Article

How do Latino Immigrants Perceive the Current Sociopolitical Context? Identifying Opportunities to Improve Immigrant Health in the United States

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Migration is an important social determinant of health for immigrants in the United States. Increased attention on Latino immigrants in recent years has sparked interest in policies that affect this population. While prior research has assessed the potential health impact of specific immigration policies, there is limited understanding of how the overall sociopolitical context shapes the health of Latino immigrants. This study examines the potential mechanisms that link the sociopolitical context and health among Latino immigrants. Specifically, we explore how perceptions of the sociopolitical context are implicated in this relationship. Qualitative interviews with community gatekeepers (n=13) and Latino immigrants (n=34) in New York City revealed general perceptions about the overall sociopolitical context, which were characterized by discrimination towards immigrants, unpredictable and mercurial circumstances, and confusion and lack of information. These perceptions influenced participants’ psycho-emotional health and health-related behaviors. Findings suggest the importance of integrating immigrants’ perceptions of the sociopolitical context into health promotion efforts. Furthermore, findings demonstrate the need for paradigm shifts in developing policy-related actions to integrate immigrants’ perspectives. We propose an integrated, multi-level framework to guide future research and practice regarding social determinants of immigrant health.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Further, ongoing debates regarding immigration policies and efforts to restrict entry of individuals from Latin America into the U.S. have created an exclusionary and stressful environment for Latinx immigrants (Blitzer 2018;Lee and Zhou 2019). Anti-immigrant rhetoric in the media and the current political discourse may also contribute to fear among Latinx immigrants (Hall 2019;Lopez et al. 2018). ...
... This finding illustrates that social support alone may not address the issue of social isolation among immigrants. Social isolation among immigrants may be related to other contextual factors, including the sociopolitical environment and attitudes towards immigrants in the U.S. (Lee and Zhou 2019). Hence, social work practitioners should not only focus on the social support provided by immigrants' friends, families, or significant others, but should also take notice of the macro-level social environment that may contribute to feelings of social isolation among immigrants. ...
Article
Full-text available
Globally, international migrants are at elevated risk for experiencing loneliness due to separation from social networks in their countries of origin. In the United States, the political rhetoric has been particularly exclusionary against Latinx immigrants, exposing them to discrimination and fear of deportation. Such environments may result in heightened levels of social isolation, which may contribute to greater risk of poor mental and physical health outcomes. Latinx immigrants, however, may access social support in their destination communities that buffers against these negative outcomes. This study sought to examine how social support and loneliness shape Latinx immigrants’ abilities to address the challenges related to migration. Multivariate linear regression analyses were conducted with survey data collected from Latinx immigrants in New York City (n = 306). Results revealed that Latinx immigrants with greater social support and less feelings of loneliness were more resilient. Specifically, findings suggest that social support may partially protect against the negative impact of isolation on Latinx immigrants’ capacity to thrive. Clinical social workers who work with immigrant groups may consider how migration during the life course affects immigrants’ social supports and experiences of loneliness. Social work interventions that integrate strategies to increase social support may provide opportunities to address social isolation and other obstacles associated with migration. Such approaches acknowledge loneliness not only as a psychological symptom, but also as a consequence of unfavorable social environments towards immigrant populations. Future research may develop and assess culturally relevant strategies to promote social support and reduce loneliness among marginalized immigrants.
... In general, Latinx families who had personal experience with immigration enforcement were more likely to endorse a lower quality of life for themselves and their children and endorse higher symptoms of depression and anxiety (Becerra et al., 2020). Anti-immigrant policies impact identity among Latinx individuals (Vargas et al., 2017) and emotional and physical health (Hardy et al., 2012;Lee & Zhou, 2020). A specific study expanded this area of research to explore reactions to immigration policies under the Trump administration (Wray-Lake et al., 2018). ...
