Editorial: Human rights and inequity in health access of Central American Migrants

Frontiers in Public Health is very pleased to publish this journal issue focusing on the health access of immigrants. Contributions to this journal issue include five articles that rely on different methodologies while focusing on diverse geographic world regions and target populations. This editorial summarizes these features while also highlighting the unique contributions of each article

Health Through a Human Right Lens at the US-Mexico Border: Increasing Access to Healthcare for Central American Immigrants

The number of immigrants seeking entry into the U.S. through asylum requests or through irregular means is increasing, and most come from the Northern Triangle of El Salvador, Guatemala, and Honduras. Immigrants come fleeing extreme poverty, violence, health and social inequities, and drastic climate changes. Most had limited access to healthcare at home, and even more limited care along the journey. Those that are allowed entry into the U.S., are confronted with feeling unwelcome in many communities, having to navigate an array of local, state, and federal laws that regulate access to healthcare. We need immigration policies that preserve the health, dignity with a multinational policy for provision of healthcare through a human rights lens from point of origin to point of destination

Leveraging Public-Private Partnerships During COVID-19: Providing Virtual Field Opportunities for Student Learners and Addressing Social Isolation in Older Adults

While preventive and management measures are important to mitigate the spread of COVID-19, strategies like social distancing can have devastating effects on older adults who are already at risk for social isolation and loneliness. In response, two Colleges of Health Professions (Social Work and Nursing) at a large public University leveraged a partnership with a national health and wellbeing company to address social isolation and loneliness in Houston area older adults during the COVID-19 pandemic. This intergenerational linkage initiative involved 707 older adults and 177 graduate social work and nursing students. This study describes the process of developing a virtual educational opportunity for students while also meeting the needs of vulnerable older adults in Houston, the third largest, and one of the most diverse cities in the U.S. Findings include student/learner outcomes, as well as self-reported improvements in loneliness scores, and unhealthy physical and mental health days among enrolled older adults

The Texas Community-Engagement Research Alliance Against COVID-19 in Disproportionately Affected Communities (TX CEAL) Consortium

The coronavirus disease 2019 (COVID-19) pandemic requires urgent implementation of effective community-engaged strategies to enhance education, awareness, and inclusion of underserved communities in prevention, mitigation, and treatment efforts. The Texas Community-Engagement Alliance Consortium was established with support from the United States’ National Institutes of Health (NIH) to conduct community-engaged projects in selected geographic locations with a high proportion of medically underserved minority groups with a disproportionate burden of COVID-19 disease and hospitalizations. The purpose of this paper is to describe the development of the Consortium. The Consortium organized seven projects with focused activities to address COVID-19 clinical and vaccine trials in highly affected counties, as well as critical statewide efforts. Five Texas counties (Bexar, Dallas, Harris, Hidalgo, and Tarrant) were chosen by NIH because of high concentrations of underserved minority communities, existing community infrastructure, ongoing efforts against COVID-19, and disproportionate burden of COVID-19. Policies and practices can contribute to disparities in COVID-19 risk, morbidity, and mortality. Community engagement is an essential element for effective public health strategies in medically underserved minority areas. Working with partners, the Consortium will use community engagement strategies to address COVID-19 disparities

Implementation of the Texas Community-Engaged Statewide Consortium for the Prevention of COVID-19

The Community Engagement Alliance (CEAL) Against COVID-19 Disparities aims to conduct community-engaged research and outreach. This paper describes the Texas CEAL Consortium\u27s activities in the first year and evaluates progress. The Texas CEAL Consortium comprised seven projects. To evaluate the Texas CEAL Consortium\u27s progress, we used components of the RE-AIM Framework. Evaluation included estimating the number of people reached for data collection and education activities (reach), individual project goals and progress (effectiveness), partnerships established and partner engagement (adoption), and outreach and education activities (implementation). During the one-year period, focus groups were conducted with 172 people and surveys with 2107 people across Texas. Partners represented various types of organizations, including 11 non-profit organizations, 4 academic institutions, 3 civic groups, 3 government agencies, 2 grassroots organizations, 2 faith-based organizations, 1 clinic, and 4 that were of other types. The main facets of implementation consisted of education activities and the development of trainings. Key recommendations for future consortiums relate to funding and research logistics and the value of strong community partnerships. The lessons learned in this first year of rapid deployment inform ongoing work by the Texas CEAL Consortium and future community-engaged projects

Psychological status of Hispanic and non -Hispanic mothers of mentally retarded and mentally ill children

