Journal of immigrant health最新文献

A preliminary survey was conducted with 102 migrant day laborers (MDLs) to assess HIV risk and related contextual problems and issues. These men were primarily Mexican, of low SES background, low in acculturation to the United States, and their income ranged from $100 and $400 a week, 40% of which is sent back home. The psychosocial context of HIV risk included concerns expressed about lack of money and employment, followed by racism, social isolation, sadness and loneliness. High rates of alcohol use and binge drinking that co-occur with sexual activities were reported. While only 7% of MDLs reported illegal injection drug use, needles were frequently shared without bleach cleaning. Men generally did not carry condoms and knowledge of proper condom use was poor. For the most common form of sex reported, vaginal sex, condom use was infrequent. However, men did report confidence in being able to insist on condom use in challenging sexual situations, and they also reported fairly frequent pro-condom attitudes and behaviors within their social circles. Slightly over half of the men reported sexual activity with female partners, during the past 2 months. These female partners were almost evenly divided into regular sex partners, including spouses, and riskier partners such as one time only sex partners, prostitutes, and multiple sex partners. Results also indicated encouraging efforts by MDLs to reduce risk with risky partners (e.g., more condom use).

The study aimed to investigate the rates of self-reported physical and emotional spousal abuse among recent Canadian-immigrant (CI) women compared to Canadian-born (CB) women. The study conducted secondary data analyses on the General Social Survey, 1999. A sample of CB (n = 3548) and CI (n = 313) women was drawn that included women 25 to 49 years of age who were currently married or in a common-law relationship. Person weights and bootstrapping estimates were used to estimate the 95% confidence intervals. The proportion of emotional spousal abuse was higher in CI (14.7%, 95% CI: 10.7-18.8%) compared to CB women (8.7%, 95% CI: 7.8-9.6%). However, the proportion of physical spousal abuse was not statistically different between two groups. Possible explanations are discussed setting direction for future research and services for immigrant women.

Canadian federal policy provides a framework for the immigration and health experiences of immigrant women. The official immigration category under which a migrant is admitted determines to what degree her right to remain in the country (immigration status) is precarious. Women immigrants fall primarily into the more dependent categories and they experience barriers to access to health services arising from this precarious status. Federal immigration and health policies create direct barriers to health through regulation of immigrants' access to services as well as unintended secondary barriers. These direct and secondary policy barriers intersect with each other and with socio-cultural barriers arising from the migrant's socioeconomic and ethno-cultural background to undermine equitable access to health for immigrant women living in Canada.

The Marshallese immigrant population, part of a growing Asian American and Pacific Islander population in the United States, has adverse health conditions and disparities that are mainly attributed to their pre-migration health status. Little is known about the perceived and real barriers Marshallese experience in accessing and utilizing health services in the United States. Because of these barriers, their health status is known to exacerbate. This formative study used qualitative methods, using an ethnographic approach, to identify the ethnocultural and socioeconomic barriers to existing health services as perceived by immigrant Marshallese living in Northwest Arkansas. Recommendations were made to improve timely, culturally competent, and appropriate health services.

This study examines mortality patterns among Canadian immigrants, including both refugees and non-refugees, 1980-1998. Records of a stratified random sample of Canadian immigrants landing between 1980-1990 (N = 369,936) were probabilistically linked to mortality data (1980-1998). Mortality rates among immigrants were compared to those of the general Canadian population, stratifying by age, sex, immigration category, region of birth and time in Canada. Multivariate analysis examined mortality risks for various immigrant subgroups. Although immigrants presented lower all-cause mortality than the general Canadian population (SMR between 0.34 and 0.58), some cause-specific mortality rates were elevated among immigrants, including mortality from stroke, diabetes, infectious diseases (AIDS and hepatitis among certain subgroups), and certain cancers (liver and nasopharynx). Mortality rates differed by region of birth, and were higher among refugees than other immigrants. These results support the need to consider the heterogeneity of immigrant populations and vulnerable subgroups when developing targeted interventions.

