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1.
BMC Public Health ; 24(1): 1261, 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38720262

RESUMEN

BACKGROUND: In Bangladesh, remittances constitute a substantial portion of the country's foreign exchange earnings and serve as a primary source of income. However, a considerable number of Bangladeshi citizens reside overseas without proper documentation, exposing them to significant challenges such as limited access to healthcare and socioeconomic opportunities. Moreover, their irregular migration status often results in engaging in risky health behaviors that further exacerbate their vulnerability. Hence, this study aimed to investigate the risky health behavior and HIV/STI susceptibility of Bangladeshi irregular international migrants residing across the globe with undocumented status. METHODS: Using a qualitative Interpretative Phenomenological Approach (IPA), 25 illegal migrants were interviewed who are currently living illegally or returned to their home country. The author used a thematic approach to code and analyze the data, combining an integrated data-driven inductive approach with a deductive approach. Concurrent processing and coding were facilitated by employing the Granheim model in data analysis. RESULTS: The study identified four risky health behaviors among irregular Bangladeshi migrants: hazardous living conditions, risky jobs, suicidal ideation, and tobacco consumption. Additionally, the authors found some HIV/STI risk behavior among them including engaging in unprotected sex, consuming alcohol and drugs during sexual activity, and having limited access to medical facilities. CONCLUSIONS: The findings of this study can be used by health professional, governments, policymakers, NGOs, and concerned agencies to develop welfare strategies and initiatives for vulnerable undocumented migrant workers.


Asunto(s)
Conductas de Riesgo para la Salud , Investigación Cualitativa , Enfermedades de Transmisión Sexual , Migrantes , Humanos , Bangladesh/etnología , Femenino , Masculino , Adulto , Enfermedades de Transmisión Sexual/etnología , Migrantes/estadística & datos numéricos , Migrantes/psicología , Adulto Joven , Persona de Mediana Edad , Inmigrantes Indocumentados/estadística & datos numéricos , Inmigrantes Indocumentados/psicología , Ideación Suicida , Asunción de Riesgos
2.
JAMA ; 330(3): 238-246, 2023 07 18.
Artículo en Inglés | MEDLINE | ID: mdl-37462705

RESUMEN

Importance: Professional medical organizations recommend that adults receive routine postpartum care. Yet, some states restrict public insurance coverage for undocumented immigrants and recently documented immigrants (those who received legal documentation status within the past 5 years). Objective: To examine the association between public insurance coverage and postpartum care among low-income immigrants and the difference in receipt of postpartum care among immigrants relative to nonimmigrants. Design, Setting, and Participants: A pooled, cross-sectional analysis was conducted using data from the Pregnancy Risk Assessment Monitoring System for 19 states and New York City including low-income adults with a live birth between 2012 and 2019. Exposure: Giving birth in a state that offered public insurance coverage for postpartum care to recently documented or undocumented immigrants. Main Outcomes and Measures: Self-reported receipt of postpartum care by the category of coverage offered (full coverage: states that offered publicly funded postpartum care regardless of immigration status; moderate coverage: states that offered publicly funded postpartum care to lawfully residing immigrants without a 5-year waiting period, but did not offer postpartum care to undocumented immigrants; no coverage: states that did not offer publicly funded postpartum care to lawfully present immigrants before 5 years of legal residence or to undocumented immigrants). Results: The study included 72 981 low-income adults (20 971 immigrants [29%] and 52 010 nonimmigrants [71%]). Of the 19 included states and New York City, 6 offered full coverage, 9 offered moderate coverage, and 4 offered no coverage; 1 state (Oregon) switched from offering moderate coverage to offering full coverage. Compared with the states that offered full coverage, receipt of postpartum care among immigrants was 7.0-percentage-points lower (95% CI, -10.6 to -3.4 percentage points) in the states that offered moderate coverage and 11.3-percentage-points lower (95% CI, -13.9 to -8.8 percentage points) in the states that offered no coverage. The differences in the receipt of postpartum care among immigrants relative to nonimmigrants were also associated with the coverage categories. Compared with the states that offered full coverage, there was a 3.3-percentage-point larger difference (95% CI, -5.3 to -1.4 percentage points) in the states that offered moderate coverage and a 7.7-percentage-point larger difference (95% CI, -10.3 to -5.0 percentage points) in the states that offered no coverage. Conclusions and Relevance: Compared with states without insurance restrictions, immigrants living in states with public insurance restrictions were less likely to receive postpartum care. Restricting public insurance coverage may be an important policy-driven barrier to receipt of recommended pregnancy care and improved maternal health among immigrants.


