Occupational Stress and Mental Health Among Healthcare Workers Serving Socially Vulnerable Populations During the COVID-19 Pandemic

The purpose of this study was to analyze occupational and personal stressors, mental health indicators, perceived discrimination and help-seeking behaviors among healthcare workers and providers (HCWPs) serving socially vulnerable groups such as immigrants, refugees, farmworkers, homeless individuals, people living in poverty, and other disadvantaged populations in the United States (U.S.) during the COVID-19 pandemic. Using a cross-sectional descriptive approach, we gathered information between July and September 2020, from a sample of 407 affiliates of two national organizations of clinic-based HCWPs who worked at federally funded and community safety-net clinics. Informed consent was obtained from all participants who completed a self-administered online survey available in English and Spanish. Our results indicated that the HCWPs serving vulnerable groups in the midst of the pandemic experienced high levels of occupational and personal stressors as well as anxiety and depressive symptomology. Major occupational stressors were excessive workload, long working-hours, and institutional barriers to refer and follow-up on their clients\u27 access to needed social services. High-rated personal stressors included sleep disorders, lack of and child-care, partner\u27s loosing job, and other family related situations. Our findings suggest that HCWPs working with vulnerable populations need specialized interventions that bolster their mental health and well-being as the pandemic continues to unfold. We recommend implementing initiatives that encourage HCWPs\u27 to be actively involved in clinic decisions regarding employee safety and protection as well as in management decisions to improve work place infrastructure and capacity to respond to the social needs of their clients. Lessons learned from the pandemic are useful tools in designing protocols for addressing the mental-health needs of HCWPs in health-care organizations that attend to socially underprivileged populations

How Stressed are Health Providers During the Pandemic?

This is the first in a series of policy briefs from the Latino Research Institute’s COVID-19 Research Consortium. The Consortium is an interdisciplinary forum in which researchers share resources, methods, and other vital information regarding the effect of COVID-19 on Latino populations. Data reported in this Policy Brief comes from the following research project: Salgado de Snyder, V.N., Villatoro, A., McDaniel, M., Garcia, D., & Parra-Medina, D. (2021); “Psychosocial Impact of COVID-19 on Health Care Workers and Providers Survey, 2020.” Latino Research Institute. The University of Texas at Austin.The global COVID-19 pandemic has dramatically affected daily life, most especially among healthcare workers and providers (HCWPs). Characterized by a seemingly endless number of new COVID-19 cases and a high death toll, the ongoing pandemic has negatively affected HCWPs in the workplace and at home, especially those serving socially disadvantaged populations. In this brief, the Latino Research Institute outlines recommendations for organizations to protect the mental health and well-being of HCWPs who are exposed to extreme circumstances.Al Frente COVID Consortium, Latino Research Institute, College of Liberal Arts; Migrant Clinicians Network (MCN); National Center for Farmworkers Health (NCFH)Liberal Art

Lesiones accidentales en adultos mayores: un reto para los sistemas de salud Accidental injuries in older adults: a challenge for the health systems

OBJETIVO: Identificar los factores sociodemográficos, de salud y apoyo social relacionados con las lesiones accidentales en adultos mayores residentes de colonias urbanas marginales de las ciudades de Cuernavaca, Chilpancingo, Guadalajara y Culiacán. MATERIAL Y MÉTODOS: En 2004-2005 se llevó a cabo un estudio transversal; mediante muestra no probabilística, se entrevistó a 799 adultos mayores; se emplearon pruebas no paramétricas y un modelo multivariado de regresión logística. RESULTADOS: Del total de entrevistas, 37% notificaron lesiones y la causa principal fueron las caídas (54%). El hogar fue el sitio con mayor número de accidentes (52%). Los factores de riesgo asociados fueron edad avanzada, trabajar, mayor número de enfermedades, mayor consumo de medicamentos, remedios y bebidas alcohólicas, percepción de "mala salud", apoyo familiar inadecuado y ser cuidador de otros. CONCLUSIONES: La multicausalidad obliga, por una parte, a que toda la sociedad participe y, por la otra, a la intervención del área de la salud para prevenir y atender el problema.<br>OBJECTIVE: To identify factors (sociodemographic, health, and social support) associated with the presence of accidental injuries in older adults living in deprived urban neighborhoods in four Mexican municipalities. MATERIAL AND METHODS: Cross-sectional survey carried out in 2004-2005, with a non-probabilistic, intentional sample of 799 male and female elderly living in deprived urban areas in four Mexican municipalities. For the statistical analysis, non-parametric tests and multivariate logistic regression models were used. RESULTS: More than a third (37%) of the sample reported injuries; with falls being the main cause. Home was the venue where most accidents took place (52%). Risk factors for accidental injuries were: advanced age, working, greater number of illnesses, consumption of more medicines and remedies, self-perception of "poor" health , consumption of alcoholic beverages, inadequate family support and being a caretaker of others. CONCLUSIONS: The multi-causality of accidental injuries in older adults demands the participation of all sectors of society, and particularly public health interventions

A first analysis of research on social determinants of health in Mexico: 2005-2012.

