Immigrant-blind care: How immigrants experience the "inclusive" health system as they access care.

A growing body of scholarship examines the varying impact of legal status and race on accessing healthcare. However, a notable gap persists in comprehending the supplementary mechanisms that hinder immigrants' pathway to seek care. Drawing on ethnographic observations in various clinical settings and in-depth interviews with 28 healthcare professionals and 12 documented Haitian immigrants in a city in Upstate New York, between 2019 and 2021, I demonstrate the tension between the conceptualization and implementation of inclusive care practices by healthcare providers. I argue that the mere expansion and adoption of inclusive discourse among providers do not inherently ensure equity and the removal of barriers to healthcare access. This work contributes to the social study of medicine and race and ethnic studies by introducing the innovative concept of "immigrant-blind." Through this concept, the research sheds light on how providers' conceptualization of inclusivity proclaims medical encounters to be devoid of stratifications and rationalizes their practices which mask the profound impact of immigration status and immigration on immigrant health. Furthermore, these practices reinforce existing divisions within care settings and medical encounters, where immigration laws and enforcement practices operate and further exacerbate stratifications. By examining providers' uninformed implementation of culturally competent care practices, the findings reveal that providers stigmatize and essentialize immigrants during medical encounters. This highlights the imperative for a more nuanced and informed approach to healthcare provision, where genuine inclusivity is upheld, and barriers to access are dismantled to foster equitable and dignified healthcare experiences for all.

Foot Health Assessment and Problem Identification in a Dominican Batey Community: A Descriptive Study.

PURPOSE: Foot problems can adversely impact foot function and quality of life. Foot problems are often overlooked, particularly in populations with limited health care access. Little is known about the foot health of Haitian immigrants who live and work in the bateyes (rural sugarcane villages) of the Dominican Republic. These immigrant workers may experience foot problems that could affect foot function and the ability to work and provide for their families. DESIGN: Cross-sectional, exploratory, descriptive study design. SUBJECTS AND SETTING: A convenience sample of adults was recruited from an ongoing community-based participatory research project evaluating a mobile hypertension screening and treatment clinic program in 11 Dominican batey communities. METHODS: Foot health was assessed using the Foot Problems Checklist, a 24-item survey instrument developed for this study based on a review of the literature and foot clinician expertise. A certified foot care nurse recorded foot health data on the Foot Problems Checklist via visual and physical inspection. RESULTS: Study participants were 25 females and 16 males, aged 18 to 90 years, and all had at least one foot health problem. The most common foot problems were calluses (78%), dry skin (76%), thick nails (59%), jagged nails (29%), long/overgrown nails (17%), and skin fissures (12%). CONCLUSIONS: While the foot problems we observed were not considered serious, they could become progressively debilitating and be prevented with proper self-management guided by appropriate knowledge and skills and available supplies. We recommend the development and testing of foot care self-management interventions deliverable via mobile clinics to increase access and improve foot health outcomes.

Determinantes sociais da saúde que impactam a vivência da imigração no Brasil / Social determinants of health that impact the experience of immigration in Brazil / Determinantes sociales de la salud que impactan la experiencia de la inmigración en Brasil

Objetivo: compreender as percepções dos imigrantes haitianos sobre os Determinantes Sociais da Saúde que impactam a vivência da imigração. Método: pesquisa qualitativa, do tipo pesquisa ação participante, fundamentada no Itinerário de Pesquisa de Paulo Freire, que constitui três fases: Investigação Temática; Codificação e Descodificação; Desvelamento Crítico. Realizou-se Círculo de Cultura, no segundo semestre de 2019, com a participação de 12 imigrantes haitianos, estudantes universitários, residentes no oeste de Santa Catarina, Brasil, após aprovação pelo Comitê de Ética em pesquisa. Resultados: nos diálogos emergiram duas temáticas para discussão como determinação social da saúde e doença: saúde do imigrante no Brasil; desafios de estudar e trabalhar. Conclusão: A iniquidade de acesso aos direitos, escasso tempo para dormir e praticar exercícios físicos, saudade do Haiti, dificuldade financeira, adaptação à cultura brasileira e discriminação foram apontados como fatores determinantes que afetam a saúde. Urge a necessidade da construção de políticas públicas que garantam os direitos dos imigrantes no Brasil.