Article
Full-text available
With over 400 harmful immigration policy changes in the past 4 years, Latinx adolescents and families nationwide are developing within a context of extreme anti‐immigrant sentiment (Dismantling and reconstructing the U.S. immigration system: A catalog of changes under the Trump presidency, Migration Policy Institute, 2020). This paper introduces the Multitiered Model of Oppression and Discrimination (MMOD), a conceptual model for understanding the impacts of multiple levels of discrimination on the well‐being and development of Latinx immigrant adolescents. Interpersonal discrimination (Hispanic Journal of Behavioral Sciences, 2010, 32, 259), community‐held stereotypes (Social Psychology of Education, 2001, 5, 201), institutional policies (Children and Youth Services Review, 2018, 87, 192), and structural practices (Journal of Criminal Justice, 2020, 66, 1) can negatively impact well‐being and development among these adolescents. Culturally sustaining interventions, civic engagement and mobilization, and policies targeting inequitable policies and practices will provide healing and an avenue for liberation.
... Discrimination during the settlement period of Latinx immigrant parents has contributed significantly to the development of depressive symptoms (Ornelas & Perreira 2011). Moreover, a 2020 study indicated that discrimination toward Latinx immigrants has been widespread in the US sociopolitical climate (Lee & Zhou 2020) and can manifest as prejudice, social attitudes, and restriction of equal opportunities (Ayón 2015, Brittian et al. 2013. Undocumented status also heightens discrimination experiences, as individuals face intolerant societal views or restrictive policies. ...
Article
Full-text available
Latinx immigrant families are greatly impacted by US policies and practices that limit immigrant families’ and children's rights. This article reviews the effects of such policies and the growing literature examining migration experiences. Latinx immigrant youth and parents may encounter multiple stressors across the stages of migration, including physical and structural violence, fear, poverty, and discrimination, which contribute to higher rates of mental health problems in this population. Despite significant trauma exposure, immigrants demonstrate incredible resilience within themselves, their families, and their communities and through movements and policies aimed at protecting their rights. Numerous culturally relevant universal, targeted, and intensive interventions were developed to magnify these protective factors to promote healing, advance immigration reform, and provide trauma-informed training and psychoeducation. Psychologistsplay a crucial role in implementing, evaluating, and advocating for accessible and collaborative approaches to care so that Latinx immigrant families have the resources to combat the harmful sequelae of immigration stress.
Chapter
Women comprise slightly less than half of the total population of immigrants across the world. As advocacy and fight for equal rights, opportunities, and identity for women continue, migration opens doors to global education for immigrant women to obtain personal autonomy, independence, empowerment, and a chance of earning higher wages than what they would have earned in their home countries. On the opposite end, women may also face oppression, gender inequality, and discrimination based on their ethnicity, class, and race through migration. This chapter highlights the rewards and drawbacks experienced by migrant women and feminist theory approaches to global migration. Examining the experience of migrant women using feminist theory underpinnings could potentially lead to deeper understanding and recommendations for international policies as well as evidence-based, culturally competent interventions to assist women migrants.
Article
This paper explores the strategies that staff at two refugee-serving organizations found helpful in mitigating their increased distress from negative political rhetoric aimed at their clients. Results point to the importance of organizational acknowledgment of the distress. Additionally, staff perceived that intentionally focused organizational interventions can mitigate the emotional impacts of negative rhetoric. Finally, strategies employees used to lessen their distress and regain a sense of efficacy included recommitment to the mission, advocacy for refugees among family and friends, strong reliance on religious faith in coping, and an avoidance of the rhetoric by decreasing engagement with news and social media.
Article
Full-text available
In the context of the United States of America (U.S.), COVID-19 has influenced migrant experiences in a variety of ways, including the government's use of public health orders to prevent migration into the country and the risk of immigrants contracting COVID-19 while in detention centers. However, this paper focuses on barriers that immigrants of diverse statuses already living in the U.S.—along with their families—may face in accessing health services during the pandemic, as well as implications of these barriers for COVID-19 prevention and response efforts . We report findings from a scoping review about immigration status as a social determinant of health and discuss ways that immigration status can impede access to health care across levels of the social ecology . We then explore how recent changes to federal immigration policies and current COVID-19 federal relief efforts may serve to create additional barriers to health care for immigrants and their families. Improving health care access for immigrant populations in the U.S. will require interventions at all levels of the social ecology and across vari ous social determinants of health, both in response to COVID-19 and to strengthen health systems more broadly.
