Journal of Immigrant and Minority Health最新文献

Diverse social ties are critical facilitators of well-being among older adults. Social ties might be especially important for aging immigrants who face multiple social and economic vulnerabilities over the life course. We investigated social ties (e.g., partners, children, other family, and friends) by immigrant status among older adults in the United States (U.S.). Data come from the 2018 Health and Retirement Study (N = 4,006), a national sample of older adults in the U.S. We used multivariable logistic regression to compare social ties (e.g., partners, children, other family, and friends) by immigrant status. We further explored interactions with sex and race/ethnicity. Older immigrants are more likely to report that they can rely a lot on their partners (aOR = 1.84, 95% CI 1.27, 2.68) but less likely to rely on friends (aOR = 0.72, 95% CI, 0.55, 0.94) compared to non-immigrants. Older immigrants are also less likely to meet frequently with friends (aOR = 0.66, 95% CI, 0.51, 0.86) and with other family (aOR = 0.71, 95%, CI, 0.55, 0.91) compared to non-immigrants. Lastly, older immigrant men are significantly less likely to meet with friends compared to non-immigrant men (aOR = 0.48, 95% CI, 0.32, 0.73). As the older population in the U.S. continues to diversify and immigrant older adults navigate their support options, older immigrants-especially men-may be at risk for less variation in their social support options, particularly from extended family members and friends.

As a safety net hospital, Boston Medical Center (BMC) serves a global community of patients and is welcoming new refugee and immigrant patients at an unprecedented rate. Many of these patients are cared for by Family Medicine residents and faculty in both inpatient and outpatient settings. Currently, the care delivered by Family Medicine residents lacks uniformity due to lack of familiarity with the U.S. Centers for Disease Prevention and Control (CDC) guidelines for refugee health, differing levels of faculty preceptor experience, and variable in-house resources for primary care across five residency clinic sites. To address these disparities, a team of Family Medicine residents and faculty designed a multidisciplinary global health educational series with a focus on strengthening resident competencies in refugee and immigrant health care. Refugee and immigrant health is discussed in didactic workshops and residents apply a refugee and immigrant health care map that has been developed for use in their clinics. The primary outcome is self-reported changes in clinical practices while caring for refugee and immigrant patients who are establishing or re-establishing care in the United States. Our goal is to continue improving resident education in order to provide the most equitable care for populations at an increased risk of disparate access to care.

A high prevalence of dental caries is a significant health problem, especially in the pediatric population. Low-income minority groups, including the refugee and immigrant populations, are at higher risk of compromised oral health. It has been suggested that migrant parents do not have enough understanding of oral health, risk factors associated with dental caries, or the progress of dental decay. This systematic review aims to study quantitative literature on oral health interventions, health promotion programs, or behaviour change interventions targeting the parents/ caregivers of culturally and linguistically diverse (CALD) children. A systematic search of electronic databases, including MEDLINE, EMBASE, PUBMED, CINAHL, SCOPUS, WEB OF SCIENCE, COCHRANE, and PROQUEST, was conducted until August 2023. Randomised (RCT) or non-randomised controlled trials (NRCTs) were included. Two reviewers independently assessed the quality of the included studies using the Cochrane Risk of Bias (RoB) 2.0 and ROBINS-I tools. Meta-analysis was performed as appropriate. The initial search from the databases retrieved 2073 articles. After the removal of duplicates, 1683 articles remained. Finally, 69 articles were reviewed in full text, and 15 articles were considered eligible in this review. The RoB assessment for RCTs rated three as low-risk and three as high-risk. The serious RoB in these NRCTs mostly pertained to measurement bias based on self-reporting oral health behaviours. The meta-analysis pooling of results (for RCTs and NRCTs) favoured interventions for CALD parents' oral health knowledge [0.73 (95% CI, 0.08 to 1.38) for RCTs, 1.73 (95% CI; 1.45 to 2.02) for NRCTs] and attitudes [0.86 (95% CI, 0.31 to 1.42)]. Relatively high heterogeneity was observed. Oral health educational interventions can be effective in improving the oral health literacy of CALD parents' oral health knowledge and attitudes, especially when facilitated by lay health advisors. However, the low quality of evidence due to high heterogeneity and high RoB further highlighted the need for well-designed RCTs targeting CALD parents.