Asunto(s)
Emigrantes e Inmigrantes , Política de Salud , Accesibilidad a los Servicios de Salud , Cobertura del Seguro , Medicaid , Atención Posnatal , Adulto , Femenino , Humanos , Embarazo , Estudios Transversales , Emigrantes e Inmigrantes/legislación & jurisprudencia , Emigrantes e Inmigrantes/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Cobertura del Seguro/legislación & jurisprudencia , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/legislación & jurisprudencia , Seguro de Salud/estadística & datos numéricos , Medicaid/legislación & jurisprudencia , Medicaid/estadística & datos numéricos , Atención Posnatal/legislación & jurisprudencia , Atención Posnatal/estadística & datos numéricos , Política Pública/legislación & jurisprudencia , Estados Unidos/epidemiología , Política de Salud/legislación & jurisprudencia , Pobreza/estadística & datos numéricos , Inmigrantes Indocumentados/legislación & jurisprudencia , Inmigrantes Indocumentados/estadística & datos numéricos
3.
Hepatology ; 71(5): 1802-1812, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31487391

RESUMEN

BACKGROUND AND AIMS: Eleven million unauthorized immigrants reside in the United States and may account for 3% of deceased organ donors. Recently introduced federal and state legislation propose to address access to organ transplantation among unauthorized immigrants. The national landscape of liver transplantation (LT) for unauthorized immigrants is unknown. APPROACH AND RESULTS: We included all US LT recipients between March 2012 and December 2018 who were linked to Pew Center of Research data to estimate the population of unauthorized immigrants in each US state and by country of origin, based on US Census data. We categorized patients as unauthorized immigrants versus US citizens/residents. The main outcome measures were (1) the proportion of LTs performed for unauthorized immigrants compared with the proportion of unauthorized immigrants among total population in each US state and (2) graft failure and death post-LT. Of 43,192 LT recipients, 43,026 (99.6%) were US citizens/residents and 166 (0.4%) were unauthorized immigrants. Among unauthorized immigrants, most LTs were performed in California (47%) and New York (18%). The absolute difference in proportion of LTs performed for unauthorized immigrants compared with the proportion of unauthorized immigrants among the total population differed among states, ranging from +20% in California to -12% in Texas. The most common countries of birth among LT recipients who were unauthorized immigrants were Mexico (52%), Guatemala (7%), China (6%), El Salvador (5%), and India (5%). In competing risk analysis, unauthorized immigration status (vs. US citizens/residents) was associated with a similar risk of graft failure (subdistribution hazard ratio [sHR] 0.74; 95% confidence interval [CI], 0.40-1.34; P = 0.38) and death (sHR 0.68; 95% CI, 0.36-1.29; P = 0.23). CONCLUSIONS: LT for unauthorized immigrants is rare, and disparities in access to LT by state are present. Patient and graft survival among unauthorized immigrants is comparable with citizens/residents.


Asunto(s)
Inmigrantes Indocumentados/estadística & datos numéricos , China/etnología , El Salvador/etnología , Femenino , Rechazo de Injerto , Supervivencia de Injerto , Guatemala/etnología , Humanos , India/etnología , Trasplante de Hígado , Masculino , Persona de Mediana Edad , Estados Unidos
4.
Am J Public Health ; 111(8): 1497-1503, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33856877

RESUMEN

Under international law, the United States is obligated to uphold noncitizens' fundamental rights, including their rights to health. However, current US immigration laws-and their enforcement-not only fail to fulfill migrants' health rights but actively undermine their realization and worsen the pandemic's spread. Specifically, the US immigration system's reliance on detention, which precludes effective social distancing, increases risks of exposure and infection for detainees, staff, and their broader communities. International agreements clearly state that the prolonged, mandatory, or automatic detention of people solely because of their migration status is a human rights violation on its own. But in the context of COVID-19, the consequences for migrants' right to health are particularly acute. Effective alternatives exist: other countries demonstrate the feasibility of adopting and implementing immigration laws that establish far less restrictive, social services-based approaches to enforcement that respect human rights. To protect public health and realize its global commitments, the United States must shift away from detaining migrants as standard practice and adopt effective, humane alternatives-both amid COVID-19 and permanently.