Chapter
Women comprise slightly less than half of the total population of immigrants across the world. As advocacy and fight for equal rights, opportunities, and identity for women continue, migration opens doors to global education for immigrant women to obtain personal autonomy, independence, empowerment, and a chance of earning higher wages than what they would have earned in their home countries. On the opposite end, women may also face oppression, gender inequality, and discrimination based on their ethnicity, class, and race through migration. This chapter highlights the rewards and drawbacks experienced by migrant women and feminist theory approaches to global migration. Examining the experience of migrant women using feminist theory underpinnings could potentially lead to deeper understanding and recommendations for international policies as well as evidence-based, culturally competent interventions to assist women migrants.
Article
Full-text available
Purpose of Review This paper aims to review the literature regarding the impact of Donald Trump’s candidacy and presidency on the health of immigrants in America. Recent Findings The increase in detentions of alleged undocumented immigrants under the Trump presidency, especially his administration’s attempts to detain children apart from their families, have placed thousands into conditions that can have long-lasting physical and mental health effects. Similarly, the Trump administration’s efforts to increase deportations and restrict legal immigration has lead to immigrants’ seeking fewer health-care resources for fear of jeopardizing their or their loved ones’ chances of remaining in this country. Summary The rhetoric used and policies pursued by Donald Trump have had a measurable adverse impact on the health of documented and undocumented immigrants in America.
Article
Full-text available
The successful integration of immigrants into a host country’s society, economy, and polity has become a major issue for policymakers in recent decades. Scientific progress in the study of immigrant integration has been hampered by the lack of a common measure of integration, which would allow for the accumulation of knowledge through comparison across studies, countries, and time. To address this fundamental problem, we propose the Immigration Policy Lab (IPL) Integration Index as a pragmatic and multidimensional measure of immigrant integration. The measure, both in the 12-item short form (IPL-12) and the 24-item long form (IPL-24), captures six dimensions of integration: psychological, economic, political, social, linguistic, and navigational. The measure can be used across countries, over time, and across different immigrant groups and can be administered through short questionnaires available in different modes. We report on four surveys we conducted to evaluate the empirical performance of our measure. The tests reveal that the measure distinguishes among immigrant groups with different expected levels of integration and also correlates with well-established predictors of integration.
Article
Full-text available
The relationship between Holyrood and Westminster is an evolving one where there is some evidence of policy divergence. Underpinning policy approaches are different views of social citizenship, with the Holyrood approach maintaining elements of the post-1945 welfare settlement. The place of refugees and asylum seekers within these differing approaches is currently underexplored. This article looks at the Scottish and UK Governments’ views of social rights and how they apply to asylum seekers and refugees. It suggests that despite refugee ‘policy’ being at least partly reserved, the Scottish Government has been able to take a different approach from that of Westminster, an approach underpinned by these differing welfare outlooks.
Article
Full-text available
This article seeks to assess the extent to which international retirement migrants (IRMs) living in Spain make use of public elder-care services, as well as how public officials deal with their demands. The data stems from qualitative interviews with 19 social workers in ten communities characterised by a sizable population of retirement migrants. We found that substantial numbers of retirement migrants remain in Spain well after dependency sets in. This necessitates the development of complex strategies to obtain care by means of social networks, voluntary associations, and private care providers. A certain reluctance to engage with Spanish social services may explain the fact that these services are accessed only as a last resort when all other options have failed. However, the entire process of evaluating the needs of, and granting public care services to, retirement migrants is plagued by difficulties. Social workers cite the lack of a common language as a significant obstacle, together with insufficient information on claimants’ health, economic and family situations (many IRMs are not registered as residents in Spain). The familistic rules governing Spanish social services and the recent reductions in public budgets due to the economic crisis constitute additional barriers to the adequate protection of IRMs.
Article
Full-text available
Aim: The aim of this study is to analyse previous explanations of social inequality in health and argue for a closer integration of sociological theory into future empirical research. Methods: We examine cultural-behavioural, materialist, psychosocial and life-course approaches, in addition to fundamental cause theory. Giddens' structuration theory and a neo-materialist approach, inspired by Bruno Latour, Gilles Deleuze and Felix Guattari, are proposed as ways of rethinking the causal relationship between socio-economic status and health. Conclusions: Much of the empirical research on health inequalities has tended to rely on explanations with a static and unidirectional view of the association between socio-economic status and health, assuming a unidirectional causal relationship between largely static categories. We argue for the use of sociological theory to develop more dynamic models that enhance the understanding of the complex pathways and mechanisms linking social structures to health.
