Journal of Immigrant and Minority Health最新文献

Unhealthy alcohol use is a significant public health concern among ethnic minority immigrant gay, bisexual men, and other men who have sex with men (GBMSM) in North America. The definition of unhealthy alcohol use is any use that increases the risk of health consequences or has already led to negative health consequences. Despite its association with various health problems, this issue remains understudied in this population. Therefore, we aim to synthesize key findings to provide the prevalence of unhealthy alcohol use and related factors among this population in North America. We conducted a comprehensive literature search in multiple scientific databases to identify studies on alcohol use among ethnic minority immigrant GBMSM. Using random-effect modeling strategies, we aggregate and weigh the individual estimates, providing a pooled prevalence of unhealthy alcohol use within this population. Our review included 20 articles with 2971 participants (i.e., 53% were Latino, 45% were Asian/Pacific Islanders, and 2% were African). The meta-analysis revealed that 64% (95% CI 0.50, 0.78) of the participants reported recent alcohol use, while 44% (95% CI 0.30, 0.59) engaged in unhealthy alcohol use. Co-occurring health issues identified in the studies are other substance use (32%; 95% CI 0.21, 0.45), positive HIV status (39%; 95% CI 0.14, 0.67), and mental health issues (39%; 95% CI 0.21, 0.58). We also identified several factors associated with unhealthy alcohol use, including risky sexual behaviors, experiences of discrimination based on race and sexual orientation, and experiences of abuse. However, meta-regression results revealed no statistically significant associations between alcohol use and co-occurring health problems. This is the first study to systematically review unhealthy alcohol use among ethnic minority immigrant GBMSM. Despite the high burden of alcohol use, there is a dearth of research among Asian and African GBMSM. Our findings underscore the need for more research in these groups and provide insights to inform targeted clinical prevention and early intervention strategies to mitigate the adverse consequences of unhealthy alcohol use among ethnic minority immigrant GBMSM.

Weight stigma is a social justice issue that can lead to weight-based discrimination and mistreatment. In pregnancy, emerging evidence has highlighted that weight stigma predominantly affects individuals who have larger bodies and is associated with postpartum depression and avoidance of healthcare. Racial and ethnic background will influence perceptions of, and responses to, weight stigma and therefore it is necessary to ensure diverse voices are represented in our understanding of weight stigma. Semi-structured interviews were conducted with ten women who were within one year postpartum; nine identified as Black or African American and one as Hawaiian. Thematic analysis led to identification of three themes: (1) sources of weight stigma and their response to it, (2) support systems to overcome weight stigma, and (3) intersectional experiences. Women reported that sources of weight stigma included unsolicited comments made about their weight often coming from strangers or healthcare professionals that resulted in emotional distress. Support systems identified were family members and partners who encouraged them to not focus on negative remarks made about weight. Intersectional accounts included comparing their bodies to White women, suggesting that they may carry their weight differently. Women shared that, although they felt immense pressure to lose weight quickly postpartum, motherhood and childcare was their utmost priority. These findings inform further prospective examination of the implications of weight stigma in pregnancy among diverse populations, as well as inform inclusive public health strategies to mitigate weight stigma.

Immigrants to the United States often have longer life expectancies than their U.S.-born counterparts, however it is unclear whether a similar "immigrant advantage" exists for immigrants from the Middle East and North Africa (MENA). This study uses a novel machine-learning name classifier to offer one of the first national-level examinations of MENA mortality patterns by nativity in the United States. A recurrent neural network model was developed to identify MENA individuals based on given name and surname characteristics. The model was trained on more than 2.5 million mortality-linked social security records in the Berkeley Unified Numident Mortality Database (BUNMD). Mortality rates and life expectancy were estimated using a Gompertz distribution and maximum likelihood estimation, focusing on high-coverage years between 1988 and 2005 and deaths over age 65. Foreign-born MENA men over 65 showed a significant immigrant mortality advantage with a hazard ratio (HR) of 0.64 and an estimated 3.13 additional years of life expectancy at age 65 compared to U.S.-born counterparts. Foreign-born MENA women also exhibited an advantage, with a HR of 0.71 and an additional 2.24 years of life expectancy at age 65. This study is one of the first national-level analyses of mortality outcomes among the over-65 MENA population in the United States, finding a MENA immigrant mortality advantage. The results suggest further research is needed to identify and disaggregate the MENA population in health research.