Objective. To examine the research on social determinants of health (SDH) produced in Mexico during the period 2005-2012, based on the characterization of the national health research system and the scientific production on this topic. Materials and methods. Two-stage analyses: Review of Mexican documents and official sources on health research and systematic bibliographic review of the literature on SDH. Results. Although SDH were mentioned in the Specific Action Plan for Health Research 2007-2012, they are not implemented in strategies and goals, as the emphasis is put mostly in infrastructure and administrative aspects of research. In the period studied, 145 articles were published on SDH topics such as health conditions, health systems and nutrition and obesity. Conclusions. In spite of the availability of research on SDH in Mexico, the operationalization of such findings into health policies has not been possible. The current Sectorial Program on Health 2013-2018 represents a window of opportunity to position research findings that promote health equity policie

Modelo de integración de recursos para la atención de la salud mental en la población rural de México

OBJETIVO: Identificar conductas de utilización de servicios para resolver problemas de salud mental en los pobladores de localidades rurales de México; construir un modelo sobre los caminos de la atención para la salud mental que siguen los pobladores rurales, y proponer un modelo de integración para mejorar la calidad y el acceso a estos servicios. MATERIAL Y MÉTODOS: En 1997 se realizaron entrevistas a profundidad con 21 pobladores adultos (nueve hombres y 12 mujeres), y siete prestadores de servicios de una comunidad rural del estado de Jalisco, México. El rango de edad de las mujeres fue de 23 a 44 años, 10 casadas y dos solteras. Los hombres tenían entre los 30 y 74 años de edad, ocho casados y un viudo. Los prestadores de servicios fueron un sacerdote, un médico general, un encargado de farmacia, dos enfermeras y dos sanadores tradicionales (un sobador y un curandero). RESULTADOS: El primer intento que hace una persona para remediar un síntoma es acudir a los autocuidados. Cuando éstos no son suficientes para aliviarlo, las personas avanzan al segundo ámbito del camino: buscar ayuda de la red social, cuyos miembros, además de brindar información referente a remedios y cuidados, ofrecen su apoyo emocional e instrumental. Si después de consultar a la red el síntoma no ha desaparecido, el individuo busca la ayuda de otras fuentes externas, concretamente la de los miembros del sistema etnomédico local. La gente en esas localidades busca ayuda del médico únicamente cuando el síntoma persiste o cuando ha sido referido en repetidas ocasiones por algún miembro del sistema etnomédico local o de su red social. La búsqueda de un especialista de la salud mental (psiquiatra o psicólogo) es muy improbable entre los pobladores rurales debido a la dificultad de acceso geográfico a estos servicios por el costo que implica hacer uso de éstos y por la distancia cultural existente entre el prestador de servicios y el paciente. CONCLUSIONES: Para llevar a cabo con éxito programas de intervención culturalmente sensibles en el medio rural se requiere contar con información detallada, derivada de la investigación y de la participación activa de todos los recursos humanos e institucionales disponibles, desde profesionales e investigadores auténticamente multidisciplinarios, hasta educadores, líderes sociales, religiosos, políticos, miembros de la comunidad e instituciones de esas localidades. El modelo propuesto de integración de recursos personales y comunitarios para la atención de la salud contempla la creación de programas de sensibilización, información y capacitación para los pobladores de la comunidad y los prestadores de servicios; el sistema etnomédico y el sistema formal de salud se proponen como indispensables

"No hacen viejos los años, sino los daños": envejecimiento y salud en varones rurales

Objetivo. Analizar los factores sociales asociados al estado de salud de hombres mayores de 60 años que viven en contextos de pobreza en áreas rurales de México. Material y métodos. De febrero a octubre de 2002 se llevó a cabo un estudio transversal, descriptivo, con una muestra intencional de 392 adultos mayores residentes de zonas rurales de los estados de Guerrero, Morelos y Jalisco, utilizando un cuestionario especialmente diseñado y piloteado con anterioridad. Las variables de estudio incluyeron características sociodemográficas, bienestar generalizado, problemas de salud, consumo de algunos alimentos y algunos indicadores de salud mental, fuerza personal y apoyo social. Utilizando el paquete estadístico SPSS v. II.I se llevaron a cabo pruebas de Ji cuadrada de Pearson para variables categóricas; para analizar el consumo diferencial de alimentos se hicieron pruebas de ANOVA de una vía. Resultados. Los ancianos de este estudio eran casados o viudos y tenían un promedio de seis hijos. Los ancianos de Morelos informaron haber padecido un mayor número de enfermedades y haber tenido un consumo más alto de bebidas alcohólicas, en comparación con los ancianos de los otros dos estados. De la muestra total, 60% notificaron el uso tanto de remedios caseros como de medicamentos para aliviar sus malestares de salud. Más de la mitad no recibía apoyo familiar adecuado. Conclusiones. Los resultados de este estudio sugieren que el proceso de envejecimiento entre los hombres participantes es percibido como una carga, fundamentalmente debido al contexto de pobreza en que viven. La falta de ingresos suficientes y acceso a servicios de salud a través de planes de pensión y jubilación adecuados para los ancianos que viven en pobreza, es un problema que requiere de atención inmediata