Article
Full-text available
The population of refugees in the UK is expanding and will expand further given the UK Government's response to the European refugee crisis. This paper breaks new ground by undertaking a gender analysis of integration outcomes across a range of areas, namely social networks, language proficiency, health, education, employment and housing, that are highly relevant for social policy. Using the UK's only longitudinal survey on refugees, we conduct secondary data analysis to examine the factors associated with integration outcomes. We find significant gender differences in language, self-reported health, ability to budget for household expenses and access to formal social networks and quality housing, with women generally faring worse than men and some inequalities enduring or intensifying over time. We call for the recording of refugee outcomes in institutional monitoring data to enable inequalities to be identified and addressed. The findings also enable the identification of social policy areas in which a gender sensitive approach might be necessary.
Article
Full-text available
This article contributes to an understanding of how conditionality applies across social security and immigration policies in restricting the access to social benefits of national citizens, EU and non-EU citizens. Specifically, the article builds on Clasen and Clegg’s (2007) framework of conditionality in the context of welfare state reform by extending that conceptual framework to include migration. The framework is applied to examine how different levels of conditionality have been implemented in UK policy reforms to restrict access to rights of residence and to social benefits. It is argued that a conditionality approach moves beyond a binary of citizens and migrants in social policy analysis, contributing to an understanding of the dynamics and interactions of work-related conditions in restricting access to social benefits, with implications for inequalities that cut across national, EU and non-EU citizens in terms of the relationship of particular groups to the market.
Chapter
Full-text available
Although Arizona is perhaps the most visible state to initiate draconian policies to apprehend and deport undocumented immigrants and to deter others from coming into the state, it is not the only one. In spite of costly litigation against SB 1070, economic boycotts to the state, and numerous protests, other states have followed the actions of Arizona legislators. Several states have proposed and passed Arizona-style bills since SB 1070 was signed into law in April 2010 in Arizona.
Article
Full-text available
Background: The evidence base for the impact of social determinants of health has been strengthened considerably in the last decade. Increasingly, the public health field is using this as a foundation for arguments and actions to change government policies. The Health in All Policies (HiAP) approach, alongside recommendations from the 2010 Marmot Review into health inequalities in the UK (which we refer to as the 'Fairness Agenda'), go beyond advocating for the redesign of individual policies, to shaping the government structures and processes that facilitate the implementation of these policies. In doing so, public health is drawing on recent trends in public policy towards 'joined up government', where greater integration is sought between government departments, agencies and actors outside of government. Methods: In this paper we provide a meta-synthesis of the empirical public policy research into joined up government, drawing out characteristics associated with successful joined up initiatives.We use this thematic synthesis as a basis for comparing and contrasting emerging public health interventions concerned with joined-up action across government. Results: We find that HiAP and the Fairness Agenda exhibit some of the characteristics associated with successful joined up initiatives, however they also utilise 'change instruments' that have been found to be ineffective. Moreover, we find that - like many joined up initiatives - there is room for improvement in the alignment between the goals of the interventions and their design. Conclusion: Drawing on public policy studies, we recommend a number of strategies to increase the efficacy of current interventions. More broadly, we argue that up-stream interventions need to be 'fit-for-purpose', and cannot be easily replicated from one context to the next.
Article
Full-text available
Australia's post-war programme of mass immigration has been accompanied by growing ethnic and racial diversity. This process of diversification accelerated markedly from the 1970s onwards after the abandonment of the White Australia Policy in the 1960s. Despite this diversification, Australia has been able to sustain itself as a peaceful liberal democracy. It is the contention of this article that Australia's policies of multiculturalism have played an important role in contributing to this state of relative peacefulness. This article seeks to assemble some evidence from the Australian experience to the notion that the peacefulness of Australian society may, in some measure, be understood as a product of the contribution of its policies of multiculturalism to engendering and reinforcing those very virtues which liberal democracies require in order to sustain themselves over time.
Article
Full-text available
The authors discuss the components of consensual qualitative research (CQR) using open-ended questions to gather data, using words to describe phenomena, studying a few cases intensively, recognizing the importance of context, using an inductive analytic process, using a team and making decisions by consensus, using auditors, and verifying results by systematically checking against the raw data. The three steps for conducting CQR are developing and coding domains, constructing core ideas, and developing categories to describe consistencies across cases (cross analysis). Criteria for evaluating CQR are trustworthiness of the method, coherence of the results, representativeness of the results to the sample, testimonial validity, applicability of the results, and replicability across samples. Finally, the authors discuss implications for research, practice, and training.