Persons deemed a danger to themselves, others, or gravely disabled may receive involuntary psychiatric commitment if family, other residents, law enforcement, or clinicians initiate this process. On September 30, 2005, a Danish newspaper published cartoons depicting the Prophet Muhammad. This publication led to the worst foreign policy crisis in Denmark since World War II. Whereas protests within Denmark against the cartoon remained peaceful, this cartoon controversy-including the attacks on four Danish embassies outside of Denmark-may have reduced societal tolerance for threatening or deviant behavior among non-Western immigrants. We applied Box-Jenkins interrupted time-series methods to test whether this cartoon controversy coincided with greater than expected counts of new involuntary psychiatric commitments among non-Western immigrants. The analytic period spans 48 quarters from January 1995 to December 2006. Findings support the hypothesis in that new involuntary psychiatric commitments rose 43% during the controversy (p <.01). Changes in help-seeking overall for mental health services do not appear to account for this rise in new involuntary commitments. Population-wide controversies may lower societal tolerance for behavior deemed deviant-and in this case, specifically among non-Western immigrants.

As a vulnerable population, immigrants can be disproportionately affected by disasters. Because of their legal and migratory status, immigrants may have different challenges, needs, and possibilities when facing a disaster. Yet, within disaster studies, immigrants are rarely studied alone. Instead, they are often considered part of the large heterogeneous group of racial and ethnic minorities in the United States. This racial classification points to a gap in the literature and in our understanding of how disadvantaged groups may cope with disasters. To address this gap, the current study hypothesizes that: (1) Immigrants have unique experiences and disaster impacts compared to the broader aggregated category of racial and ethnic minorities in the U.S. and (2) There are variations in disaster experiences and impacts across different types of immigrant subgroups beyond refugees. To explore these hypotheses, a study of the literature across six databases from 2018 to 2023was conducted. The review identified a total of 17 articles discussing immigrant experiences during disasters. Major cross-cutting themes on immigrant disaster experiences include fear of deportation, restrictive immigration status, excessive economic burden and labor exploitation, employment rigidity, adverse health outcomes, limited informational resources and limited social capital, selective disaster relief measures, and infrastructural challenges as regards to housing and transportation. Many of the themes identified are unique to immigrants, such as the fear of deportation, restrictive immigration status and visa policies, and selective disaster relief measures.

In the United States, populations of Latino individuals tend to have better mortality outcomes than socioeconomically similar racial and ethnic comparators; this has been termed the "Latino Paradox". However, advantages from the Latino paradox seem to fade and may be susceptible to other factors (like the COVID-19 pandemic). Quality primary care may improve mortality, but the effect of the intersection of all of these factors in Latino patients is uncertain. There is burgeoning evidence that Latino patients may have more robust utilization of high value primary care services, especially when accessible in a community-oriented fashion. This utilization may become less robust, especially in services that require a more integrated delivery system, as individuals and generations spend more time in the United States. Primary care research may provide additional insights into the underpinnings of the Latino paradox and may complement the public health foundation that has undergirded work on the paradox in the last few decades. Investments in primary care infrastructure and research may be beneficial to the health of Latinos in the United States, and incorporating the needs of this diverse population into primary care system design at scale may pay large dividends for our societal health.