Immigrants from Asian countries are the fastest-growing undocumented population in the United States (U.S.), yet not much is known about their health. This scoping review identifies the nature and extent of scientific literature on the health of undocumented Asian immigrants in the U.S. We conducted a comprehensive search of six electronic databases in 2024. Inclusion criteria were empirical articles written in English, published in peer-reviewed scientific journals from 2010 to 2024, and focused on a health outcome or health-related issue involving undocumented Asian immigrants. Results are summarized narratively. We identified 13 peer-reviewed publications. Nine studies were quantitative, and four were qualitative. Eight studies were conducted in California; two studies used national secondary data sources. Studies were mixed in their research focus. They covered a range of health outcomes and issues, such as mental health (n = 4), health services and access (n = 2), contraceptive use (n = 1), COVID-19 (n = 2), and HIV (n = 1). Three studies measured self-rated health alongside other conditions, such as disability, health insurance coverage, chronic health conditions, and obesity. Scholarship on the health of undocumented Asian immigrants is a growing research area. Given the small number of studies identified, future research with larger diverse samples, more robust methodology, and greater topical variety are warranted to understand the health of this population better and reduce potential inequities.

Immigrants, nearly half of whom prefer a language other than English (LOE), face structural barriers to healthcare. This subgroup is believed to be at increased risk for reduced access to quality healthcare, yet few studies have examined the health needs and utilization patterns of LOE-preferring patients who seek care in the Emergency Department (ED). Given that the ED is often an entry point to the health system, we sought to characterize the health patterns of this population in an urban ED setting. We conducted a retrospective chart review of the electronic medical records of 1,566 patients who utilized interpreter services in the ED or Urgent Care) at an urban safety net hospital. We found that LOE-preferring patients had high levels of chronic disease. We also found that the majority of these patients had not seen a primary care provider (PCP) within the study period. PCP visits were positively associated with ED utilization suggesting that those without a PCP are less likely to receive ED care. These findings point to a need for greater policy and community health solutions addressing the high burden of chronic disease and underutilization of healthcare for those with LOE preferences.

Work has not examined if acculturation or enculturation may predict endorsed benefits, barriers, and intentions to seek mental health services for depression, specifically among Latino students enrolled in a rural and majority Latino immigrant institution of higher education. An improved understanding of factors informing mental health help-seeking is needed to identify possible intervention points to address gaps in accessing depression treatment. Participants (N = 406) read a vignette depicting a person with depressive symptoms. Participants were asked if they would seek help for depression if in the situation described in the vignette. Participants provided text responses about their preferences for managing depression symptoms and their mental health help-seeking history. Additionally, participants completed a self-report depression symptom screener, demographic surveys, acculturation assessment, and questionnaires on perceived benefits and barriers to seeking mental health services. Path analysis was used to test the link between acculturation status and intent to seek services for depression, with benefits and barriers as mediators. The results revealed that higher perceived benefits and lower barriers were directly associated with greater intentions to seek help. Furthermore, an indirect effect of acculturation on help-seeking intentions via higher perceived benefits of seeking care was observed. These findings persisted after controlling for age, gender, depression, and history of seeking care for depression. Future work should test the replicability of this finding with diverse college students living in predominantly immigrant communities. Universities might consider tailoring outreach initiatives to provide information on the range and accessibility of mental health services, the location of mental health service centers, and the procedures for accessing such services.

