the children of undocumented immigrant than to their parents. Multivariate logistic regression analyses suggest that factors such as liberal ideology and perceptions of commonalities with Latinos increase support levels. Despite a lack of support among a majority of respondents, the influence of perceived commonalities with immigrants suggests that reform advocates and political elites who mobilize along ethnic or human solidarity may be successful in creating conditions for the inclusion of undocumented immigrants in the public provision of health care at the state level.

The Impact of Health Care and Immigration Reform on Latino Support for President Obama and Congress

At the start of their term, the Obama administration pledged to reform two failing policy systems in the United States: immigration and health care. The Latino populations’ attitudes toward these two critical policy areas are particularly relevant due to the large foreign born population in the Latino community and the large number of Latinos who lack health insurance. Yet studies have not examined what factors shape Latino approval ratings and whether support for health and immigration reform affect Latino approval ratings of the current administration. We use the 2009 Latino Decisions survey and find that the foundations of Latino approval ratings are political in nature, with support for health and immigration policy reform driving support of the current administration. Given the vital role the Latino electorate played during the 2008 election, the success of these two policy reform efforts may have major implications for the 2012 elections.

Brown-Utility Heuristic? The Presence and Contributing Factors of Latino Linked Fate

In an electoral system governed by the plurality rule, those groups who wield the greatest amount of power in the United States are those who vote as a cohesive bloc. Although the size of the Latino population is growing, it is unclear whether all Latinos perceive a shared collective identity that will be exercised in the political realm. This study uses the Latino National Survey, a nationally representative telephone survey of 8,600 Latino adults, to examine how individual Latinos perceive their personal fates and the fate of their national origin group with the larger panethnic community. The authors utilize ordered logistic regression analysis to test their hypotheses regarding the impact of immigration experiences, race, and socioeconomic status on Latino linked fate. Results suggest that linked fate for Latinos may be a temporary phenomenon, as linked fate for Latinos appears to be based on marginalization derived from economic status and immigration experiences.

Outcome following tricuspid valve detachment for ventricular septal defects closure

OBJECTIVES

Detachment of the septal leaflet of the tricuspid valve from the annulus (TVD) has been used to improve visualization of ventricular septal defects (VSDs), but may be associated with increased operative time, heart block, and the development of tricuspid regurgitation (TR).

METHODS

Patients undergoing VSD closure between 1/1/96 and 31/12/99 were retrospectively reviewed. Follow-up was obtained from the patients' cardiologists.

RESULTS

Transatrial VSD closure was performed in 172 patients with TVD in 36 (21%) at the surgeon's discretion. The leaflet incision was repaired with a separate suture (22) or with the VSD patch suture (14). Additional procedures including arch augmentation, closure of atrial septal defects, and closure of additional VSDs were performed in 93 (68%) non-TVD patients and 20 (56%) TVD patients. The median age was 6.2 months (range 1 day to 46 years) and the median weight was 5.9 kg (range 1.5-71.5 kg). Cardiopulmonary bypass (CPB) time was 64+/-24 min and cross-clamp time was 34+/-16 min. One hospital death occurred in an infant with tracheal stenosis. No child in either group developed complete heart block. The median duration of postoperative stay was 4 days (range 2-49 days). There were no differences in CPB time, cross-clamp time or postoperative stay between the TVD and non-TVD groups (P>0.1 for all). At a mean follow-up of 17+/-15 months, there have been two late deaths unrelated to cardiac disease. No child in the TVD group required reoperation for residual VSD, compared to three in the non-TVD group. No child in the TVD group has greater than mild TR, but six in the non-TVD group have greater than mild TR. No child in either group has undergone reoperation for TR.

CONCLUSIONS

TVD is a safe, effective technique to improve visualization of VSD and is not associated with heart block, increased operative time, or TR. TVD may result in improved preservation of tricuspid valve architecture and decrease the incidence of significant postoperative TR.

Ectopic automatic atrial tachycardia in children: clinical characteristics, management and follow-up

Ectopic automatic atrial tachycardia, an uncommon type of supraventricular tachycardia in children and adults, has been reported to be resistant to medical therapy, and surgical or cryoblation has been recommended. This report describes 10 infants and children (median age 6 months; range birth to 7.5 years) with automatic atrial tachycardia and their management and follow-up. Digoxin alone was unsuccessful in controlling tachycardia in all 10 patients but decreased the tachycardia rate by 5 to 20% in 8. Intravenous (0.1 mg/kg body weight per dose) and oral propranolol successfully suppressed tachycardia in three of five patients and oral propranolol successfully controlled tachycardia in two of five other patients. Class I antiarrhythmic agents--quinidine (three patients), procainamide (four patients) and phenytoin (three patients)--did not control tachycardia in any patients but made the tachycardia rate worse in three patients. Intravenous (5 mg/kg per dose) and oral amiodarone suppressed tachycardia in three of four patients and oral amiodarone suppressed it in another patient. Thus, intravenous propranolol and amiodarone were effective in acutely suppressing automatic ectopic atrial tachycardia and predicted the response to long-term oral therapy. One patient had persistent tachycardia after surgical ablation of the high right atrial ectopic focus, and another patient had unsuccessful catheter ablation of the high right atrial ectopic focus (25 J). During follow-up (10 to 28 months), ectopic atrial tachycardia resolved completely in four patients and was well controlled in four patients.

Oncocytic cardiomyopathy of infancy with Wolff-Parkinson-White syndrome and ectopic foci causing tachydysrhythmias in children

Two female infants, ages 6 months and 13 months, were first seen in the newborn period with supraventricular tachycardia associated with Wolff-Parkinson-White syndrome. One infant had echocardiographic and angiographic evidence of diffuse cardiomyopathy and died suddenly at home. The other infant was seen initially at 13 months of age with refractory ventricular tachycardia and died following surgical resection of arrhythmogenic foci on the left and right ventricles. Autopsy showed diffuse patchy oncocytic cardiomyopathy in both instances. Serial histologic sections of the cardiac conduction system showed oncocytic involvement of the atrioventricular (AV) node, His bundle, and bundle branches. Both infants had interruption of the anulus fibrosus by oncocytic cells at several sites, resulting in multiple accessory AV and nodoventricular connections. Additionally, patient No. 1 had an accessory AV connection by oncocytic cells in the fatty fibrous tissue of the left AV sulcus. To our knowledge, this is the first report of multiple accessory AV connections of oncocytic cells seen during histologic study. In addition, both infants had oncocytic involvement of the exocrine and endocrine glands. This report discusses the clinicopathologic correlations in these two patients, the literature on oncocytic cardiomyopathy, and the types of dysrhythmias found in these patients and their management.

Aneurysm of main pulmonary artery in a neonate with airway obstruction and heart failure: long-term survival after pulmonary artery aneurysmectomy and patent ductus arteriosus ligation

A neonate was seen with complete atelectasis of the left lung secondary to compression of the left main bronchus by a congenital aneurysmal main pulmonary artery. Operation consisted of pulmonary artery aneurysmectomy and ligation of an associated patent ductus arteriosus. Follow-up (3 years after operation) demonstrated complete resolution of the atelectasis and congestive heart failure.