SDH-NET: a South–North-South collaboration to build sustainable research capacities on social determinants of health in low- and middle-income countries

Background: It is desirable that health researchers have the ability to conduct research on health equity and contribute to the development of their national health system and policymaking processes. However, in low- and middle-income countries (LMICs), there is a limited capacity to conduct this type of research due to reasons mostly associated with the status of national (health) research systems. Building sustainable research capacity in LMICs through the triangulation of South–North-South (S-N-S) collaborative networks seems to be an effective way to maximize limited national resources to strengthen these capacities. This article describes how a collaborative project (SDH-Net), funded by the European Commission, has successfully designed a study protocol and a S-N-S collaborative network to effectively support research capacity building in LMICs, specifically in the area of social determinants of health (SDH); this project seeks to elaborate on the vital role of global collaborative networks in strengthening this practice. Methods: The implementation of SDH-Net comprised diverse activities developed in three phases. Phase 1: national level mapping exercises were conducted to assess the needs for SDH capacity building or strengthening in local research systems. Four strategic areas were defined, namely research implementation and system performance, social appropriation of knowledge, institutional and national research infrastructure, and research skills and training/networks. Phase 2: development of tools to address the identified capacity building needs, as well as knowledge management and network strengthening activities. Phase 3: identifying lessons learned in terms of research ethics, and how policies can support the capacity building process in SDH research. Results: The implementation of the protocol has led the network to design innovative tools for strengthening SDH research capacities, under a successful S-N-S collaboration that included national mapping reports, a global open-access learning platform with tools and resources, ethical guidelines for research, policy recommendations, and academic contributions to the global SDH discourse. Conclusions: The effective triangulation of S-N-S partnerships can be of high value in building sustainable research capacity in LMICs. If designed appropriately, these multicultural, multi-institutional, and multidisciplinary collaborations can enable southern and northern academics to contextualize global research according to their national realitie

Economic and social consequences of COVID-19 and mental health burden among Latinx young adults during the 2020 pandemic

Latinx young adults 18–25 years old face unique challenges that disproportionately put them at high risk of experiencing health as well as economic and social burden due to the Coronavirus disease (COVID-19) pandemic. The present study examined how economic and psychosocial consequences as a result of the pandemic were associated with mental health issues among a community sample of Latinx young adults (N = 83) from Central Texas. Participants completed an online survey of COVID-related experiences and mental health needs. The survey asked about personal and family experiences of COVID-19 in two significant areas: (a) economic strain (e.g., economic hardship, food insecurity) and (b) psychosocial burden (e.g., losing relationships, substance use). Regression analyses examined the association of COVID-19 consequences on level of mental health symptoms and clinically significant outcomes. Relative to economic consequences, psychosocial consequences due to the COVID-19 pandemic were associated with higher levels of mental health symptoms. In contrast, in few cases, economic strain resultant from the pandemic was correlated with clinically significant outcomes among this sample. Collectively, findings suggest that the costs of the pandemic do not only pertain to mortality from illness but also to morbidity as it relates to deteriorating social circumstances and mental health. Findings from this study call for immediate attention to implement policies and programs to help mitigate the economic and social–emotional consequences of COVID-19 such as easy access to low-cost virtual mental health resources to Latinx young adults

It was really painful to watch:” Latinx young adults’ experiences of proximal and collective witnessing

Latinxs in the United States have been targeted by racialized immigration policies that threaten the well-being of not only those directly affected but also those who witness the hardship brought about by these events. This study explored Latinx young adults’ experiences of witnessing hardship brought to others both personally and among the collective. Data from 21 individual interviews were analyzed using thematic analysis. Analyses revealed four themes across two research questions describing what types of events Latinx young adults report witnessing as well as the effects of this witnessing. Types of witnessing included (a) proximal witnessing, describing experiences of witnessing that are localized or experience-near; (b) collective witnessing, relating to experiences of witnessing among the collective Latinx population; and effects included (c) internalized effects, representing the ways that the experiences of others were internalized; and (d) mobilizing effects, in which participants engaged in behavioral changes resulting from witnessing the experiences of others. Findings point to the need to consider the deleterious effects of vicarious trauma among communities of color in the United States and further implications for practice and policy