Article
Full-text available
The sociological study of the mental health of racial-ethnic minorities addresses issues of core theoretical and empirical concern to the discipline. This review summarizes current knowledge about minority mental health and identifies conceptual and methodological problems that continue to confront research in this field. First, a critique is presented of epidemiological approaches to the definition and measurement of mental health in general, and minority mental health in particular, including an overview of the most frequently used symptom scales and diagnostic protocols. Next, the most important research studies conducted over the past two decades are summarized and discussed, and comparisons of prevalence rates and correlates of depressive symptomatology among Black, Hispanic, Asian, and American Indian ethnic groups are provided. Following the overview of descriptive epidemiological findings, some key analytic issues surrounding the study of stress, adaptation and minority mental health are considered. Finally, we propose various recommendations for future research.
Article
Full-text available
The Obama administration faces daunting challenges to reform health care. The authors, commissioners on the World Health Organization's Commission on the Social Determinants of Health, believe that strategies to improve health by affecting the social determinants may gain bipartisan support. These determinants-including the effects of poverty, education, the treatment of women, employment opportunities, and limited access to medical care for some-are as important in promoting health, if not more so, than the direct medical determinants of health. Focusing on these determinants makes more sense than waiting until people become sick and seek care, and it often costs much less.
Article
Full-text available
A hypothesized need to form and maintain strong, stable interpersonal relationships is evaluated in light of the empirical literature. The need is for frequent, nonaversive interactions within an ongoing relational bond. Consistent with the belongingness hypothesis, people form social attachments readily under most conditions and resist the dissolution of existing bonds. Belongingness appears to have multiple and strong effects on emotional patterns and on cognitive processes. Lack of attachments is linked to a variety of ill effects on health, adjustment, and well-being. Other evidence, such as that concerning satiation, substitution, and behavioral consequences, is likewise consistent with the hypothesized motivation. Several seeming counterexamples turned out not to disconfirm the hypothesis. Existing evidence supports the hypothesis that the need to belong is a powerful, fundamental, and extremely pervasive motivation.
Article
Full-text available
In this article, the authors present an empirical example of triangulation in qualitative health research. The Canadian Heart Health Dissemination Project (CHHDP) involves a national examination of capacity building and dissemination undertaken within a series of provincial dissemination projects. The Project's focus is on the context, processes, and impacts of health promotion capacity building and dissemination. The authors collected qualitative data within a parallel-case study design using key informant interviews as well as document analysis. Given the range of qualitative data sets used, it is essential to triangulate the data to address completeness, convergence, and dissonance of key themes. Although one finds no shortage of admonitions in the literature that it must be done, there is little guidance with respect to operationalizing a triangulation process. Consequently, the authors are feeling their way through the process, using this opportunity to develop, implement, and reflect on a triangulation protocol.
Article
Full-text available
This article reviews the current status of theory and research concerning the social determinants of health. It provides an overview of current conceptualizations and evidence on the impact of various social determinants of health. The contributions of different disciplines--epidemiology, sociology, political economy, and the human rights perspective--to the field are acknowledged, but profound gaps persist in our understanding of the forces that drive the quality of various social determinants of health and why research is too infrequently translated into action. Many of these gaps in knowledge concern the political, economic, and social forces that make implementation of public policy agendas focused on strengthening the social determinants of health problematic. The author identifies the areas of inquiry needed to help translate knowledge into action.
Article
Full-text available
Risk perceptions are central to many health behavior theories. However, the relationship between risk perceptions and behavior, muddied by instances of inappropriate assessment and analysis, often looks weak. A meta-analysis of eligible studies assessing the bivariate association between adult vaccination and perceived likelihood, susceptibility, or severity was conducted. Thirty-four studies met inclusion criteria (N = 15,988). Risk likelihood (pooled r = .26), susceptibility (pooled r = .24), and severity (pooled r = .16) significantly predicted vaccination behavior. The risk perception-behavior relationship was larger for studies that were prospective, had higher quality risk measures, or had unskewed risk or behavior measures. The consistent relationships between risk perceptions and behavior, larger than suggested by prior meta-analyses, suggest that risk perceptions are rightly placed as core concepts in theories of health behavior.
