Understanding the Socio-Economic, Health Systems & Policy Threats to Latino Health: Gaining New Perspectives for the Future

The emergence of the Latino population as the largest and diverse minority group in the U.S. presents challenges and opportunities for health practitioners, leaders and policy makers. Some evidence suggests that Latinos, and immigrants in particular, exhibit better health outcomes than would be expected given their average socio-economic status. Yet, overshadowing this positive health outlook are socio-economic, health system and policy barriers which disproportionately impact Latino health and well-being. This paper briefly discusses the Latino health paradox. It identifies the socio-economic, health systems barriers and public policies that threaten any potential health advantage. Finally, it suggests policy and prevention strategies for promoting the health of the largest emerging minority group in the U.S. Latinos

Beyond acculturation: Immigration, discrimination, and health research among Mexicans in the United States

Evidence suggests that, despite their lower socio-economic status, certain health outcomes are better for first-generation Mexican immigrants than their US-born counterparts. Socio-cultural explanations for this apparent epidemiological paradox propose that culture-driven health behaviors and social networks protect the health of the first generation and that, as immigrants acculturate, they lose these health-protecting factors. However, the prominence granted to acculturation within these explanations diverts attention from structural and contextual factors, such as social and economic inequalities, that could affect the health of immigrants and their descendants. The aim of this study is to offer a conceptual redirection away from individual-centered acculturation models towards a more complex understanding of immigrant adaptation in health research. To this end, 40 qualitative in-depth interviews were conducted with first- and second-generation Mexican immigrant women in Southeastern Michigan. The women's narratives highlighted a key process linked to their integration into US society, in which the second generation experienced a more pervasive and cumulative exposure to "othering" than the first generation. The findings point to "othering" and discrimination as potential pathways through which the health of immigrants and their descendants erodes. The paper concludes by proposing a conceptual model that locates "othering" processes within a structural framework, and by drawing implications for research on immigrant health and on discrimination and health.Immigration Latinos Othering Discrimination Acculturation USA Women

Understanding the Socio-Economic, Health Systems & Policy Threats to Latino Health: Gaining New Perspectives for the Future

Abstract The emergence of the Latino population as the largest and diverse minority group in the U.S. presents challenges and opportunities for health practitioners, leaders and policy makers. Some evidence suggests that Latinos, and immigrants in particular, exhibit better health outcomes than would be expected given their average socio-economic status. Yet, overshadowing this positive health outlook are socio-economic, health system and policy barriers which disproportionately impact Latino health and well-being. This paper briefly discusses the Latino health paradox. It identifies the socio-economic, health systems barriers and public policies that threaten any potential health advantage. Finally, it suggests policy and prevention strategies for promoting the health of the largest emerging minority group in the U.S. Latinos

“They Are Clipping Our Wings”: Health Implications of Restrictive Immigrant Policies for Mexican-Origin Women in a Northern Border Community

We examine racialization processes experienced by women of Mexican origin in a northern border community during a protracted period of restrictive immigrant policies that have disparately affected Mexican-origin communities, and consider pathways through which these experiences may affect health. This grounded theory analysis draws on interviews conducted in 2013–2014 with 48 first, 1.5, and second generation Mexican-origin women living in Detroit, MI. Racialization processes blurred boundaries between Latinas/os, immigrants, and undocumented immigrants. Racialized policies and interactions required women to negotiate shifting and often precarious social and political terrain. We describe racializing markers used by agents of multiple institutions to assess the legal status of women and members of their social networks, shaping their access to the resources over which institutional agents held power. Specifically, we consider the dynamic mechanisms by which multiple legal, social, and employment institutions exacted immigrant policing and bureaucratic surveillance. These include: (1) interior and border immigration enforcement agents’ active surveillance of residents; (2) local law enforcement officials’ assertion of authority over driver’s licenses and contact with immigration officials, often in traffic-related encounters; (3) Secretary of State clerks’ discretion in assessing legal status and issuing driver’s licenses and state IDs; (4) social welfare agents’ scrutiny of citizenship status in determining access to nutritional, economic, and medical resources; and (5) employers’ exploitation of these structural vulnerabilities to justify unfair treatment of immigrant workers. We theorize several mechanisms, by which these processes affect health, including: stigmatization; hypervigilance; and restricted access to health-promoting resources