Asunto(s)
COVID-19/prevención & control , Emigración e Inmigración/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Determinantes Sociales de la Salud/estadística & datos numéricos , Migrantes/estadística & datos numéricos , Inmigrantes Indocumentados/estadística & datos numéricos , COVID-19/epidemiología , Emigración e Inmigración/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Derechos Humanos/estadística & datos numéricos , Humanos , Derecho a la Salud/estadística & datos numéricos , Determinantes Sociales de la Salud/legislación & jurisprudencia , Justicia Social , Migrantes/legislación & jurisprudencia , Inmigrantes Indocumentados/legislación & jurisprudencia , Estados Unidos
5.
BMC Pregnancy Childbirth ; 21(1): 733, 2021 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-34715815

RESUMEN

BACKGROUND: The unregistered population remains under-researched because of its "invisible" status in statistics. Studies on perinatal health outcomes of unregistered women remains particularly limited. Our objectives were 1) to describe the sociodemographic profiles of women who are not legally residing in Belgium and 2) to analyze the associations of registration status with pregnancy outcomes according to socioeconomic status and nationality. METHODS: We analysed data from birth and death certificates taken from the Belgian civil registration system, linked with the National Population Registry (NPR). The data relates to all singleton babies born between 2010 and 2016 (n = 871,283), independent of their mother's NPR registration status. We used logistic regression to estimate the odds ratios for the associations between perinatal outcomes (perinatal mortality, prematurity and low birth weight) and maternal NPR registration status according to socioeconomic status and maternal nationality. RESULTS: Over the study period, 1.9% of births were to mothers without NPR-registration. Unregistered women from newer EU member states and non-European countries were particularly disadvantaged from a socioeconomic point of view. Apart from women with a South American nationality, all other groups of unregistered women had higher rates of prematurity, low birth weight, and perinatal mortality, compared to registered mothers (p < 0.0001). Unregistered women from Belgium and EU15 nationalities had particularly higher rates of prematurity, low birth weight, and perinatal mortality, compared to registered mothers, even after adjustment for socioeconomic status (p < 0.0001). The excess of perinatal mortality for non-European unregistered mothers could partly be explained by their precarious socioeconomic situation. CONCLUSIONS: This is the first study to include data on mothers who were not legally residing in Belgium. Unregistered women giving birth in Belgium are likely a heterogeneous socioeconomic group. Overall, unregistered women have increased risks of adverse perinatal outcomes, but it is likely that the causal mechanisms differ starkly between Belgian, European and non-European women. Further research is needed to understand the mechanisms behind these accrued rates. It is important to keep measuring the health outcomes of the populations which are "invisible" in national statistics, in order to identify the groups in most need of integration and access to services.


Asunto(s)
Etnicidad/estadística & datos numéricos , Recién Nacido de Bajo Peso , Mortalidad Perinatal , Mujeres Embarazadas/etnología , Nacimiento Prematuro , Clase Social , Inmigrantes Indocumentados/estadística & datos numéricos , Adulto , Bélgica/epidemiología , Femenino , Humanos , Lactante , Embarazo , Resultado del Embarazo/epidemiología , Sistema de Registros , Estadísticas Vitales , Poblaciones Vulnerables
6.
BMC Pregnancy Childbirth ; 21(1): 191, 2021 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-33676438

RESUMEN

BACKGROUND: Undocumented pregnant women constitute a vulnerable group of people who lack equal access to pregnancy care. Previous research has shown that undocumented migrants encounter difficulties in accessing health services, the onset of prenatal care is delayed, and women have an increased risk for infectious diseases. The aim of this study was to describe the use of maternal health care services and the obstetric outcomes of undocumented women in Helsinki, capital city of Finland, in addition to comparing the results with all pregnant women in Finland. METHODS: The study was a retrospective register-based study consisting of data collected between 2014 to 2018 from the electronic medical records of the public maternity clinic and maternity hospital in Helsinki, Finland. The study population consists of 62 individual pregnancies of undocumented women. The results of the study were compared with national data on parturients and deliveries (N = 47,274 women) and with prenatal screening tests for infectious diseases (N = 51,447 [HIV, HBV], N = 51,446 [syphilis]). RESULTS: The majority (91%) of the undocumented women attended public prenatal care. However, four women received no prenatal care and three women were denied access to care. Undocumented women entered prenatal care later and had fewer visits compared with all pregnant women. The majority (71%) of the undocumented women received inadequate prenatal care as the number of visits was less than eight. Of the study population, 5% (3/59) tested positive for HIV, 3% (2/59) for HBV, and 2% (1/57) for syphilis. The prevalence of HIV (p-value < 0.001) and HBV (p-value = 0.007) was significantly higher amongst undocumented women compared with all pregnant women. CONCLUSIONS: Undocumented women entered prenatal care later than recommended. Most women received inadequate prenatal care and some of them did not receive prenatal care at all. The prevalence of infectious diseases was significantly higher and the coverage of prenatal screenings deficient amongst undocumented pregnant women.


