Suchergebnisse

RationaleLittle is known about how undocumented immigrants navigate healthcare utilization issues apart from access.ObjectiveWe examine a unique population of undocumented immigrants who have access to healthcare - college students at the University of California - to identify how immigration status hinders mental health service utilization in the absence of barriers related to eligibility and insurance coverage.MethodWe conducted semistructured interviews between March and July 2017 with 30 undocumented students at a University of California campus.ResultsWe argue that undocumented immigration status informs mental health-related illness cognitions to negatively affect students' ability to assess their own mental health and need for services. Students expressed low perceived need because they normalized mental strain as a natural product of their unstable immigration status. Many viewed treatment as futile because it could not address underlying immigration-related issues. They also anticipated stigmas associated with mental illness as well as their own undocumented status.ConclusionSolutions to address utilization disparities must go beyond eliminating formal barriers to health access and address such psychosocial barriers, as well as the larger political and social context that produces them.

RationaleLittle is known about how undocumented immigrants navigate healthcare utilization issues apart from access.ObjectiveWe examine a unique population of undocumented immigrants who have access to healthcare - college students at the University of California - to identify how immigration status hinders mental health service utilization in the absence of barriers related to eligibility and insurance coverage.MethodWe conducted semistructured interviews between March and July 2017 with 30 undocumented students at a University of California campus.ResultsWe argue that undocumented immigration status informs mental health-related illness cognitions to negatively affect students' ability to assess their own mental health and need for services. Students expressed low perceived need because they normalized mental strain as a natural product of their unstable immigration status. Many viewed treatment as futile because it could not address underlying immigration-related issues. They also anticipated stigmas associated with mental illness as well as their own undocumented status.ConclusionSolutions to address utilization disparities must go beyond eliminating formal barriers to health access and address such psychosocial barriers, as well as the larger political and social context that produces them.

A large literature documents a strong and consistent educational gradient in health: more-educated persons enjoy lower rates of morbidity and mortality. This literature has generally focused on the amount of schooling one completes but has yet to comprehensively examine other facets of education, such as educational quality or school segregation. More importantly, the literature has generally conceptualized education at the level of individual persons and has yet to fully study the structural dimensions of education and the production of educational inequities. The goal of this article is to identify several areas of educational inequity beyond personal educational attainment. These include (a) population differences in the strength of the educational gradient in health, (b) educational quality, (c) school segregation, and (d) the role of place of education among immigrants. We also discuss some emerging issues, such as student debt and pathways to education. Accordingly, there is much work to be done to further our knowledge regarding the relationship between education and health.

AbstractQualitative work has found that Latino food pantry recipients share food and reciprocally provide social support to their food-insecure neighbors. These findings suggest that neighborhood cohesion (NC) may serve as an important community-level resource that Latinos utilize as a coping mechanism when food-insecure. High levels of NC may be a proxy for instrumental support outside the household and act as a buffer against the adverse health effects of food insecurity including type 2 diabetes (T2D), which is highly sensitive to food insecurity. The purpose of this study was to quantitatively test this theory by examining whether NC moderated the association between T2D and food security (FS) status among Latino adults nationwide. We used data from the 2013–2018 National Health Interview Survey (n = 23,478). We found that FS status was associated with T2D prevalence, with Latino adults having a higher odds of T2D if they had low FS or very low FS compared to their FS counterparts. We also found Latinos adults who reported high NC had a lower odds of T2D compared to those who reported low NC. However, we did not find there was significant interaction between FS status and NC on T2D. NC may instead be a precursor to FS status, rather than a buffer of food insecurity on T2D. Low NC may lead to less instrumental support and tangible benefits that determine FS. Additionally, perceived NC might not align with objective NC and T2D may be too distal of a health outcome to test the protective effect of NC.

Abstract
Objective
To determine whether Latino undocumented immigrants had a steeper decline in Emergency Department (ED) utilization compared to Latino Medi-Cal patients in a Los Angeles safety-net hospital, March 13, 2020, to May 8, 2020.

Study Design
The data were extracted from patient medical records for ED visits at LAC + USC Medical Center from January 2018 to September 2020. We analyzed weekly ED encounters among undocumented Latino patients in the nine-week period after COVID was declared a national emergency. We applied time-series routines to identify and remove autocorrelation in ED encounters before examining its relation with the COVID-19 pandemic. We included Latino patients 18 years of age and older who were either on restricted or full-scope Medi-Cal (n = 230,195).

Results
All low-income Latino patients, regardless of immigration status, experienced a significant decline in ED utilization during the first nine weeks of the pandemic. Undocumented patients, however, experienced an even steeper decline. ED visits for this group fall below expected levels between March 13, 2020, and May 8, 2020 (coef. =  − 38.67; 95% CI =  − 71.71, − 5.63). When applied to the weekly mean of ED visits, this translates to a 10% reduction below expected levels in ED visits during this time period.

Conclusion
Undocumented immigrants' health care utilization was influenced by external events that occurred early in the pandemic, such as strict stay-at-home orders and the public charge rule change. Health care institutions and local policy efforts could work to ensure that hospitals are safer spaces for undocumented immigrants to receive care without immigration concerns.

AbstractThe COVID-19 pandemic has produced significant psychological distress for college students due to the sudden proliferation of stressors. We examine whether and how self and parental immigration status contributes to Latina/o/x college students' mental health and pandemic stressors during the initial months of the pandemic. We draw on quantitative and qualitative survey data collected in March–June 2020 with 1,600 Latina/o/x University of California undergraduate students from three self-identified groups: undocumented students, US citizens with at least one undocumented parent, and US citizens with lawfully present parents. Quantitative analyses reveal that the pandemic produced widespread negative mental health effects but the severity of these effects did not differ by self/parental immigration status. Our qualitative analyses identify common pandemic-related stressors across our three student groups (financial insecurity, COVID-19 virus concerns, academic strains, and social dynamics); however, undocumented students and US citizens with undocumented parents identify unique aspects of these stressors due to legal vulnerabilities. Self and parental undocumented status also compromises the ability to manage common pandemic stressors because of immigration status-related exclusion from necessary resources. Ultimately, we argue that the high-stress nature of the pandemic elevated mental distress across all student groups, but the structural exclusion of undocumented immigrants contributes to unique experiences of stress among Latina/o/x undocumented students and US citizen students with undocumented parents.

Citizenship is both a system of privilege and a source of social identity. This study examines whether there are disparities in psychological distress between citizens and noncitizens, and whether these disparities may be explained by markers of social disadvantage (e.g., poverty, discrimination) or perceptions of success in the United States (i.e., subjective social status). We analyze data from the Asian subsample ( n = 2,095) of the National Latino and Asian American Study. The data show that noncitizens report greater psychological distress compared with naturalized citizens and native-born citizens after accounting for sociodemographics (e.g., age, gender, Asian subgroup), socioeconomic characteristics (education, employment, income-to-poverty ratio), immigration (e.g., interview language, years in the United States, acculturative stress), health care visits, and everyday discrimination. Preliminary evidence suggests that subjective social status may explain some of the disparities between naturalized citizen and noncitizen Asian Americans.