Article
The definition of health is not just a theoretical issue, because it has many implications for practice, policy, and health services. The current definition of health, formulated by the WHO, is no longer adequate for dealing with the new challenges in health care systems. Despite many attempts to replace it, no alternative definition has reached a wide level of consensus. Assuming an epistemological perspective, the need for a unique definition has to be rejected in favor of a plural approach in which cannot exist the best definition of health but many different definitions, more or less useful depending on the scope of application. Nevertheless, it should be noted that not all potential definitions of health are fit to pursue clinical scientific goals. Based on recent scientific debate, one can maintain that each definition of health should have at least 9 features to work well within the clinical scientific field. Moving from this perspective, a new definition has been developed for pursuing health, especially in the fields of chronic patients and older people.
Article
Volunteering is an under-studied yet potentially beneficial avenue for immigrant integration. Whereas past research has provided important insights into the benefits of immigrant volunteering, it has been frequently based on convenience samples. This paper contributes to the literature on immigrant volunteering on two levels. First, we test less explored questions: the differences between immigrant and native-born volunteers on several volunteer indicators, and the contextual factors (cultural, social, and organisational) associated with immigrants’ proclivity to volunteer. Second, we rely on a representative sample of the German population, and use propensity score matching to strengthen the robustness of our analysis. Findings suggest that, although native-born individuals display higher rates of volunteering than immigrants, they do not significantly differ on most indicators once immigrants become volunteers. Furthermore, time since migration, social networks and organisational membership are significant drivers of immigrant volunteering. Our findings are a signal for policymakers because social policies could better address contextual and organisational barriers.
Article
Anti-immigrant rhetoric and political actions gained prominence and public support before, during, and after the 2016 presidential election. This anti-immigrant political environment threatens to increase health disparities among undocumented persons, immigrant groups, and people of color. I discuss the mechanisms by which anti-immigrant stigma exacerbates racial/ethnic health disparities through increasing multilevel discrimination and stress, deportation and detention, and policies that limit health resources. I argue that the anti-immigrant sociopolitical context is a social determinant of health that affects mostly communities of color, both immigrants and nonimmigrants. Public health has a moral obligation to consider how immigration policy is health policy and to be prepared to respond to worsening health disparities as a result of anti-immigrant racism.
Article
Structural racism has been linked to racial health inequalities and may operate through an unequal labor market that results in inequalities in psychosocial workplace environments (PWE). Experiences of the PWE may be a critical but understudied source of racial health disparities as most adults spend a large portion of their lives in the workplace, and work-related stress affects health outcomes. Further, it is not clear if the objective characteristics of the workplace are important for health inequalities or if these inequalities are driven by the perception of the workplace. Using data from the 2008 to 2012 waves of the Health and Retirement Study (HRS), a probability-based sample of US adults 50 years of age and older and the Department of Labor's Occupational Information Network (O*NET), we examine the role of both standardized, objective (O*NET) and survey-based, subjective (as in HRS) measures of PWEs on health and Black-White health inequalities. We find that Blacks experience more stressful PWEs and have poorer health as measured by self-rated health, episodic memory function, and mean arterial pressure. Mediation analyses suggest that these objective O*NET ratings, but not the subjective perceptions, partially explain the relationship between race and health. We discuss these results within the extant literature on workplace and health and health inequalities. Furthermore, we discuss the use of standardized objective measures of the PWE to capture racial inequalities in workplace environment.
Article
There has been a great deal of state-level legislative activity focused on immigration and immigrants over the past decade in the United States. Some policies aim to improve access to education, transportation, benefits, and additional services while others constrain such access. From a social determinants of health perspective, social and economic policies are intrinsically health policies, but research on the relationship between state-level immigration-related policies and Latino health remains scarce. This paper summarizes the existing evidence about the range of state-level immigration policies that affect Latino health, indicates conceptually plausible but under-explored relationships between policy domains and Latino health, traces the mechanisms through which immigration policies might shape Latino health, and points to key areas for future research. We examined peer-reviewed publications from 1986-2016 and assessed 838 based on inclusion criteria; 40 were included for final review. These 40 articles identified four pathways through which state-level immigration policies may influence Latino health: through stress related to structural racism; by affecting access to beneficial social institutions, particularly education; by affecting access to healthcare and related services; and through constraining access to material conditions such as food, wages, working conditions, and housing. Our review demonstrates that the field of immigration policy and health is currently dominated by a “one-policy, one-level, one-outcome” approach. We argue that pursuing multi-sectoral, multi-level, and multi-outcome research will strengthen and advance the existing evidence base on immigration policy and Latino health.