Asunto(s)
Servicios de Salud Materna , Atención Perinatal , Complicaciones Infecciosas del Embarazo , Diagnóstico Prenatal , Inmigrantes Indocumentados/estadística & datos numéricos , Adulto , Femenino , Finlandia/epidemiología , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Servicios de Salud Materna/normas , Servicios de Salud Materna/estadística & datos numéricos , Aceptación de la Atención de Salud , Atención Perinatal/métodos , Atención Perinatal/normas , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Diagnóstico Prenatal/métodos , Diagnóstico Prenatal/estadística & datos numéricos , Prevalencia , Poblaciones Vulnerables
7.
J Low Genit Tract Dis ; 25(2): 86-91, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33395153

RESUMEN

OBJECTIVE: This study compared cervical cancer knowledge, screening practices, and barriers to screening among undocumented and documented Hispanic women. MATERIALS AND METHODS: An anonymous cross-sectional survey was administered to self-identifying Hispanic women older than 21 years at community-based clinics and health care-focused community sites in Rhode Island. The survey included demographics, immigration status, questions related to cervical cancer knowledge, screening practices, and barriers to screening. Participants were stratified based on their immigration status. Categorical variables were compared by χ2 or Fisher exact test. Knowledge scores and the number of barriers were compared by t test and Wilcoxon rank sum test, respectively. p values of less than .05 were considered statistically significant. RESULTS: Seventy-three undocumented women and 70 documented women were enrolled. Undocumented women had a significantly lower mean cervical cancer knowledge score (3.53, SD =1.97) compared with documented women (4.43, SD = 2.04; p = .0085) and also experienced more barriers to having cervical cytology or a human papillomavirus test (p = .001). Eighty-eight percent of the undocumented women and 47% of the documented women did not have health insurance (p < .0001). Sixty-two percent of the undocumented women felt that their lack of documentation was a barrier to cervical cancer screening. Fifty percent of the undocumented and 47% of the documented women had never heard of the human papillomavirus vaccine. CONCLUSIONS: Undocumented women have significantly lower mean cervical cancer knowledge scores compared with documented women. A lack of legal documentation is a significant barrier to cervical cancer screening among Hispanic women. Challenges inherent to being undocumented may contribute to women's lower knowledge scores and more pronounced barriers.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Prueba de Papanicolaou/psicología , Prueba de Papanicolaou/estadística & datos numéricos , Inmigrantes Indocumentados/estadística & datos numéricos , Adulto , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Seguro de Salud , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Rhode Island , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino , Frotis Vaginal , Adulto Joven
8.
Annu Rev Public Health ; 41: 289-308, 2020 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-32237989

RESUMEN

Undocumented Latinx immigrants experience unique factors prior to migration, during migration, and after migration that shape their health. Our review summarizes the limited but growing literature highlighting how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect the mental and physical health of undocumented Latinx immigrants. We also discuss how policies and social ties can promote their health. We focus on areas of particular concern, including health care, mental health, and HIV. Future research should use interdisciplinary approaches and intersectional frameworks to understand and address health inequities. Conducting research with undocumented Latinx immigrant communities requires community engagement, assurance of confidentiality, and creative recruitment and retention strategies. Recommendations for public health practice include investing in community health centers and organizations to ensure access to health and social services; presenting results with sufficient contextualization to interpret their generalizability; and advocating for federal-, state-, and local-level policy changes that reduce the negative health consequences associated with being undocumented.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/tendencias , Hispánicos o Latinos/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Servicio Social/estadística & datos numéricos , Inmigrantes Indocumentados/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Predicción , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
9.
Med Care ; 58(6): 541-548, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32011423

RESUMEN

OBJECTIVES: We sought to determine the associations between maternal citizenship and health care access and utilization for US-born Latino youth and to determine whether maternal distress is a moderator of the associations. METHODS: Using 2010-2017 Integrated Public Use Microdata Series National Health Interview Survey data, multivariable logistic regressions were run to examine the associations among maternal citizenship and health care access and utilization for US-born Latino youth. Maternal citizenship and distress interactions were tested. RESULTS: Noncitizen mothers had higher odds of reporting uninsurance, lack of transportation for delaying care, and lower odds of health care utilization for their youth than citizen mothers. Compared with no distress, moderate and severe distress were positively associated with uninsurance, delayed medical care due to cost, lack of transportation, and having had an emergency department visit for their youth. Moderate distress was positively associated with youth having had a doctor's office visit. Noncitizen mothers with moderate distress were less likely to report their youth having had an emergency department visit than citizen mothers with moderate distress. Among severely distressed mothers, noncitizen mothers were more likely to report youth uninsurance and delayed care due to lack of transportation compared with citizen mothers. CONCLUSIONS: Health care access and utilization among US-born Latino youth are influenced by maternal citizenship and distress. Maternal distress moderates the associations among maternal citizenship and youth's health care access and use. Almost one-third of all US-born youth in the United States are Latino and current federal and state noninclusive immigration policies and anti-Latino immigrant rhetoric may exacerbate health care disparities.


Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Madres/estadística & datos numéricos , Aceptación de la Atención de Salud/etnología , Adolescente , Adulto , Estudios Transversales , Emigrantes e Inmigrantes/psicología , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Humanos , Lenguaje , Modelos Logísticos , Masculino , Madres/psicología , Factores Socioeconómicos , Estrés Psicológico/etnología , Inmigrantes Indocumentados/psicología , Inmigrantes Indocumentados/estadística & datos numéricos , Estados Unidos
10.
Am J Public Health ; 110(9): 1397-1404, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32673107

RESUMEN

Objectives. To estimate treatment rates of high cholesterol, hypertension, and diabetes among Hispanic/Latino immigrants by immigration status (i.e., naturalized citizens, documented immigrants, or undocumented immigrants).Methods. We performed a cross-sectional analyses of the Hispanic Community Health Study/Study of Latinos (visit 2, 2014-2017). We restricted our analysis to Hispanic/Latino immigrants with high cholesterol (n = 3974), hypertension (n = 3353), or diabetes (n = 2406); treatment was defined as use of statins, antihypertensives, and antidiabetics, respectively.Results. When compared with naturalized citizens, undocumented and documented immigrants were less likely to receive treatment for high cholesterol (38.4% vs 14.1%; prevalence ratio [PR] = 0.37 [95% confidence interval [CI] = 0.27, 0.51] and 25.7%; PR = 0.67 [95% CI = 0.58, 0.76]), hypertension (77.7% vs 57.7%; PR = 0.74 [95% CI = 0.62, 0.89] and 68.1%; PR = 0.88 [95% CI = 0.82, 0.94]), and diabetes (60.3% vs. 50.4%; PR = 0.84 [95% CI = 0.68, 1.02] and 55.8%; PR = 0.93 [95% CI = 0.83, 1.03]); the latter did not reach statistical significance. Undocumented and documented immigrants had less access to health care, including insurance coverage or a usual health care provider, than naturalized citizens. Therefore, adjusting for health care access largely explained treatment disparities across immigration status.Conclusions. Preventing cardiovascular disease among Hispanic/Latino immigrants should focus on undertreatment of high cholesterol, hypertension, and diabetes by increasing health care access, especially among undocumented immigrants.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Emigrantes e Inmigrantes/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Adulto , Anciano , Antihipertensivos/uso terapéutico , Estudios Transversales , Diabetes Mellitus/tratamiento farmacológico , Femenino , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Hipercolesterolemia/tratamiento farmacológico , Hipertensión/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Masculino , Persona de Mediana Edad , Factores de Riesgo , Inmigrantes Indocumentados/estadística & datos numéricos
11.
Int J Equity Health ; 19(1): 141, 2020 08 20.
Artículo en Inglés | MEDLINE | ID: mdl-32819364

RESUMEN

An estimated 2 million foreign-born migrants of working age (15-64) were living in South Africa (SA) in 2017. Structural and practical xenophobia has driven asylum-seekers, refugees, and undocumented migrants in SA to abject poverty and misery. The Coronavirus Disease 2019 (COVID-19) containment measures adopted by the SA government through the lockdown of the nation have tremendously deepened the unequal treatment of asylum-seekers and refugees in SA. This can be seen through the South African government's lack of consideration of this marginalized population in economic, poverty, and hunger alleviation schemes. Leaving this category of our society out of the national response safety nets may lead to negative coping strategies causing mental health issues and secondary health concerns. An effective response to the socioeconomic challenges imposed by the COVID-19 pandemic should consider the economic and health impact of the pandemic on asylum-seekers, refugees, and undocumented migrants.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Disparidades en el Estado de Salud , Neumonía Viral/epidemiología , Refugiados/estadística & datos numéricos , Inmigrantes Indocumentados/estadística & datos numéricos , Poblaciones Vulnerables/estadística & datos numéricos , Adolescente , Adulto , COVID-19 , Infecciones por Coronavirus/prevención & control , Gobierno , Humanos , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Factores Socioeconómicos , Sudáfrica/epidemiología , Adulto Joven
12.
Semin Dial ; 33(1): 52-57, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31909855