Objective: to understand the perceptions of Haitian immigrants about the social determinants of health that impact on the experience of immigration. Method: this qualitative, participant action study was based on Paulo Freire's research itinerary, which consists of three phases: thematic research; encoding and decoding; and critical unveiling. A "culture circle" was held, after ethics committee approval, in the second half of 2019, with the participation of 12 immigrant Haitian university students residing in western Santa Catarina, Brazil. Results: in the dialogues, two themes emerged for discussion as representing the social determination of health and disease: immigrants' health in Brazil; and challenges of studying and working. Conclusion: inequity in access to rights, lack of time to sleep and exercise, homesickness for Haiti, financial difficulties, adaptation to Brazilian culture, and discrimination were identified as determinant factors that affect health. There is an urgent need to build public policies to guarantee immigrants' rights in Brazil.

Objetivo: comprender las percepciones de los inmigrantes haitianos sobre los determinantes sociales de la salud que impactan en la experiencia de la inmigración. Método: este estudio cualitativo de acción participante se basó en el itinerario de investigación de Paulo Freire, que consta de tres fases: investigación temática; codificación y decodificación; y revelación crítica. Se realizó un "círculo cultural", luego de la aprobación del comité de ética, en el segundo semestre de 2019, con la participación de 12 estudiantes universitarios haitianos inmigrantes residentes en el occidente de Santa Catarina, Brasil. Resultados: en los diálogos surgieron dos temas de discusión que representan la determinación social de la salud y la enfermedad: la salud de los inmigrantes en Brasil; y desafíos de estudiar y trabajar. Conclusión: la inequidad en el acceso a los derechos, la falta de tiempo para dormir y hacer ejercicio, la nostalgia por Haití, las dificultades económicas, la adaptación a la cultura brasileña y la discriminación fueron identificadas como factores determinantes que afectan la salud. Urge construir políticas públicas para garantizar los derechos de los inmigrantes en Brasil.

Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal.

BACKGROUND: The province of Quebec (Canada) has implemented a breast cancer screening program to diagnose this cancer at an early stage. The strategy is to refer women 50 to 69 years old for a mammogram every two years by sending an invitation letter that acts as a prescription. Ninety per cent (90%) of deaths due to breast cancer occur in women aged 50 and over. Numerous studies have shown social inequalities in health for most diseases. With breast cancer, a significant paradox arises: its incidence is lower among disadvantaged women and yet, more of them die from this disease. The health care system might play a role in this inequality. The scientific literature documents the potential for creating such inequalities when prevention does not consider equity among social groups. Immigrant women are often disadvantaged. They die of breast cancer more than non-immigrants. Studies attribute this to late-stage diagnosis due to poor adherence to mammography screening programs. PURPOSE OF THE STUDY: The main objective of our research is to assess how Haitian immigrant women in Montreal are reached by the Quebec Breast Cancer Screening Program, and specifically how they perceive the mammogram referral letter sent by the program. METHODS: The study uses a two-step qualitative method: i) In-depth interviews with influential community workers to identify the most relevant issues; ii) Focus groups with disadvantaged women from Montreal's Haitian community. RESULTS: A mammogram referral letter from the Breast Cancer Screening Program may be a barrier to compliance with mammography by underprivileged Haitian women in Montreal. This might be attributable to a low level of literacy, poor knowledge of the disease, and lack of financial resources. CONCLUSION: Barriers may be underestimated in underprivileged immigrant and non-immigrant communities. A preventive strategy must be adapted to different sub-groups and must also take into account lower literacy levels. To increase mammography uptake, it is crucial that the benefits of prevention be clearly identified and described in understandable terms. Finally, economic access to follow-up measures should be considered.

Implementing Two Randomized Pragmatic Trials of HPV Self-sampling among Underserved Women: Challenges and Lessons Learned.

