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SPEAKING TO a gymnasium full of high schoolers in 2015, Angela Merkel sought to explain why Germany needed to close its borders to the tide of Syrian refugees. She was [...]

Research has consistently linked discrimination and poorer health; however, fewer studies have focused on immigration-related discrimination and mental health outcomes. Drawing on quantitative surveys (N = 1,131) and qualitative interviews (N = 63) with Latino undergraduate students who are undocumented or U.S. citizens with undocumented parents, we examine the association between perceived immigration-related discrimination and mental health outcomes and the process through which they are linked. Regression analyses identify an association between immigration-related discrimination and increased levels of depression and anxiety; this relationship did not vary by self and parental immigration status. Interview data shed light on this result as immigration-related discrimination manifested as individual discrimination as well as vicarious discrimination through family and community members. We contend that immigration-related discrimination is not limited to individual experiences but rather is shared within the family and community, with negative implications for the mental health of undocumented immigrants and mixed-status family members.

The US is the world leader in imprisoning immigrants. Its mass immigration detention system emerged as an extension of mass incarceration, rooted in a legacy of racist US immigration and criminal laws. Immigration policy is a structural determinant of health that negatively affects the health of imprisoned immigrants, their families, and their communities. The systemic harms of detention facilities, which we refer to as immigration prisons, have been extensively documented, yet incrementalist reforms have failed to result in improved outcomes for immigrants. We argue that ending the practice of immigrant imprisonment is the most effective solution to mitigating its harms. Community-based programs are safer and less expensive than imprisonment, while also being effective at ensuring compliance with government requirements. We identify several priorities for researchers and policy makers to tackle the health inequities resulting from this structurally racist system. These include applying a critical, intersectional lens to studying the policies and practices that drive imprisonment, engaging affected communities in research and policy development, and creating an accountable and transparent system of data collection and release to inform health interventions. The reliance of the US on immigrant imprisonment is a policy choice with immense social and economic costs; dismantling it is critical to advancing health equity.

Although exclusionary immigration policies are associated with fear of deportation and avoidance of public benefits, relationships between immigration enforcement policy and public charge policies are largely unknown. Using a California population-based survey of 1103 Asian and Latinx immigrants in 2018, we tested the relationship between immigrants experiences with law enforcement and their concern about public charge. Direct encounters with various forms of law enforcement, including being asked to show proof of citizenship by law enforcement, staying inside to avoid police or immigration officials, and having known someone who had been deported, were associated with immigrants avoidance of public benefits due to public charge concerns. Latinx immigrants were more likely to be concerns about public charge than Asians. Intersections among immigration policies deserve further consideration. There is a need to provide accurate and reliable information to immigrant communities about public benefits and advocate for inclusive immigration policies.

A framework termed "the citizenship shield" is introduced to conceptualize how legal protections buffer against negative health outcomes among Latinx immigrants in the United States. In this study, we tested the citizenship shield framework in the context of the disproportionate impact of the COVID-19 pandemic on Latinx immigrants. We investigated the connection between immigration status, discrimination, food insecurity, and negative health outcomes. Analyses involved testing mediation and moderation models among a community-based sample of 536 Latinx immigrants holding five statuses (i.e., U.S. citizenship, permanent residency, Deferred Action for Childhood Arrivals, undocumented, and temporary status). Results suggested that food insecurity mediated the link between discrimination and negative impacts from the pandemic for Latinx immigrants across all statuses. Follow up analyses suggested that two of the three paths were moderated by immigration status. This research provides novel, important data to inform health interventions and federal policy targeted for the most vulnerable immigrants in the United States.