Article
Rationale: Despite abundant state-level policy activity in the U.S. related to immigration, no research has examined the mental health impact of the overall policy climate for Latinos, taking into account both inclusionary and exclusionary legislation. Objective: To examine associations between the state-level policy climate related to immigration and mental health outcomes among Latinos. Methods: We created a multi-sectoral policy climate index that included 14 policies in four domains (immigration, race/ethnicity, language, and agricultural worker protections). We then examined the relation of this policy climate index to two mental health outcomes (days of poor mental health and psychological distress) among Latinos from 31 states in the 2012 Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey of non-institutionalized individuals aged 18 years or older. Results: Individuals in states with a more exclusionary immigration policy climate had higher rates of poor mental health days than participants in states with a less exclusionary policy climate (RR: 1.05, 95% CI: 1.00, 1.10). The association between state policies and the rate of poor mental health days was significantly higher among Latinos versus non-Latinos (RR for interaction term: 1.03, 95% CI: 1.01, 1.06). Furthermore, Latinos in states with a more exclusionary policy climate had 1.14 (95% CI: 1.04, 1.25) times the rate of poor mental health days than Latinos in states with a less exclusionary policy climate. Results were robust to individual- and state-level confounders. Sensitivity analyses indicated that results were specific to immigration policies, and not indicators of state political climate or of residential segregation. No relationship was observed between the immigration policy index and psychological distress. Conclusion: These results suggest that restrictive immigration policies may be detrimental to the mental health of Latinos in the United States.
Article
Evidence on social determinants of health and health equity (SDH/HE) is abundant but often not translated into effective policy action by governments. Governments’ health policies have continued to privilege medical care and individualised behaviour-change strategies. In the light of these limitations, the 2008 Commission on the Social Determinants of Health called on health agencies to adopt a stewardship role; to take action themselves and engage other government sectors in addressing SDH/HE. This article reports on research using analysis of health policy documents – published by nine Australian national or regional governments – to examine the extent to which the Australian health sector has taken up such a role. We found policies across all jurisdictions commonly recognised evidence on SDH/HE and expressed goals to improve health equity. However, these goals were predominantly operationalised in health care and other individualised strategies. Relatively few strategies addressed SDH/HE outside of access to health care, and often they were limited in scope. National policies on Aboriginal health did most to systemically address SDH/HE. We used Kingdon's (2011) multiple streams theory to examine how problems, policies and politics combine to enable, partially allow, or prevent action on SDH/HE in Australian health policy.
Article
It is now well documented that many of the key drivers of health reside in our everyday living conditions. In the last two decades, public health has urged political action on these critical social determinants of health (SDH). As noted by the World Health Organisation, encouraging action in this area is challenging. Recent research has argued that public health researchers need to gain a deeper understanding of the complex and changing rationalities of policymaking. This, it seems, is the crucial next step for social determinants of health research. In this paper, we turn our attention to the practitioners of 'the art of government', in order to gain insight into how to secure upstream change for the SDH. Through interviews with policy actors (including politicians, senior government advisors, senior public servants and experienced policy lobbyists) the research sought to understand the nature of government and policymaking, as it pertains to action on the SDH. Through exploring the policy process, we examine how SDH discourses, evidence and strategies align with existing policy processes in the Australian context. Participants indicated that approaches to securing change that are based on linear conceptualisations of the policy process (as often found in public health) may be seen as 'out of touch' with the messy reality of policymaking. Rather, a more dialogic approach that embraces philosophical and moral reasoning (alongside evidence) may be more effective. Based on our findings, we recommend that SDH advocates develop a deeper awareness of the political and policy structures and the discursive conventions they seek to influence within specific settings. Copyright © 2015 Elsevier Ltd. All rights reserved.