BACKGROUND: Haitian and Hispanic immigrant women experience substantial disparities in cervical cancer screening. Recently, our team completed two randomized trials of human papillomavirus (HPV) self-sampling as a cervical cancer screening strategy among Haitian and Hispanic women, using a community-based participatory research (CBPR) approach. OBJECTIVE: To reflect on lessons learned in the process of completing two large randomized cancer screening trials within underserved communities. METHODS: Haitian and Hispanic women were randomized to HPV self-sampling versus navigation to Pap smear versus standard cervical cancer screening education in the first trial, and HPV self-sampling delivered in-person versus via mail in the second trial. LESSONS LEARNED: During the two trials, our team encountered several challenges. The lessons learned from these challenges allowed for the strengthening of our community partnerships, study procedures, and our ability to conduct CBPR within an academic setting. CONCLUSIONS: Lessons learned from our trials may be useful to other researchers engaging in CBPR within underserved communities.

Stress and depression in the context of migration among Haitians in the United States.

Our global communities are becoming increasingly more diverse and interwoven; thus, research that enhances our understanding of the multidimensional relationship between depression and migration among distinct ethnic groups is imperative. This study examined the relationship between migration-related stress and depression and the extent to which that relationship is modified by other factors, through the lens of the stress process model. This cross-sectional pilot study used purposive sampling methods to recruit 76 first-generation Haitian immigrants living in South and West Florida from February 2018-May 2018. Descriptive statistics, bivariate and multiple regressions were utilized to assess associations among migration-related stress (Demands of Immigration Scale), depression (Center for Epidemiological Studies Depression (CESD), Zanmi Lasante Depression Symptom Inventory (ZLDSI)), and key demographic variables. Findings showed a strong positive correlation between migration-related stress and depression (CESD (ß =.606, 95% CI [.296, .556]) and ZLDSI (ß = .624, 95% CI [.242, .440]). Relative to the standardized coefficient, migration-related stress was the strongest predictor of depression after controlling for other predictors. Presence at the 2010 earthquake was the only significant moderator, showing an amplifying effect between migration-related stress and depression (ZLDSI) for those in Haiti during the 2010 earthquake. Consideration of pre-migration factors and the degree of migration-related stress encountered while adapting to life post-migration is critical because they play a significant role in shaping immigrants' depression realities. Community-based services that incorporate or partner with established immigrants to strengthen support for the most vulnerable immigrants early on after migration could serve to mitigate migration-related stressors and facilitate mental health promotion and prevention.

Parental Perceptions of Culturally Sensitive Care and Well-Child Visit Quality.

OBJECTIVE: Incorporating culturally sensitive care into well-child visits may help address pediatric preventive care disparities faced by racial and ethnic minorities, families with limited English proficiency, and immigrants. We explored parents' perspectives about the extent to which their children's pediatric care is culturally sensitive and potential associations between culturally sensitive care and well-child visit quality. METHODS: We conducted cross-sectional surveys with parents attending a well-child visit for a child ages 3 to 48 months. To measure culturally sensitive care, we created a composite score by averaging 8 subscales from an adapted version of the Clinicians' Cultural Sensitivity Survey. We assessed well-child visit quality through the Promoting Healthy Development Survey. Multivariate linear regression was used to understand associations between demographic characteristics and parent-reported culturally sensitive care. We used multivariate logistic regression to examine associations between culturally sensitive care and well-child visit quality. RESULTS: Two hundred twelve parents (71% of those approached) completed the survey. Parents born abroad, compared with those born in the United States, reported significantly higher culturally sensitive care scores (+0.21; confidence interval [CI]: 0.004, 0.43). Haitian parents reported significantly lower culturally sensitive care scores compared with non-Hispanic white parents (-0.49; CI: -0.89, -0.09). Parent-reported culturally sensitive care was significantly associated with higher odds of well-child visit quality including receipt of anticipatory guidance (adjusted odds ratio: 2.68; CI: 1.62, 4.62) and overall well-child visit quality (adjusted odds ratio: 2.54; CI: 1.59, 4.22). CONCLUSIONS: Consistent with prior research of adult patients, this study demonstrates an association between parent-reported culturally sensitive care and well-child visit quality. Future research should explore best practices to integrating culturally sensitive care in pediatric preventive health care settings.