Colonialism can be seen as a historical process, or an ideology. As this article demonstrates, for Canadian Doukhobors, it is also a lived experience. Canadian Doukhobors, or Spirit Wrestlers, are a group of pacifist religious dissenters of mixed ethnic origins who immigrated to Canada from the Russian Empire in 1899. The worldview of the Doukhobors was radically different from the principles on which the colonial government was founded. The goal of this article is to describe the colonial policies directed towards the Doukhobors, their anticolonial struggles, and to consider the implications of the Doukhobor history for contemporary anti-colonial thought in Canada and worldwide. The government subjected Doukhobors to a range of discriminatory actions including cancellation of earlier granted land registries in Saskatchewan, incarcerations for refusal of military service (despite an existing legal exemption), taking away children of some Doukhobors and placing them in a juvenile detention center to force the assimilation. While considering the significance of the Doukhobor struggles against colonialism, the article proposes a new term, 'colonial privilege.' This article is reflexive and sheds a new light on the earlier recorded facts. Keywords: Anti-colonialism, anti-racism, colonial privilege, Doukhobors (Spirit Wrestlers), linguicism, pacifism. Le colonialisme peut etre considere comme un processus historique ou une ideologie. Comme le demontre cet article, pour les Doukhobors canadiens, il s'agit egalement d'une experience vecue. Les Doukhobors canadiens, ou lutteurs spirituels, sont un groupe de dissidents religieux pacifistes d'origines ethniques diverses qui ont immigre au Canada en provenance de l'Empire russe en 1899. La vision du monde des Doukhobors etait radicalement differente des principes sur lesquels le gouvernement colonial etait fonde. L'objectif de cet article est de decrire les politiques coloniales menees a l'encontre des Doukhobors, leurs luttes anticoloniales et d'examiner les implications de l'histoire des Doukhobors pour la pensee anticoloniale contemporaine au Canada et dans le monde. Le gouvernement a soumis les Doukhobors a toute une serie d'actions discriminatoires, notamment l'annulation de l'enregistrement des terres octroyees anterieurement en Saskatchewan, l'incarceration pour refus du service militaire (malgre une exemption legale existante), l'enlevement des enfants de certains Doukhobors et leur placement dans un centre de detention pour mineurs afin de les forcer a s'assimiler. Tout en considerant l'importance des luttes des Doukhobors contre le colonialisme, l'article propose un nouveau terme, celui de 'privilege colonial'. Cet article est reflexif et jette une nouvelle lumiere sur les faits precedemment repertories. Mots-cles : Anticolonialisme, antiracisme, privilege colonial, Doukhobors (Lutteurs Spirituels), linguisme, pacifisme., 'We were brought here on a ship that had been transporting cattle, and we were treated like cattle' (from a poem in Russian by a Doukhobor). INTRODUCTION 'The pluralistic diversity' [...]

Little is known about how exclusionary immigration laws affect ethnic identity and self-esteem among Latinx middle school students. Arizonas SB 1070, which required local officers to verify the legal status of detained individuals, garnered national attention for its impact on immigrant and Latinx communities. This study tested a longitudinal parallel multiple mediation model where perceptions of the effects of an exclusionary immigration law (Arizonas SB 1070) on self-esteem were mediated by dimensions of ethnic identity (ethnic centrality, ethnic private regard, ethnic public regard). Data were collected from a two-wave survey of 891 early adolescents ranging in age from 10 to 14 years (M = 12.09 years; SD = 0.99), a majority (71%) of whom were of Mexican descent. Analyses revealed an indirect effect of T1 perceptions of this law on T2 self-esteem (7 months later), holding T1 measures constant, with T2 ethnic centrality, private regard, and public regard acting as mediators. Perceived effects of this exclusionary law led to increased self-esteem through increased dimensions of ethnic identity. Results reveal how ethnic identity functions as a multidimensional construct in the process through which exclusionary immigration policy may impact the self-esteem of Latinx early adolescents.

BackgroundThe objectives were to assess (a) the association between poor oral health and mild cognitive impairment (MCI) in Hispanic/Latino immigrants and (b) potential modification effects on this association by age at immigration.MethodsData were from the Hispanic Community Health Study/Study of Latinos and its ancillary study-the Study of Latinos-Investigation of Neurocognitive Aging. MCI, a binary outcome variable, defined by the National Institute on Aging-Alzheimer's Association criteria. The main exposure was significant tooth loss (STL), defined as a loss of 8 or more teeth, and periodontitis, classified using the Centers for Disease Control and Prevention and American Academy of Periodontology case classification. Multiple logistic regression was used to assess the association between STL/periodontitis and MCI and test moderation effects of age at immigration. The analytical sample comprised 5 709 Hispanic/Latino adult immigrants.ResultsHispanic/Latino immigrants with STL (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI]: 1.01-1.85) were more likely to have MCI than those with greater tooth retention. Overall, migration to the United States after age 18 was associated with greater odds of MCI than migration at a younger age. A significant interaction effect between STL and age at immigration revealed that the effect of STL on MCI is even higher in those who immigrated to the United States at ages 35-49 years.ConclusionsSTL is a significant risk factor for MCI and age at immigration had a modification effect on the association between STL and MCI. Better access to dental care, health education on risk factors of MCI, and promotion of good oral health may mitigate the burden of cognitive impairment in Hispanics/Latinos.

