Academic Health Centers and Humanitarian Crises: One Health System's Response to Unaccompanied Children at the Border

University of California Health (UCH) provided a system-wide, rapid response to the humanitarian crisis of unaccompanied children crossing the southern U.S. border in the midst of the COVID-19 pandemic in 2021. In collaboration with multiple federal, state, and local agencies, UCH mobilized a multidisciplinary team to deliver acute general and specialty pediatric care to unaccompanied children at 2 Californian emergency intake sites (EISs). The response, which did not disrupt normal UCH operations, mobilized the capacities of the system and resulted in a safe and developmentally appropriate environment that supported the physical and mental health of migrant children during this traumatic period. The capacities of UCH's 6 academic health centers ensured access to trauma-informed medical care and culturally sensitive psychological and social support. Child life professionals provided access to exercise, play, and entertainment. Overall, 260 physicians, 42 residents and fellows, 4 nurse practitioners participated as treating clinicians and were supported by hundreds of staff across the 2 EISs. Over 5 months and across both EISs, a total of 4,911 children aged 3 to 17 years were cared for. A total of 782 children had COVID-19, most infected before arrival. Most children (3,931) were reunified with family or sponsors. Continuity of care after reunification or placement in a long-term shelter was enhanced by use of an electronic health record. The effort provided an educational experience for residents and fellows with instruction in immigrant health and trauma-informed care. The effort benefitted from UCH's recent experience of providing a system-wide response to the COVID-19 pandemic. Lessons learned are reported to encourage the alignment and integration of academic health centers' capacities with federal, state, and local plans to better prepare for and respond to the accelerating need to care for those in the wake of disasters and humanitarian crises.

Maternal Acceptance/Rejection of Mexican Migrant Mothers

This study examined correlates of maternal acceptance of preschool children in a sample of Mexican-American migrant farmworker mothers, including problems in life conditions (education, employment, relatives, friends, partner/spouse, children, health, housing, and finances) and social support (task, emotional, source, satisfaction, accessibility). One hundred Mexican-American mothers of preschoolers who participated in the Texas Migrant Council's Headstart Program were interviewed with regard to demographic information, social support, and problems in life conditions. The results supported the hypothesis that total social support accounts for more variation in maternal acceptance/rejection than problems in life conditions alone. Social support accounted for 75% of the variance in maternal acceptance/rejection of preschool children, and accessibility to support predicted the largest proportion of the variance. The results suggest that it is important to identify Mexican-American migrant farmworker mothers isolated from social support, since such isolation, in combination with problems in life conditions, places their children at higher risk for maternal rejection.

Migration Experiences of Foreign Educated Nurses

Purpose: Global nurse migration has a recognized impact on host and source countries, but the lived experience of foreign educated nurses is an important aspect of the success of this migration. A systematic review of the literature was conducted to understand the lived migration and acculturation experiences of foreign educated nurses. Design: A systematic review of the literature, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was conducted. Primary research articles or secondary analyses were selected based on keyword and citation-based searches ( n = 44). Findings: Nurses’ experiences included migration and licensing barriers, difficulty with communication, racism and discrimination, skill underutilization, acculturation, and the role of the family. Conclusions: Barriers encountered in host countries may impede acculturation and successful nursing practice, resulting in circular migration and poor patient safety outcomes. Implications for Practice: Social support systems and cultural orientation programs can mitigate the impacts of social isolation and racism. Addressing common barriers can help minimize deskilling and allow safe and effective transitions to host countries.