Determinantes sociais da saúde de mulheres imigrantes haitianas: repercussões no enfrentamento da COVID-19 / Social determinants of health of Haitian immigrant women: repercussions in facing COVID-19

Objetivos: Compreender as repercussões da COVID-19 no contexto dos determinantes sociais da saúde de mulheres imigrantes haitianas. Método: Estudo qualitativo, tipo ação-participante, fundamentado nos pressupostos de Freire, realizando-se um Círculo de Cultura Virtual, com a participação de 11 mulheres imigrantes haitianas. Foram percorridas as etapas do Itinerário de Pesquisa: Investigação Temática; Codificação e Descodificação; Desvelamento Crítico. Resultados: Nos diálogos emergiram o medo em relação à pandemia, escassos recursos econômicos, preconceito e racismo como aspectos dos determinantes sociais de saúde, que implicam na sua saúde mental das imigrantes, mas que referiram sentir-se acolhidas no Brasil. Conclusão: A partir dos determinantes sociais da saúde, apresentados pelas mulheres imigrantes haitianas no enfrentamento da pandemia mostra- se relevante a articulação entre ações de promoção da saúde, com ênfase na competência cultural, de forma a estimular o empoderamento das pessoas.

Objectives: To understand the repercussions of COVID-19 in the context of the social determinants of health of Haitian immigrant women. Method: Qualitative, participatory action study, based on Freire's assumptions, with a Virtual Culture Circle andbthe participation of eleven Haitian immigrant women. The stages of the Research Itinerary were covered: Thematic Research; Encoding and Decoding; Critical Unveiling. Results: In the dialogues, fear of the pandemic, scarce economic resources, prejudice, and racism emerged as aspects of the social determinants of health, which affect the mental health of immigrants but who mentioned feeling welcomed in Brazil. Conclusion: Based on the social determinants of health, presented by Haitian immigrant women in facing the pandemic, the collaboration between health promotion actions is relevant, with an emphasis on cultural capability, in order to stimulate the empowerment of individuals.

Utilização de serviços de saúde por imigrantes haitianos na grande Cuiabá, Mato Grosso, Brasil / Use of health services by Haitian immigrants in Cuiabá-Mato Grosso, Brazil

Resumo O objetivo deste artigo é analisar a utilização de serviços de saúde por imigrantes haitianos residentes na grande Cuiabá, Mato Grosso. Trata-se de um estudo transversal, com uma amostra probabilística de 452 imigrantes haitianos residentes em Cuiabá e Várzea Grande, entrevistados entre dezembro de 2014 e fevereiro de 2015. Foram avaliadas as características sociodemográficas e de saúde, hábitos de vida e a utilização dos serviços de saúde. Na análise dos dados foram calculados o teste de Qui-quadrado e a Regressão de Poisson para investigar os fatores associados à utilização dos serviços de saúde. Verificou-se que 45,6% dos entrevistados utilizaram algum serviço de saúde no Brasil, sendo maior a prevalência entre as mulheres, aqueles com maior renda, maior tempo de residência no Brasil, melhor entendimento da língua portuguesa e que autoavaliaram sua saúde como ruim. Os principais serviços utilizados foram Unidade Básica de Saúde (UBS) e atendimento de urgência e emergência públicos. Conclui-se que os imigrantes foram assistidos pelo SUS em acordo com o princípio constitucional do direito à saúde no Brasil.

Abstract This paper aims to analyze the use of health services by Haitian immigrants in Cuiabá, Mato Grosso. This is a cross-sectional study with a random sample of 452 Haitian immigrants in Cuiabá and Várzea Grande, interviewed between December 2014 and February 2015. Sociodemographic and health characteristics, lifestyle factors, and the use of health services were evaluated. Data analysis included Chi-square test and Poisson regression to investigate the factors associated with the use of health services. We found that 45.6% of respondents used some health service in Brazil, with a higher prevalence of use among women, those with higher income, longer residence time in Brazil, better understanding of the Portuguese language, and with poor self-reported health. The PHC Unit (UBS) and public urgent and emergency care were the primary services used. We conclude by saying that the SUS assisted the immigrants under the Brazilian constitutional principle of the right to health.

A Comparative Case Series of Haitian and non-Haitian Stroke Patients at a Single Center in Miami, Florida.