Mexican-Origin Women’s Construction and Navigation of Racialized Identities: Implications for Health Amidst Restrictive Immigrant Policies

This study examines how Mexican-origin women construct and navigate racialized identities in a postindustrial northern border community during a period of prolonged restrictive immigration and immigrant policies, and it considers mechanisms by which responses to racialization may shape health. This grounded theory analysis involves interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. In response to institutions and institutional agents using racializing markers to assess their legal status and policing access to health-promoting resources, women engaged in a range of strategies to resist being constructed as an "other." Women used the same racializing markers or symbols of (il)legality that had been used against them as a malleable set of resources to resist processes of racialization and to form, preserve, and affirm their identities. These responses include constructing an authorized immigrant identity, engaging in immigration advocacy, and resisting stigmatizing labels. These strategies may have different implications for health over time. Findings indicate the importance of addressing policies that promulgate or exacerbate racialization of Mexican-origin communities and other communities who experience growth through migration. Such policies include creating pathways to legalization and access to resources that have been invoked in racialization processes, such as state-issued driver's licenses

Impact of change over time in self-reported discrimination on blood pressure: implications for inequities in cardiovascular risk for a multi-racial urban community

Objectives: The 21st century has seen a rise in racism and xenophobia in the United States. Few studies have examined the health implications of heightened institutional and interpersonal racism. This study examines changes in reported discrimination and associations with blood pressure over time among non-Latino Blacks (NLBs), Latinos, and non-Latino Whites (NLWs) in an urban area, and variations by nativity among Latinos.Design: Data from a probability sample of NLB, Latino, and NLW Detroit, Michigan residents were collected in 2002-2003, with follow-up at the same addresses in 2007-2008. Surveys were completed at 80% of eligible housing units in 2008 (n = 460). Of those, 219 participants were interviewed at both time points and were thus included in this analysis. Discrimination patterns across racial/ethnic groups and associations with blood pressure were examined using generalized estimating equations.Results: From 2002 to 2008, NLBs and Latinos reported heightened interpersonal and institutional discrimination, respectively, compared with NLWs. There were no differences in associations between interpersonal discrimination and blood pressure. Increased institutional discrimination was associated with stronger increases in systolic and diastolic blood pressure for NLBs than NLWs, with no differences between Latinos and NLWs. Latino immigrants experienced greater increases in blood pressure with increased interpersonal and institutional discrimination compared to US-born Latinos.Conclusions: Together, these findings suggest that NLBs and Latinos experienced heightened discrimination from 2002 to 2008, and that increases in institutional discrimination were more strongly associated with blood pressure elevation among NLBs and Latino immigrants compared to NLWs and US-born Latinos, respectively. These findings suggest recent increases in discrimination experienced by NLBs and Latinos, and that these increases may exacerbate racial/ethnic health inequities

Addressing Urban Health in Detroit, New York City, and Seattle Through Community-Based Participatory Research Partnerships

Objective. This study describes key activities integral to the development of 3 community-based participatory research (CBPR) partnerships. Methods. We compared findings from individual case studies conducted at 3 urban research centers (URCs) to identify crosscutting adaptations of a CBPR approach in the first 4 years of the partnerships’ development. Results. Activities critical in partnership development include sharing decisionmaking, defining principles of collaboration, establishing research priorities, and securing funding. Intermediate outcomes were sustained CBPR partnerships, trust within the partnerships, public health research programs, and increased capacity to conduct CBPR. Challenges included the time needed for meaningful collaboration, concerns regarding sustainable funding, and issues related to institutional racism. Conclusions. The URC experiences suggest that CBPR can be successfully implemented in diverse settings