In this paper, we describe a research protocol for surveying and interviewing Latinx immigrants recently arrived at the US southern border, and we raise important and unique issues that need to be considered with this population. The main objective is to share experiences, challenges, opportunities, and essential considerations (which we call lessons learned) that researchers should take into account when working with this vulnerable study population. The six lessons learned focus on: (1) fostering relationships with community partners; (2) participant consent and compensation; (3) linguistic and cultural fluency of researchers; (4) adapting data collection procedures to the environment and conditions; (5) establishing trust with participants and being trustworthy; and (6) addressing the ethical considerations of research with immigrant populations and the positionality of researchers. This paper provides a unique perspective of working with a vulnerable population that is in transit, often coming from circumstances of danger and risk to their lives, who are now headed towards new and uncertain experiences that may include disadvantage, exclusion or other risks. The lessons learned from the field inform best practices for working with recently arrived Latinx immigrants, with implications for public health research that may extend to other immigrant populations.

Asylum medicine clinics that train clinicians to conduct forensic medical and mental health evaluations (FME) have proliferated in the United States, but there is still significant unmet need in training. We created a 12-week curriculum to develop the core skills needed to conduct effective, trauma-informed FME. Our course used a "flipped classroom" model; participants reviewed didactics in advance from a national, peer-reviewed training program, the Asylum Medicine Training Initiative, and used in-class time for case-based practice as experiential learning. Participants completed feedback surveys after each session in addition to pre-and post-course assessments. Sixteen clinicians with diverse geographic, professional, and demographic backgrounds participated in the course from January-March 2023. The three key themes that emerged from qualitative feedback were high participant satisfaction with the course model; participant desire for additional opportunities for practice; and participant desire for community-building. Post-course surveys showed that most participants felt only "somewhat comfortable" with the core skills emphasized in the course. Taken together, these findings suggest that curricula in asylum medicine should focus on experiential learning, skills practice, and building longitudinal mentorship. This curriculum is an innovative educational model that differs from the traditional didactic training that has been the mainstay in asylum medicine education. The curriculum is replicable and can be tailored to local environments or broad virtual communities.

Immigration policy, particularly regarding migrants crossing the US-Mexico border, has been a highly debated topic for years. There is a continued debate on how to maintain national security while protecting the health and dignity of migrants. In this commentary, we argue that the Biden Administration's "Proclamation on Securing the Border" issued on June 4, 2024, alongside the Department of Homeland Security (DHS) and Department of Justice's (DOJ) Interim Final Rule, poses a significant threat to the health of migrants seeking asylum at the US-Mexico border by forcing more migrants to wait in encampments in border towns. Specifically, migrants are more likely to face increased exposure to disease, mental health effects, and violence as a result of this proclamation. We call for structural policy reform and propose several alternative policies that can be enacted at the regional and national levels to help maintain the health and dignity of migrants while still prioritizing border security.

Research suggests that stress due to racism may underlie the disproportionately high rates of adverse pregnancy outcomes experienced by Black women in the US. Study objectives: (1) Identify forms of systemic racism affecting pregnancy outcomes and (2) increase understanding about the role of racism in adverse pregnancy outcomes for Black women. A systematic review was conducted to explore the relationship between systemic racism and pregnancy outcomes for Black women. Searches were performed using EBSCO Academic Search Complete, CINAHL Complete, and Consumer Health Complete first between January to April 2021 and subsequently between November 2023 to January 2024. Included studies were observational, written in English, had full-text availability, examined at least one form of systemic racism and pregnancy outcome, and reported results for Black women. A meta-analysis was performed using a random effects model, summary effect estimates were pooled by pregnancy outcome. The I² statistic was used to measure heterogeneity between studies. A total of 32 studies were included in the review. Significant pooled effects of exposure to systemic racism were observed for preterm birth 0.30 (95% CI 0.12-0.48), small for gestational age 0.31 (95% CI 0.05-0.58), and low birth weight 0.24 (95% CI 0.11-0.37). Among studies that compared results by race, exposure to systemic racism had a significant and rather large effect on preterm birth for Black women (d_s = 0.62; 95% CI 0.06-0.41). Exposure to systemic racism has a significant effect on preterm birth, small for gestational age, and low birth weight for Black women. Having knowledge of how racism contributes to stress and poor pregnancy outcomes can help health professionals improve delivery of quality care to Black women. Future research should continue identifying forms of racism positively related to adverse pregnancy outcomes.