INTRODUCTION: Although Florida is home to the largest number of Haitian immigrants, few studies exist regarding stroke in this population. METHODS: A comparative case series of Haitian (n=72) and non-Haitian (n=144) stroke patients was conducted. After matching for gender and stroke subtype (78.7% ischemic and 21.3% hemorrhagic), demographics, clinical characteristics, and outcomes were compared. RESULTS: Compared with non-Haitians, Haitian stroke patients were younger (67 vs 70.5 years; p=.0384), had higher diastolic blood pressures (88.2 vs 80.4 mm Hg; p=.006) and mean arterial pressures (112 vs 104.5 mm Hg; p=.01), and higher mean glycosylated hemoglobin values (7.2 vs 6.5 g/dL; p=.017). There were no significant differences in stroke severity or rates of tissue plasminogen activator (tPA) administration. Haitians were almost 80% less likely to have Medicare or private insurance (OR= 0.23; p<.001). DISCUSSION: Haitian immigrants need improved access to care and prevention of known stroke risk factors, including hypertension and hyperglycemia.

Use of health services by Haitian immigrants in Cuiabá-Mato Grosso, Brazil. / Utilização de serviços de saúde por imigrantes haitianos na grande Cuiabá, Mato Grosso, Brasil.

This paper aims to analyze the use of health services by Haitian immigrants in Cuiabá, Mato Grosso. This is a cross-sectional study with a random sample of 452 Haitian immigrants in Cuiabá and Várzea Grande, interviewed between December 2014 and February 2015. Sociodemographic and health characteristics, lifestyle factors, and the use of health services were evaluated. Data analysis included Chi-square test and Poisson regression to investigate the factors associated with the use of health services. We found that 45.6% of respondents used some health service in Brazil, with a higher prevalence of use among women, those with higher income, longer residence time in Brazil, better understanding of the Portuguese language, and with poor self-reported health. The PHC Unit (UBS) and public urgent and emergency care were the primary services used. We conclude by saying that the SUS assisted the immigrants under the Brazilian constitutional principle of the right to health.

O objetivo deste artigo é analisar a utilização de serviços de saúde por imigrantes haitianos residentes na grande Cuiabá, Mato Grosso. Trata-se de um estudo transversal, com uma amostra probabilística de 452 imigrantes haitianos residentes em Cuiabá e Várzea Grande, entrevistados entre dezembro de 2014 e fevereiro de 2015. Foram avaliadas as características sociodemográficas e de saúde, hábitos de vida e a utilização dos serviços de saúde. Na análise dos dados foram calculados o teste de Qui-quadrado e a Regressão de Poisson para investigar os fatores associados à utilização dos serviços de saúde. Verificou-se que 45,6% dos entrevistados utilizaram algum serviço de saúde no Brasil, sendo maior a prevalência entre as mulheres, aqueles com maior renda, maior tempo de residência no Brasil, melhor entendimento da língua portuguesa e que autoavaliaram sua saúde como ruim. Os principais serviços utilizados foram Unidade Básica de Saúde (UBS) e atendimento de urgência e emergência públicos. Conclui-se que os imigrantes foram assistidos pelo SUS em acordo com o princípio constitucional do direito à saúde no Brasil.

High Prevalence of Food Insecurity and Factors Associated with Haitian Immigrants in Southern Chile.

The objective was to determine the association between sociodemographic factors and food insecurity (FI) in Haitian immigrants in southern Chile. An analytical cross-sectional design was used. The sample consisted of Haitian immigrants residing in Southern Chile, who were recruited from community centers and completed a sociodemographic questionnaire and the Latin-American and Caribbean Food Security Scale. Multivariable analyses were performed to identify factors associated with FI. FI prevalence in the 234 participants was 78%; 60% had severe FI. Having children (OR 3.6; 95% CI 1.6-7.4), limited Spanish proficiency (OR 3.5; 95% CI 1.8-7.3), no access to basic services (OR 2.8; 95% CI 1.2-6.4), and not being a legal permanent resident (OR 2.4; 95% CI 1.1-6.1) were associated with significantly higher odds of FI. Over three-quarters of Haitian immigrants in southern Chile suffer from FI. Tailored intervention strategies are needed to address this major public-health issue, with a special focus on those at highest risk, including families with children, and those with limited Spanish proficiency, no access to basic services, and without legal permanent resident status.