RESUMEN

Access to hemodialysis for undocumented immigrants with end stage renal disease (ESRD) is widely variable across the United States and highly dependent upon state policy. Some states have enacted policies to provide coverage for standard dialysis to undocumented immigrants, while other states do not provide coverage. Patients living in some states which do not provide coverage rely on emergency federal coverage through the Emergency Medical Treatment and Active Labor Act. However, this act requires that patients present with an acute, life-threatening condition in order to receive dialysis, which is then referred to as "emergency-only hemodialysis" (EoHD). Because EoHD requires patients to present in life-threatening condition, patients who rely on EoHD suffer from debilitating physical symptoms and psychosocial distress. Undocumented immigrants who receive EoHD also have staggeringly higher mortality rates than those who receive standard hemodialysis. Moreover, in comparison with standard dialysis, EoHD results in greater health care utilization and higher health care costs. Therefore, EoHD represents a very low value care practice, providing substandard care at a greater cost. Policy change is urgently needed to provide undocumented immigrants with ESRD access to the standard of care; that is, three-times weekly standard hemodialysis or peritoneal dialysis.


Asunto(s)
Política de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/organización & administración , Fallo Renal Crónico/terapia , Diálisis Renal , Inmigrantes Indocumentados/legislación & jurisprudencia , Humanos , Fallo Renal Crónico/epidemiología , Inmigrantes Indocumentados/estadística & datos numéricos , Estados Unidos
13.
Demography ; 57(5): 1597-1623, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32914332

RESUMEN

Immigration enforcement cooperation between final-destination and transit countries has increased in the last decades. I examine whether the Southern Border Plan, an immigration enforcement program implemented by the Mexican government in 2014, has curbed intentions of unauthorized migrants from El Salvador, Guatemala, and Honduras to migrate to the United States. I use the announcement of the Southern Border Plan to implement a difference-in-differences approach and compare the evolution of short-run intentions to engage in additional unauthorized crossings of Central American (treatment group) relative to Mexican deportees (comparison group). The findings suggest that increased enforcement in Mexico decreases the likelihood of attempting repeated unauthorized crossings.


Asunto(s)
Emigración e Inmigración/legislación & jurisprudencia , Emigración e Inmigración/estadística & datos numéricos , Aplicación de la Ley , Inmigrantes Indocumentados/estadística & datos numéricos , América Central/etnología , Humanos , México/epidemiología , Estados Unidos/epidemiología
14.
Demography ; 57(6): 2327-2335, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33123981

RESUMEN

Using nationally representative survey data, this research note examines the association between immigrant legal status and poverty in the United States. Our objective is to test whether estimates of this association vary depending on the method used to infer legal status in survey data, focusing on two approaches in particular: (1) inferring legal status using a logical imputation method that ignores the existence of legal-status survey questions (logical approach); and (2) defining legal status based on survey questions about legal status (survey approach). We show that the two methods yield contrasting conclusions. In models using the logical approach, among noncitizens, being a legal permanent resident (LPR) is counterintuitively associated with a significantly greater net probability of being below the poverty line compared with their noncitizen peers without LPR status. Conversely, using the survey approach to measure legal status, LPR status is associated with a lower net probability of living in poverty, which is in line with a growing body of qualitative and small-sample evidence. Consistent with simulation experiments carried out by Van Hook et al. (2015), the findings call for a more cautious approach to interpreting research results based on legal status imputations and for greater attention to potential biases introduced by various methodological approaches to inferring individuals' legal status in survey data. Consequently, the approach used for measuring legal status has important implications for future research on immigration and legal status.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Proyectos de Investigación/normas , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Asistencia Pública/estadística & datos numéricos , Reproducibilidad de los Resultados , Inmigrantes Indocumentados/estadística & datos numéricos , Estados Unidos
15.
BMC Public Health ; 20(1): 629, 2020 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-32375729

RESUMEN

BACKGROUND: Studies have observed that recent Latino immigrants tend to have a physical health advantage compared to immigrants who have been in the US for many years or Latinos who are born in the United States. An explanation of this phenomenon is that recent immigrants have positive health behaviors that protect them from chronic disease risk. This study aims to determine if trends in positive cardiovascular disease (CVD) risk behaviors extend to Latino immigrants in California according to citizenship and documentation status. METHODS: We examined CVD behavioral risk factors by citizenship/documentation statuses among Latinos and non-Latino US-born whites in the 2011-2015 waves of the California Health Interview Survey. Adjusted multivariable logistic regressions estimated the odds for CVD behavioral risk factors, and analyses were stratified by sex. RESULTS: In adjusted analyses, using US-born Latinos as the reference group, undocumented Latino immigrants had the lowest odds of current smoking, binge drinking, and frequency of fast food consumption. There were no differences across the groups for fruit/vegetable intake and walking for leisure. Among those with high blood pressure, undocumented immigrants were least likely to be on medication. Undocumented immigrant women had better patterns of CVD behavioral risk factors on some measures compared with other Latino citizenship and documentation groups. CONCLUSIONS: This study observes that the healthy Latino immigrant advantage seems to apply to undocumented female immigrants, but it does not necessarily extend to undocumented male immigrants who had similar behavioral risk profiles to US-born Latinos.