OBJECTIVES: Immigration enforcement policies are associated with immigrants barriers to health care. Current evidence suggests that enforcement creates a chilling effect in which immigrants avoid care due to fear of encountering enforcement. Yet, there has been little examination of the impact of immigrants direct encounters with enforcement on health care access. We examined some of the first population-level data on Asian and Latinx immigrants encounters with law and immigration enforcement and assessed associations with health care access. METHODS: We analyzed the 2018 and 2019 Research on Immigrant Health and State Policy survey in which Asian and Latinx immigrants in California (n=1681) reported on 7 enforcement experiences (eg, racial profiling and deportation). We examined the associations between measures of individual and cumulative enforcement experiences and the usual sources of care and delay in care. RESULTS: Latinx, compared with Asian respondents, reported the highest levels of enforcement experiences. Almost all individual enforcement experiences were associated with delaying care for both groups. Each additional cumulative experience was associated with a delay in care for both groups (OR=1.30, 95% CI 1.10-1.50). There were no associations with the usual source of care. CONCLUSION: Findings confirm that Latinx immigrants experience high levels of encounters with the enforcement system and highlight new data on Asian immigrants enforcement encounters. Direct experiences with enforcement have a negative relationship with health care access. Findings have implications for health systems to address the needs of immigrants affected by enforcement and for changes to health and immigration policy to ensure immigrants access to care.

Policy Points There is growing attention to the role of immigration and immigrant policies in shaping the health and well-being of immigrants of color. The early 21st century in the United States has seen several important achievements in inclusionary policies, practices, and ideologies toward immigrants, largely at subnational levels (e.g., states, counties, cities/towns). National policies or practices that are inclusionary toward immigrants are often at the discretion of the political parties in power. Early in the 21st century, the United States has implemented several exclusionary immigration and immigrant policies, contributing to record deportations and detentions and worsening inequities in the social drivers of health.

This study examines changes in the sociodemographic patterns of deportation and voluntary return of undocumented immigrants from the United States to Mexico during three US presidential administrations (2001 to 2019) with different immigration policies. Most previous studies examining these migration flows for the United States as a whole have relied exclusively on counts of deportees and returnees, thereby ignoring changes over the past 20 y in the characteristics of the undocumented population itself, i.e., the population at risk of deportation or voluntary return. We estimate Poisson models based on two data sources that permit us to compare changes in the sex, age, education, and marital status distributions of both deportees and voluntary return migrants with the corresponding changes in the undocumented population during the Bush, Obama, and Trump administrations: the Migration Survey on the Borders of Mexico-North (Encuesta sobre Migración en las Fronteras de México-Norte) for counts of deportees and voluntary return migrants and the Current Population Surveys Annual Social and Economic Supplement for estimated counts of the undocumented population living in the United States. We find that whereas disparities by sociodemographic characteristics in the likelihood of deportation generally increased beginning in Obamas first term, sociodemographic disparities in the likelihood of voluntary return generally decreased over this period. Despite heightened antiimmigrant rhetoric during the Trump administration, the changes in deportation and voluntary return migration to Mexico among the undocumented during Trumps term were part of a trend that began early in the Obama administration.

The 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.