La salud de trabajadores inmigrantes haitianos en Mato Grosso, Brasil: vulnerabilidades y riesgos / The health of Haitian immigrant workers in Mato Grosso, Brazil: vulnerabilities and risks

RESUMEN Se describen las relaciones entre inmigración, salud, trabajo y ambiente con el objetivo de analizar la inserción de inmigrantes haitianos en procesos productivos de Mato Grosso, destacando los riesgos para la salud y las vulnerabilidades socioambientales. Se trata de una investigación-acción desarrollada junto a la comunidad haitiana, organizaciones de la sociedad e instituciones del Estado. En 2014 y 2015 se aplicó un cuestionario a población haitiana de la ciudad de Cuiabá (capital del estado de Mato Grosso), para caracterizar sus condiciones de vida y trabajo. Además, se relevaron datos de distintas instituciones y el registro de empleadores que sometieron a trabajadores a condiciones de esclavitud contemporánea. Los resultados muestran 2.151 trabajadores haitianos registrados en el mercado formal de trabajo en 2014, distribuidos en 27 municipios de Mato Grosso. Dos sectores económicos se destacaron en la absorción de trabajadores haitianos: las industrias de transformación (principalmente frigoríficos) y la construcción civil. Entre los 452 haitianos entrevistados, el 52,7% estaba trabajando y el 26,5% mencionó una carga horaria semanal superior a 48 horas. El estudio indica la fragilidad de la inserción social de esta población, la cual se expresa en la presencia de haitianos en áreas y procesos productivos de alto riesgo socioambiental.

ABSTRACT The relationships among immigration, health, work and environment are explored with the aim of analyzing the insertion of Haitian immigrants in the productive processes of Mato Grosso, highlighting health risks and socioenvironmental vulnerabilities. An action research study was carried out in conjunction with the Haitian community, social organizations and State institutions. In 2014 and 2015, a questionnaire was applied among the Haitian population of the city of Cuiabá (capital state of Mato Grosso) to characterize living and working conditions. In addition, data from different institutions and the registry of employers that submitted workers to conditions of modern-day slavery were analyzed. The results include 2,151 Haitian workers involved in the formal labor market in 2014, distributed in 27 municipalities of Mato Grosso. Two economic sectors in particular absorbed Haitian workers: transformative industries (especially meat processing plants) and civil construction. Among the 452 Haitians interviewed, 52.7% were working and 26.5% reported a workweek longer than 48 hours. The study shows the fragility of the social insertion of this population, expressed through the presence of Haitians in areas and productive processes of high social risk.

Socioeconomic and Health Profile of Haitian Immigrants in a Brazilian Amazon State.

We analyzed the sociodemographic profile, migration journey, health conditions, and health care access and utilization among recent Haitian immigrants to the Brazilian Amazon state of Mato Grosso. We conducted a cross-sectional study with a probabilistic sample of 452 Haitians. We administered a bilingual questionnaire from December 2014 to February 2015. Data were analyzed using chi square tests to evaluate differences among groups. The majority of participants were married men younger than 35 years old. They mostly came from the Haiti's Artibonite Department, living in Brazil for less than a year. Half of the participants were employed at the time of the interviews, and 81.8% relied exclusively on the Brazilian Unified Healthcare System for medical care. The overall health profile and health care access were good. Haitian migration to Brasil is a case of South-South migration driven by economic needs. Our population had good health status despite socioeconomic challenges.

"Sex Is a sin": Afro-Caribbean Parent and Teen Perspectives on Sex Conversations.