Feminization of migration: a global health challenge

Demographers are slowly bringing the migration of women to the forefront as women become the majority of migrants worldwide. Migration can provide new opportunities for women on their own or jointly with their spouses to improve their lives, escape oppressive social relations, and support children and other family members who are left behind. It also can expose women to new vulnerabilities resulting from their precarious legal status, abusive working conditions, and health risks.¹ Migrant women are triply disadvantaged by race/ethnicity, their status as nonnationals, and gender inequalities.²

The health status of latino immigrant women in the United States and future health policy implications of the affordable care act

Immigrant women of Mexican birth face unique health challenges in the United States. They are at increased risk for developing many preventable health conditions due in part to limited access to healthcare and benefits, legal status, and inadequate income. Increased vulnerability of women has established a growing need to focus on their healthcare needs because of their role, position, and influence in the family. The purpose of this article is to review factors that impact the health status of Mexican-born women living in the United States and review policy implications of the Affordable Care Act for this population. Mexican-born women are the largest female immigrant group in the United States. Therefore, they comprise the group that will need health coverage in the greatest proportion. As a result, there will be a need for culturally and linguistically appropriate healthcare services and culturally sensitive providers.

Maternal predictors of behavioral problems among Mexican migrant farmworker children

This study investigated the impact of maternal parenting factors on the emotional and behavioral health of Mexican Migrant Head Start children. Although the majority of children sampled in this study did not exhibit problematic behaviors, the findings concluded that children who demonstrated emotional and behavioral problems experienced a more rejecting maternal parenting style, greater parenting stress, and mothers reporting feelings of depression. Gender differences were found between the behavioral and emotional problems of sons and daughters. Surprisingly, years in the United States, maternal birthplace, income, education, and language spoken in the home were not associated with child behavioral problems.

Fostering health equity: clinical and research training strategies from nursing education

Racism, ethnocentrism, segregation, stereotyping, and classism are tightly linked to health equity and social determinants of health. They lead to lack of power, money, resources, and education which may result in poor health care access and outcomes. Health profession faculties must address the complex relationships that exist between individual, interpersonal, institutional, social and political factors that influence health outcomes in both clinical and research training. Thus, the purposes of this paper are to provide examples of training strategies from nursing education that foster cultural sensitivity. First, assumptions about health equity, culture, ethnicity and race are explored. Second, clinical training within an undergraduate and graduate context are explored, including an undergraduate cancer case study and in a graduate pediatric nursing program are described to demonstrate how cultural models can be used to integrate the biomedical and psychosocial content in a course. Third, research training for summer scholars and doctoral and post doctoral fellows (short and long term) is described to demonstrate how to increase the number and quality of scholars prepared to conduct research with vulnerable populations. Research training strategies include a summer research institute, policy fellowship, and a scholars "pipeline" program. A unique perspective is presented through collaboration between a nursing school and a center for health disparities research.

Developing the research pipeline: increasing minority nursing research opportunities

The need to increase the number of minority nurses in policy and leadership positions in health care administration, academia, and research has been acknowledged. Limited academic and research training opportunities are available specifically designed to develop a cadre of minority nurse scientists to conduct the research needed to ultimately reduce health disparities within racial and ethnic minority populations. This article describes a collaborative approach to research career development at the doctoral level.

Mental health and disabilities: what we know about racial and ethnic minority children

The recognition that children and adolescents suffer from mental health problems and disabilities is a recent phenomenon, not arising until the late 19th century. Because of the increasing numbers and importance of ethnic minority children and youth to the vitality of the United States, their mental health and disabilities can no longer be overlooked. Mental health is paramount for fostering social integration, unity, and inclusiveness within and between ethnic groups. Thus the significance of changing demographics and the disparity in mental health indicators make this a key issue for the future. Nursing research in this area has been limited, in spite of the fact that mental health problems and disabilities exert a disproportionate negative effect on racial and ethnic minority children (NIMH, 2001a). The purpose of this chapter is to critique the available nursing research on mental health and disabilities in racial and ethnic minority children, including how such research has been conceptualized, conducted, and interpreted.

Assessing cultural competence of policy organizations

Assessment of the capabilities of human service providers to care for individuals from diverse cultures has been widely discussed in the literature. However, a less examined area is the appraisal of the cultural competence of the administrative or policy bodies whose actions shape the character of these human services. This article demonstrates an approach for evaluating a policy organization's cultural competence using a governmental agency as a case study. Findings from this assessment prompted this agency to generate plans to further enhance its cultural competence.