Health information technology (HIT) use among foreign-born adults of Middle Eastern and North African (MENA) descent is understudied. MENA Americans are currently categorized as "White" in the United States (US) on federal forms. Our purpose was to uncover the prevalence of HIT use among MENA immigrants compared to US- and foreign-born White adults before and after adjusting for covariates. The 2011-2018 National Health Interview Survey data (n = 161,613; ages 18 + years) were analyzed. HIT uses evaluated were searching for health information, filling prescriptions, scheduling appointments, and communicating with healthcare providers via email (last 12 months). Crude and multivariable logistic regression models were used to estimate the odds of each HIT use (searching for health information, filling prescriptions, scheduling appointments, and/or communicating with healthcare providers via email), and overall use of any HIT before and after adjustment. The most common HIT use was looking up health information (46.4% foreign-born MENA, 47.8% foreign-born White, 51.2% US-born White; p = .0079). Foreign-born adults of MENA descent had lower odds (OR = 0.64; 95% CI = 0.56-0.74) of reporting any HIT use, but no difference in reporting all HIT uses compared to US-born White adults. This is the first study to explore HIT use among MENA Americans. Results contribute to growing body of literature showing the health of MENA Americans differs from White Americans. A separate racial/ethnic identifier is needed to better capture HIT uses among populations of MENA descent.

Individuals living with cancer and survivors of cancer who self-identify as Hispanic experience higher pain burden and greater barriers to pain management compared with their non-Hispanic counterparts. The Society for Integrative Oncology-ASCO guideline recommends acupuncture and massage for cancer pain management. However, Hispanic individuals' expectations about these modalities remain under-studied and highlight a potential barrier to treatment utilization in this population. We conducted a subgroup analysis of baseline data from two randomized clinical trials to evaluate ethnic differences in treatment expectations about integrative pain treatment modalities among Hispanic and non-Hispanic cancer patients and survivors of cancer. The Mao Expectancy of Treatment Effects (METE) instrument was used to measure treatment expectancy for electro-acupuncture, auricular acupuncture, and massage therapy. Results of this study demonstrated that Hispanic participants reported greater expectation of benefit from electroacupuncture, auricular acupuncture, and massage (all P < 0.01). After controlling for age, gender, race, and education, Hispanic ethnicity remained significantly associated with greater expectation of benefit from integrative therapies for pain (coef.=1.47, 95% CI, 0.67-2.27). Non-white race (coef.=1.04, 95% CI, 0.42-1.65), no college education (coef.=1.16, 95% CI, 0.59-1.74), and female gender (coef.=0.94, 95% CI, 0.38-1.50) were also associated with a greater expectation of benefit from integrative therapies. Pain management should be informed by a shared decision-making approach that aligns treatment expectancy with treatment selections to optimize outcomes. Compared with non-Hispanic participants, Hispanic individuals reported higher expectation of benefit from acupuncture and massage, highlighting the potential role for integrative therapies in addressing ethnic pain disparities. Trial Registration NCT02979574 NCT04095234.

This study examines whether an immigrant health advantage exists among US Whites, a group often used as a reference category in research on racial and ethnic health disparities. Using recent data from the National Health Interview Survey (2019-2022), I disaggregate non-Hispanic White adults (n = 41,752) by nativity status and use logistic regression models to assess differences in six measures of mental and physical health. The analysis includes self-reported conditions (depression, anxiety, fair/poor self-rated health) and diagnosed conditions that require interaction with the healthcare system (hypertension, diabetes, and chronic obstructive pulmonary disease, COPD). Foreign-born Whites have a significantly lower prevalence of each health outcome relative to US-born Whites. The immigrant health advantage remains significant for depression, anxiety, fair/poor health (i.e., self-reported conditions) and diagnosed hypertension, after adjusting for sociodemographic and healthcare characteristics. In contrast, the inclusion of these explanatory factors reduces the nativity gap in diagnosed diabetes and COPD to non-significance. Overall, the results indicate important variation in health among Whites that is missed in studies that focus on US-born Whites, alone. Scholars must continue to monitor the health of White immigrants, who are projected to grow to 20% of the US immigrant population in the years to come.