This study characterized (a) mothers' childhood and teenage experiences with sex conversations and (b) families' perceptions of current parent-child sex conversations within two underserved Afro-Caribbean communities in the U.S. Fourteen dyads comprised of Haitian and Jamaican mothers and teens (aged 14-18) living in Miami, Florida, completed semi-structured interviews sharing their experiences with sex conversations. Researchers analyzed data using thematic content analysis. Mothers' mean age was 41.85 years, (SD = 5.50) and teens' mean age was 16.35 years, (SD = 1.31). Most mothers reported forbidden or little childhood experiences with parent-child sex conversations. They affected their sexual attitudes, behaviors, and ability to discuss sex with their children. Although some mothers benefited from educational and skill development others shared fear-based messages with their children that some teens believed adversely affected the mother-child relationship quality. Culturally appropriate, skill-based approaches are necessary to improve families' communication self-efficacy for healthy sex conversations to occur in Afro-Caribbean families.

[The health of Haitian immigrant workers in Mato Grosso, Brazil: vulnerabilities and risks]. / La salud de trabajadores inmigrantes haitianos en Mato Grosso, Brasil: vulnerabilidades y riesgos.

The relationships among immigration, health, work and environment are explored with the aim of analyzing the insertion of Haitian immigrants in the productive processes of Mato Grosso, highlighting health risks and socioenvironmental vulnerabilities. An action research study was carried out in conjunction with the Haitian community, social organizations and State institutions. In 2014 and 2015, a questionnaire was applied among the Haitian population of the city of Cuiabá (capital state of Mato Grosso) to characterize living and working conditions. In addition, data from different institutions and the registry of employers that submitted workers to conditions of modern-day slavery were analyzed. The results include 2,151 Haitian workers involved in the formal labor market in 2014, distributed in 27 municipalities of Mato Grosso. Two economic sectors in particular absorbed Haitian workers: transformative industries (especially meat processing plants) and civil construction. Among the 452 Haitians interviewed, 52.7% were working and 26.5% reported a workweek longer than 48 hours. The study shows the fragility of the social insertion of this population, expressed through the presence of Haitians in areas and productive processes of high social risk.

Se describen las relaciones entre inmigración, salud, trabajo y ambiente con el objetivo de analizar la inserción de inmigrantes haitianos en procesos productivos de Mato Grosso, destacando los riesgos para la salud y las vulnerabilidades socioambientales. Se trata de una investigación-acción desarrollada junto a la comunidad haitiana, organizaciones de la sociedad e instituciones del Estado. En 2014 y 2015 se aplicó un cuestionario a población haitiana de la ciudad de Cuiabá (capital del estado de Mato Grosso), para caracterizar sus condiciones de vida y trabajo. Además, se relevaron datos de distintas instituciones y el registro de empleadores que sometieron a trabajadores a condiciones de esclavitud contemporánea. Los resultados muestran 2.151 trabajadores haitianos registrados en el mercado formal de trabajo en 2014, distribuidos en 27 municipios de Mato Grosso. Dos sectores económicos se destacaron en la absorción de trabajadores haitianos: las industrias de transformación (principalmente frigoríficos) y la construcción civil. Entre los 452 haitianos entrevistados, el 52,7% estaba trabajando y el 26,5% mencionó una carga horaria semanal superior a 48 horas. El estudio indica la fragilidad de la inserción social de esta población, la cual se expresa en la presencia de haitianos en áreas y procesos productivos de alto riesgo socioambiental.

Duvalier Regime in Haiti and Immigrant Health in the United States.

BACKGROUND: Haitians immigrate to the United States for many reasons, including the opportunity to escape political violence. The extant literature on Haitian immigrant health focuses on post-migration, rather than pre-migration, environments and experiences. Objective: In this study, we analyze health outcomes data from a nationally representative sample of Haitian immigrants in the United States from 1996 to 2015. We estimate age-adjusted associations between pre-migration residence in Haiti during the repressive regimes and generalized terror of Francois and Jean-Claude Duvalier, who ran Haiti from 1957 to 1986. METHODS: We used ordered probit regression models to quantify age-adjusted associations between the duration of pre-migration residence in Haiti during the Duvalier regime, and the distribution of post-migration health status among Haitian immigrants in the United States. Findings: Our study sample included 2,438 males and 2,800 females ages 15 and above. The mean age of males was 43.5 (standard deviation, 15.5) and the mean age of females was 44.7 (standard deviation, 16.6). Each additional decade of pre-migration residence in Haiti during the Duvalier regime is associated with a 2.9 percentage point decrease (95% confidence interval 0.6 to 5.3) in excellent post-migration health for males, and a 2.8 percentage point decrease (95% confidence interval, 0.8 to 4.8) for females. Within the subsample of Haitian immigrants with any pre-migration residence in Haiti during the Duvalier regime, each additional decade since the regime is associated with a 3.3 percentage point increase (95% confidence interval, 1.2 to 5.5) in excellent post-migration health for males, and a 2.3 percentage point increase (95% confidence interval, 0.5 to 4.1) for females. CONCLUSIONS: Overall, we found statistically significant and negative associations between the Duvalier regime and the post-migration distribution of health status 10 to 57 years later. We found statistically significant and positive associations between the length of time since the Duvalier regime and post-migration health.