This study provided a cross-sectional, multivariate description of variables influencing the mental health of mothers of dually diagnosed (mentally retarded and mentally ill) children. Twenty-nine mothers of children with mental retardation and mental illness participated in this study. Fifteen were African-American and 13 Hispanic; one identified herself as both. Mothers ranged in age from 24 to 80 and averaged 47 years of age. The average chronological age of the children was 15.59 years old. Sixty-two percent of the children were male (n = 18) and 38% were female (n = 11). The average verbal, performance and full scale IQ\u27s of the children were 59.94, 63.74, and 59.68, respectively. Participants completed a Demographic Data Form and four scales measuring situation-specific distress levels (Brief Symptom Inventory), opinions and attitudes about mental illness (Opinions About Mental Illness Scale), levels of social support (Inventory of Socially Supportive Behaviors), and level of acculturation to American society (Short Acculturation Scale). Data on the children was collected from clinic records, including Vineland Adaptive Behavior Scale scores, IQ scores, psychiatric and medical diagnoses, and medication. Hispanic mothers obtained a mean score suggesting a moderate degree of acculturation to mainstream American culture. However, they clearly preferred their own culture with regard to language and ethnic loyalty, media preferences, and ethnic social relationships. Scores on the BSI were identical to a comparison group of non-psychiatric adults, with the exception of the Paranoid Ideation Symptom Dimension score, which was statistically but not clinically significant. Scores on the Inventory of Socially Supported Behaviors suggested the mothers received slightly higher than average levels of support during the preceding month. Participant scores on the Opinions About Mental Illness Scale ranged from a mean of 12.10 on the Interpersonal Etiology Subscale to a mean of 45.21 on the Unsophisticated Benevolence Subscale. Data analyses suggest a significant positive correlation between the mothers\u27 Global Severity Index of the BSI and the childrens\u27 Full Scale IQ. In addition the GSI was also found to be positively related to scores on the Interpersonal Etiology subscale of the OMI. Possible explanations and implications for servicing this high-need population are discussed

Why Culture and Context Matters: Examining Differences in Mental Health Stigma and Social Distance Between Latino Individuals in the United States and Mexico

This study examines the influence of cultural context on social distance and perceptions of stigma towards mental health conditions among Latino populations in Houston, TX, USA and Mexico City, Mexico. We employed a community-based experimental vignette survey to assess perceptions towards individuals experiencing symptoms of alcohol misuse, depression, and psychosis. Participants (n = 513) from Houston and Mexico City were asked about their willingness to accept community members experiencing mental health symptoms in various social roles, their perceptions of stigma related to these symptoms, anticipated danger, possible positive outcomes, and the community member’s ability to change. Findings demonstrate significant differences in stigma perceptions between Latino respondents in the US and in Mexico. Houston participants reported lower public stigma and perceived dangerousness of someone with mental health concerns compared to respondents in Mexico City. Furthermore, the cultural context may influence the association between various dimensions of stigma, with some inverse relationships occurring based on location of data collection. Findings illuminate the complex interplay between cultural context, mental health symptoms, and stigma, and underscores the need for culturally nuanced interventions to reduce mental health stigma and promote service utilization in Latino communities

Public Stigma Toward Schizophrenia Within Latino Communities in the United States

Public stigma toward those experiencing symptoms of schizophrenia in the general population is high; yet research into such stigma within the diverse Latino communities remains under-investigated. This study employed a randomized experimental vignette methodology to assess various domains of public stigma toward individuals experiencing psychosis and/or diabetes within Latino communities. A communitybased sample of 243 Latino adults participated. Contrary to our expectations, respondents who were more sympathetic toward those with mental health problems tended to score higher on public stigma. The belief that a person was responsible for their own mental health problems was associated with higher levels of stigma. Results indicate that perceptions of dangerousness toward someone experiencing psychosis were common, and the perception that a person was responsible for their mental health problems was associated with higher levels of stigma Results emphasize the complex nature of stigma within the diverse Latino communities and the need for ongoing research

Ethical Considerations in Global Mental Health Research: Lessons Learned From Binational U.S.–Mexico Collaborations

Binational research is critical to better understand the health, mental health, and health outcomes of immigrant communities. Binational studies are often difficult to conduct, however, due to cost, challenges with participant recruitment and data collection, lack of appropriate cross-cultural instruments, and challenges ensuring ethical reviews and approval in both counties. This research note discusses ethical issues navigating institutional review board (IRB) procedures while striving to maintain the highest ethical protection for participants when engaging in binational behavioral sciences research between México and the United States. We discuss the need to clarify requirements for international research between México and the United States and navigating differences that may exist or emerge between IRBs in México and the United States. We provide some recommendations to assist researchers in ensuring IRB approval for their research protocols and ethical protection for their participants

Implementation of the Texas Community-Engaged Statewide Consortium for the Prevention of COVID-19

The Community Engagement Alliance (CEAL) Against COVID-19 Disparities aims to conduct community-engaged research and outreach. This paper describes the Texas CEAL Consortium’s activities in the first year and evaluates progress. The Texas CEAL Consortium comprised seven projects. To evaluate the Texas CEAL Consortium’s progress, we used components of the RE-AIM Framework. Evaluation included estimating the number of people reached for data collection and education activities (reach), individual project goals and progress (effectiveness), partnerships established and partner engagement (adoption), and outreach and education activities (implementation). During the one-year period, focus groups were conducted with 172 people and surveys with 2107 people across Texas. Partners represented various types of organizations, including 11 non-profit organizations, 4 academic institutions, 3 civic groups, 3 government agencies, 2 grassroots organizations, 2 faith-based organizations, 1 clinic, and 4 that were of other types. The main facets of implementation consisted of education activities and the development of trainings. Key recommendations for future consortiums relate to funding and research logistics and the value of strong community partnerships. The lessons learned in this first year of rapid deployment inform ongoing work by the Texas CEAL Consortium and future community-engaged projects