Article
Although immigration and immigrant populations have become increasingly important foci in public health research and practice, a social determinants of health approach has seldom been applied in this area. Global patterns of morbidity and mortality follow inequities rooted in societal, political, and economic conditions produced and reproduced by social structures, policies, and institutions. The lack of dialogue between these two profoundly related phenomena-social determinants of health and immigration-has resulted in missed opportunities for public health research, practice, and policy work. In this article, we discuss primary frameworks used in recent public health literature on the health of immigrant populations, note gaps in this literature, and argue for a broader examination of immigration as both socially determined and a social determinant of health. We discuss priorities for future research and policy to understand more fully and respond appropriately to the health of the populations affected by this global phenomenon. Expected final online publication date for the Annual Review of Public Health Volume 36 is March 18, 2015. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
Article
Latino immigrants exhibit health declines with increasing duration in the United States, which some attribute to a loss in social status after migration or downward social mobility. Yet, research into the distribution of perceived social mobility and patterned associations to Latino health is sparse, despite extensive research to show that economic and social advancement is a key driver of voluntary migration. We investigated Latino immigrant sub-ethnic group variation in the distribution of perceived social mobility, defined as the difference between respondents' perceived social status of origin had they remained in their country of origin and their current social status in the U.S. We also examined the association between perceived social mobility and past-year major depressive episode (MDE) and self-rated fair/poor physical health, and whether Latino sub-ethnicity moderated these associations. We computed weighted logistic regression analyses using the Latino immigrant subsample (N=1561) of the National Latino and Asian American Study. Puerto Rican migrants were more likely to perceive downward social mobility relative to Mexican and Cuban immigrants who were more likely to perceive upward social mobility. Perceived downward social mobility was associated with increased odds of fair/poor physical health and MDE. Latino sub-ethnicity was a statistically significant moderator, such that perceived downward social mobility was associated with higher odds of MDE only among Puerto Rican and Other Latino immigrants. In contrast, perceived upward social mobility was not associated with self-rated fair/poor physical health. Our findings suggest that perceived downward social mobility might be an independent correlate of health among Latino immigrants, and might help explain Latino sub-ethnic group differences in mental health status. Future studies on Latino immigrant health should use prospective designs to examine the physiological and psychological costs associated with perceived changes in social status with integration into the U.S. mainland.
Article
Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health. (Am J Public Health. Published online ahead of print March 14, 2013: e1-e9. doi:10.2105/AJPH.2012.301069).
Article
Australia's post-war programme of mass immigration has been accompanied by growing ethnic and racial diversity. This process of diversification accelerated markedly from the 1970s onwards after the abandonment of the White Australia Policy in the 1960s. Despite this diversification, Australia has been able to sustain itself as a peaceful liberal democracy. It is the contention of this article that Australia's policies of multiculturalism have played an important role in contributing to this state of relative peacefulness. This article seeks to assemble some evidence from the Australian experience to ‘test’ the notion that the peacefulness of Australian society may, in some measure, be understood as a product of the contribution of its policies of multiculturalism to engendering and reinforcing those very virtues which liberal democracies require in order to sustain themselves over time.
Article
Increasing evidence suggests that public health and health-promotion interventions that are based on social and behavioral science theories are more effective than those lacking a theoretical base. This article provides an overview of the state of the science of theory use for designing and conducting health-promotion interventions. Influential contemporary perspectives stress the multiple determinants and multiple levels of determinants of health and health behavior. We describe key types of theory and selected often-used theories and their key concepts, including the health belief model, the transtheoretical model, social cognitive theory, and the ecological model. This summary is followed by a review of the evidence about patterns and effects of theory use in health behavior intervention research. Examples of applied theories in three large public health programs illustrate the feasibility, utility, and challenges of using theory-based interventions. This review concludes by identifying cross-cutting themes and important future directions for bridging the divides between theory, practice, and research.
The newest New Yorkers: characteristics of the city's foreignborn population City of
  • A P Lobo
  • J J Salvo
Lobo, A.P. and Salvo, J.J. (), The newest New Yorkers: characteristics of the city's foreignborn population City of New York. New York: Department of City Planning, Office of Immigrant Affairs.
), Grounded Theory, The Blackwell Encyclopedia of Sociology
  • K Charmaz
  • L L Belgrave
Charmaz, K. and Belgrave, L.L. (), Grounded Theory, The Blackwell Encyclopedia of Sociology: John Wiley & Sons, Ltd.