Haitianos em São Paulo: exclusão e invisibilidade social no contexto da mobilidade urbana / Not available

A partir de 2004, quando o Exército Brasileiro foi para o Haiti, atendendo aos apelos da ONU e aos interesses diplomáticos e políticos internos, aquele país passou a ser um meio para o Brasil se posicionar no contexto das Relações Internacionais, atuando como pacificador em situações de conflito. Desde a chegada das tropas brasileiras ao Haiti, surgiu uma 'ponte' entre os dois países, abrindo um caminho para os haitianos que não contemplavam nenhuma possibilidade de construção de uma vida digna em seu país migrarem para outro. O Brasil, para eles, tornava-se um destino, no movimento migratório, cheio de idealizadas afinidades culturais, com grande número de negros, festivo, receptivo e àquela época, aparentemente próspero. Apesar da ´ponte´ entre os dois países, os imigrantes, ao chegarem ao Brasil, não encontram nada que idealizaram previamente à sua saída. A cidade de São Paulo, a maior cidade da América Latina poderia ser, em tese, o destino perfeito, com grandes oportunidades de trabalho e uma vida digna Há inúmeras barreiras que esses imigrantes transpõem até chegar à metrópole. Na própria legislação brasileira, que normatiza a condição de imigrante, se verifica resquícios que impedem de atender aos princípios básicos dos Direitos Humanos. No cenário, o objetivo geral desta pesquisa é o registro do fato de como os imigrantes haitianos se relacionam com as características da Capital paulista e da cultura nacional, enfrentando toda ordem de dificuldades e sofrimento social que uma trajetória sem planejamento ou estudo pode oferecer a seus protagonistas. Para consolidar estes objetivos adota-se uma metodologia lastreada no método qualitativo de pesquisa, bem como a etnografia, que humaniza o presente trabalho científico, com relatos reais dos personagens que compõem este cenário. Por fim, em concatenação ao registrado, descreve-se o cenário atual deste fenômeno sociológico

From 2004, when the Brazilian Army went to Haiti, in response to the appeals of the UN and to the internal diplomatic and political interests, that country became a means for Brazil to position itself in the context of International Relations, acting as a peacemaker in situations of conflict. Since the arrival of Brazilian troops in Haiti, a "bridge" has emerged between the two countries, opening a way for Haitians who did not contemplate any possibility of building a decent life in their country to migrate to another. Brazil, for them, became a destination in the migratory movement, full of idealized cultural affinities, with large numbers of blacks, festive, receptive and at that time, apparently prosperous. In spite of the 'point' between the two countries, immigrants, when arriving in Brazil, find nothing they had idealized prior to their departure. The city of São Paulo, the largest city in Latin America could be, in theory, the perfect destination, with great work opportunities and a dignified life There are numerous barriers that these immigrants transpose until reaching the metropolis. In the Brazilian legislation itself, which regulates the status of immigrant, there are remnants that prevent compliance with the basic principles of Human Rights. In the scenario, the general objective of this research is to record the fact that Haitian immigrants are related to the characteristics of the capital of São Paulo and of the national culture, facing any order of difficulties and social suffering that a trajectory without planning or study can offer its protagonists. To consolidate these objectives, a methodology based on the qualitative method of research is adopted, as well as the ethnography, which humanizes the present scientific work, with real reports of the characters that make up this scenario. Finally, in concatenation to the registered, the current scenario of this sociological phenomenon is described