Little information exists regarding the perceptions that ethnic-specific groups of Asian American men have about tobacco cigarette smoking. Thirty Asian American men of immigrant status living in Seattle, Washington, were stratified by ethnicity (Chinese and Vietnamese), language (Mandarin, Cantonese, Vietnamese) and age to comprise six focus groups (two Mandarin speaking men aged 20-40 years and 10 aged 41-65+ years; three Cantonese men aged 20-40 years and another six aged 41-65+ years; four Vietnamese men aged 20-40 years and another five aged 41-65+ years). All group interviews were audio-taped and six separate hard-copy transcripts were produced, independently theme-coded by three investigators to ensure inter-rater reliability, and analyzed with QRS NUD*IST ethnographic software. Bandura (1969, 1986) categorized emergent contextual themes within the constructs of "predisposing, enabling, and reinforcing" behavioral determinants from Social Learning Theory. Smoking to be sociable emerged as the most salient theme. Awareness of tobacco-related diseases other than lung cancer was less evident, as was a self-perceived lack of will-power to quit. Concerns about side-stream smoking affecting family members, along with smoking to alleviate stress, were key findings. Further tobacco-related research is needed that incorporates considerations for cultural dynamics.

In this article we report research findings from a qualitative study of social support for immigrants and refugees in Canada. We focus on challenges from the perspectives of 137 service providers and policymakers in health and immigrant settlement who participated in in-depth interviews and focus groups in three Canadian cities. Results show that social support is perceived to play an important role in immigrant settlement and to have a positive impact on immigrant health, although immigrants face many systemic challenges. Systemic issues--limited resources, lack of integration of policies and programs and narrow service mandates--also limit service providers' abilities to meet newcomer's needs. This research suggests that changes in public discourse about immigrants' contributions, improved governance and service coordination, and a holistic, long-term perspective are important to more effectively support immigrant settlement and to promote immigrant health and well being.

In order to evaluate the health needs and consequences of barriers to health care access for the Haitian immigrant community of Miami-Dade County, Florida, we collected in 2001 demographic and health needs and access data from a probability sample of county residents of Haitian origin. We computed frequencies and prevalence ratios, and employed chi-square and logistic regression methods for data analysis. Hypertension and diabetes were among the most prevalent health conditions mentioned. Up to 39% of participants failed to have an annual physical and 10% failed to receive care for their serious health conditions. On bivariate analysis, insurance coverage, a usual place of care, educational attainment, household income, citizenship status, and duration of residency were associated with services utilization. Citizenship status was the strongest independent predictor of services utilization. The findings suggest that this community faces distinct health needs and daunting challenges to meet those needs.

Knowledge concerning patterns of health care utilization among Latino-adolescent immigrants is needed to develop culturally-appropriate programs. The objectives of this study were to estimate the annual prevalence of having had a routine physical exam and episodes of adolescents' not seeking health care when they thought they should (forgone health care) among Latino adolescents by immigrant-generational status. Cross-sectional analysis of data from Latino adolescents in Wave I of the National Longitudinal Adolescent Health Study. First-generation immigrants who had lived in the U.S. < or = 5 years were less likely to receive routine care than third-generation immigrants (39.0% vs. 54.9%). This disparity decreased after adjustment for insurance status, parental education and poverty among Mexican origin adolescents. On average, 16.0% of first-generation immigrants who had lived in the U.S. < or = 5 years and 22.5% of third-generation immigrants reported forgoing health care. After adjustment for age, insurance status, parental education and routine care, recent arrivals were less likely than third-generation immigrants to forgo health care. Recent arrivals were less likely to receive a routine physical exam and to forgo care than third-generation immigrants. Future studies should explore the effect of acculturation on knowledge, beliefs and perceptions about health, illness and care-seeking behaviors.

This was a retrospective review and descriptive analysis of the findings from the medical screening examinations conducted on the illegal migrants from Fujian Province of China (n = 589) who arrived on four boats on the West Coast of Canada between June 14 and September 9, 1999. The Canadian Navy conducted a screening medical exam of the illegal migrants, with Health Canada and Citizenship and Immigration Canada providing suggestions on the format of the exam. The illegal Chinese migrants were predominantly young, male adults. The most prevalent medical conditions detected were dermatological (55.2%), dental problems (25%), trauma (9.2%), urogenital (7.6%), and head/neck (6.6%). Recently induced trauma was more prevalent among females (20.5%) than males (6.5%). One case of community-acquired pneumonia was identified and later diagnosed as active pulmonary tuberculosis. Physicians dealing with illegal migrants should look for unusual physical findings and have a higher clinical suspicion regarding infectious diseases (tuberculosis, scabies) and abuse. Future encounters with illegal migrants should include standardized immigration screening exams, with adequate history taking and follow-up.