Asunto(s)
Enfermedades Cardiovasculares/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Emigración e Inmigración/estadística & datos numéricos , Conductas de Riesgo para la Salud , Hispánicos o Latinos/estadística & datos numéricos , Adulto , California/epidemiología , Enfermedades Cardiovasculares/epidemiología , Femenino , Disparidades en el Estado de Salud , Encuestas Epidemiológicas , Humanos , Actividades Recreativas , Modelos Logísticos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Factores de Tiempo , Inmigrantes Indocumentados/estadística & datos numéricos
16.
Eur J Public Health ; 30(6): 1186-1188, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33164047

RESUMEN

Despite concern on the impact of coronavirus disease 2019 (COVID-19) pandemic on undocumented immigrants, quantitative evidence on the issue is scant. We analyze socioeconomic and health conditions of 1590 undocumented immigrants in Milan, Lombardy, one of the regions with the highest COVID-19 clinical burden in the world that does not guarantee access to primary care for these individuals. We document a sharp reduction in visit number after lockdown, with 16% frequency of acute respiratory infections, compatible with COVID-19. Moreover, housing conditions make it difficult to implement public health measures. Results suggest the need to foster primary care by undocumented immigrants to face COVID-19 emergency.


Asunto(s)
COVID-19/epidemiología , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Inmigrantes Indocumentados/estadística & datos numéricos , Adulto , Factores de Edad , Estado de Salud , Vivienda/normas , Humanos , Italia/epidemiología , Persona de Mediana Edad , Pandemias , Atención Primaria de Salud/organización & administración , SARS-CoV-2 , Factores Sexuales , Factores Socioeconómicos
17.
Int J Health Plann Manage ; 35(1): e12-e27, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31710147

RESUMEN

OBJECTIVE: The objective of this study was to assess the impact of the stateless insurance scheme on inpatient service utilization of stateless patients in comparison to the universal coverage scheme (UCS) insurees and the uninsured. DESIGN: The retrospective study used the routinely collected health data (eg, 43-file database) from January 1,2013, to December 31,2017. The study took a sample of 9528 child patients aged 0to 18years who had an inpatient (IP)admission at the four selected district hospitals in Tak Province. The outcome variable was IP utilization rate (admissions/person/year), while the exposure was the three-insurance status: uninsured, stateless, and UCS. With the counted outcome data, the researchers applied the Poisson regression, taking confounders into account, to measure the effect of exposure on outcome. RESULTS: The overall median IP utilization rate was one admissions/person/year. Compared with the uninsured group, the stateless and the UCS insurees had 98% (incidence rate ratio [IRR]=1.980, 95% confidence interval [CI] = 1.250, 2.710) and 67% (IRR=1.670, 95% CI = 0.949, 2.390) higher IP admissions, respectively. The younger stateless insurees (2-3 years) had 16% (IRR=0.837, 95% CI=-0.036, 1.710) fewer admissions while oldest stateless insurees had 6% (IRR = 1.060, 95% CI = 0.235, 1.880) more admissions compared withtheir youngest uninsured counterpart (0-1 year). Stateless females had 21% (IRR=0.789, 95% CI = 0.344, 1.230) fewer IP admissions compared with their uninsured males counterparts. Overall IP utilization rate increased from 4% (IRR=1.040, 95% CI = 0.981,1.090) in 2014 to 14% (IRR=1.140, 95% CI = 1.070, 1.210) in 2017 compared with IP utilization in 2013. CONCLUSIONS: The study suggests that inpatient utilization rate differs by insurance status with statistical significance. Further experimental studies are needed to understand the causal effect of the stateless insurance on adverse health outcomes in stateless children in the country.