INTRODUCTION: Women of color and immigrant women are more likely than US-born White women to report mistreatment and poor quality of care during their reproductive health care. Surprisingly little research exists on how language access may impact immigrant womens experiences of maternity care, particularly by race and ethnicity. METHODS: We conducted qualitative in-depth, one-on-one semi-structured interviews from August 2018 to August 2019 with 10 Mexican and eight Chinese/Taiwanese women (n = 18) living in Los Angeles or Orange County who gave birth within the past 2 years. Interviews were transcribed and translated, and data were initially coded based on the interview guide questions. We identified patterns and themes using thematic analysis methods. RESULTS: Participants described how a lack of translators and language- and cultural-concordant health care providers and staff impeded their access to maternity care services; in particular, they described barriers to communication with receptionists, providers, and ultrasound technicians. Despite Mexican immigrants ability to access Spanish-language health care, both Mexican and Chinese immigrant women described how lack of understanding medical concepts and terminology resulted in poor quality of care, lack of informed consent for reproductive procedures, and subsequent psychological and emotional distress. Undocumented women were less likely to report using strategies that leveraged social resources to improve language access and quality care. CONCLUSIONS: Reproductive autonomy cannot be achieved without access to culturally and linguistically appropriate health care. Health care systems should ensure that comprehensive information is given to women, in a language and manner they can understand, with particular attention toward providing in-language services across multiple ethnicities. Multilingual staff and health care providers are critical in providing care that is responsive to immigrant women.

ObjectivesWe examined the association of generational status and age at immigration with later life cognitive outcomes in a diverse sample of Latinos and Asian Americans.DesignBaseline data were obtained from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study, and a prospective cohort is initiated in 2017.SettingOlder adults in Northern California.ParticipantsOur cohort consisted of Asians (n = 411) and Latinos (n = 340) who were on average 76 years old (SD = 6.8).MeasurementsWe used multivariable linear regression models to estimate associations between generational status and age at immigration (collapsed into one five-level variable) with measures of verbal episodic memory, semantic memory, and executive function, adjusting for age, gender, race and ethnicity, and own- and parental education.ResultsGenerational status and age at immigration were associated with cognitive outcomes in a graded manner. Compared to third-generation or higher immigrants, first-generation immigration in adulthood was associated with lower semantic memory (β = -0.96; 95% CI: -1.12, -0.81) than immigration in adolescence (β = -0.68; 95% CI: -0.96, -0.41) or childhood (β = -0.28; 95% CI: -0.49, -0.06). Moreover, immigration in adulthood was associated with lower executive function (β = -0.63; 95% CI: -0.78, -0.48) than immigration in adolescence (β = -0.49; 95% CI: -0.75, -0.23). Similarly, compared to third-generation individuals, first-generation immigrants had lower executive functioning scores.ConclusionsOur study supports the notion that sociocontextual influences in early life impact later life cognitive scores. Longitudinal studies are needed to further clarify how immigration characteristics affect cognitive decline.

The share of US residents who were born in Latin America and the Caribbean plateaued in the last decade or so at about 6 percent of the total US population, [...]

Abstract Background The number of migrants and asylum seekers at the Mexico-US border has increased to historic levels. Our objective was to determine the medical diagnoses and treatments of migrating people seeking care in humanitarian clinics in Matamoros, Mexico. Methods We conducted a cross-sectional study of patient encounters by migrating people through a humanitarian clinic in Matamoros, Mexico, from November 22, 2019, to March 18, 2021. The clinics were operated by Global Response Medicine in concert with local non-governmental organizations. Clinical encounters were each coded to the appropriate ICD-10/CPT code and categorized according to organ system. We categorized medications using the WHO List of Essential Medicines and used multivariable logistic regression to determine associations between demographic variables and condition frequency. Results We found a total of 8,156 clinical encounters, which included 9,744 diagnoses encompassing 132 conditions (median age 26.8 years, female sex 58.2%). People originated from 24 countries, with the majority from Central America (n = 5598, 68.6%). The most common conditions were respiratory (n = 1466, 15.0%), musculoskeletal (n = 1081, 11.1%), and skin diseases (n = 473, 4.8%). Children were at higher risk for respiratory disease (aOR = 1.84, 95% CI: 1.61–2.10), while older adults had greater risk for joint disorders (aOR = 3.35, 95% CI: 1.73–6.02). Women had decreased risk for injury (aOR = 0.50, 95% CI: 0.40–0.63) and higher risk for genitourinary diseases (aOR = 4.99, 95% CI: 3.72–6.85) compared with men. Among 10,405 medications administered, analgesics were the most common (n = 3190, 30.7%) followed by anti-infectives (n = 2175, 21.1%). Conclusions In this large study of a migrating population at the Mexico-US border, we found a variety of clinical conditions, with respiratory, musculoskeletal, and skin illnesses the most common in this study period which encompassed a period of restrictive immigration policy and the first year of the COVID-19 pandemic.