Asunto(s)
Hospitalización/estadística & datos numéricos , Hospitales de Distrito/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Inmigrantes Indocumentados/estadística & datos numéricos , Cobertura Universal del Seguro de Salud/estadística & datos numéricos , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Estudios Retrospectivos , Factores Sexuales , Tailandia
18.
Nurs Outlook ; 68(2): 242-251, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31526520

RESUMEN

BACKGROUND: It is widely acknowledged that experiences of poor treatment during health care encounters can adversely impact how individuals and communities engage with the health care system. Hence, understanding the health care seeking experiences of diverse patient populations is central to identifying ways to effectively engage with marginalized patients and provide optimal care for all patients, particularly those with marginalized identities. PURPOSE: Drawing on the narratives of 24 undocumented African immigrant women, this qualitative study aimed to understand their experiences seeking health care. METHODS: Our study was undergirded by a postcolonial feminist perspective which aims to situate participants' experiences within their given, broader societal context. Data were analyzed using the principles of thematic analysis. FINDINGS: Our findings indicate that women experienced insensitivity during health care encounters and harbored a mistrust of health care staff. DISCUSSION: Findings uncover the need for health care providers to provide culturally safe care and to identify ways to create safe spaces for undocumented patients within the health care setting.


Asunto(s)
Atención a la Salud/etnología , Atención a la Salud/estadística & datos numéricos , Emigrantes e Inmigrantes/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Inmigrantes Indocumentados/psicología , Inmigrantes Indocumentados/estadística & datos numéricos , Servicios de Salud para Mujeres/estadística & datos numéricos , Adulto , África , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Investigación Cualitativa , Estados Unidos/etnología
19.
Anthropol Med ; 27(4): 395-411, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32336126

RESUMEN

Drawing on hospital-based interviews and fieldwork in a deprived Parisian suburb, this paper analyses the spatio-temporal dynamics of risk, exposure, and mobilities in individual stories of undocumented Pakistani male migrants, and asylum seekers-receiving treatment for single and combined diagnoses of HIV, and Hepatitis C and B. Inviting alignments with the 'sexual' turn in mobility studies, it prioritises the interface of all-male undocumented migration, mobility, sexuality, and homosociality in circumscribing disease transmission geneaologies. It questions the extent to which illegal migration routes are transmission routes, and risk environments assume different levels of intensity in everyday life in Pakistan, during the journey, and in France. It emphasises inadequately addressed epidemics of HIV and hepatitis in Pakistan, the significance of unequal routes to migrant healthcare in France, and the transnational adaptation of homosocial and sexual behaviours, including MSM. These factors interplay with intensified vulnerabilities relating to childhood sexual abuse, family traumas, sexual risks related to illegal migration and undocumented status in France, chronic stresses leading to depleted mental and physical health, and restrictions on heterosexual sex facing marginalised migrants. Further, temporal vulnerabilities relate to the colonial criminalisation of homosexuality in Pakistan, widespread sexual violence-and forms of contemporary exclusion and hostility regarding Muslim migrants in Europe. Particularly, we emphasise the paradox, and need to sensitively address, a complex confluence of hidden risks that are deeply embedded in ethnic communities of solidarity and support. The findings trouble the tendency to partition global hepatitis and HIV prevalence rates by 'developed' and 'developing' country variation.


Asunto(s)
Emigración e Inmigración/estadística & datos numéricos , Infecciones por VIH/transmisión , Hepatitis Viral Humana/transmisión , Refugiados , Inmigrantes Indocumentados/estadística & datos numéricos , Adulto , Antropología Médica , Femenino , Homosexualidad Masculina , Humanos , Masculino , Persona de Mediana Edad , Pakistán/etnología , Paris , Factores de Riesgo , Adulto Joven
20.
Am J Epidemiol ; 188(1): 24-33, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30358825

RESUMEN

Unauthorized immigration is one of the most contentious policy issues in the United States. In an attempt to curb unauthorized migration, many states have considered restrictive laws intended to make life so difficult for unauthorized immigrants that they would choose to leave the country. Arizona's Senate Bill 1070, enacted in 2010, was a pioneering example of these efforts. Using population-level natality data and causal inference methods, we examined the effect of SB1070 on infants exposed before birth in Arizona. Prenatal exposure to the bill resulted in lower birth weight among Latina immigrant women, but not among US-born white, black, or Latina women. The decline in birth weight resulted from exposure to the bill being signed into law, rather than from its (limited) implementation. The findings indicate that the threat of a punitive law, even in the absence of implementation, can have a harmful effect on the birth outcomes of the next generation.


Asunto(s)
Peso al Nacer , Emigración e Inmigración/legislación & jurisprudencia , Inmigrantes Indocumentados/legislación & jurisprudencia , Inmigrantes Indocumentados/estadística & datos numéricos , Arizona/epidemiología , Femenino , Humanos , Embarazo , Estados Unidos/epidemiología
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