The Impact of Cultural Health Capital on Market Choice Along the Texas-Mexico Border.

Transnational cultural health capital (CHC) includes individual resources such as skills and behaviors patients use to manage healthcare exclusion and negotiate care. This study examines the impact of CHC on decisions by Hispanic people who live in El Paso, Texas, to utilize one or more markets for healthcare. We expand on the current literature and present novel findings by quantifying several aspects of CHC that may contribute to cross-border health-seeking behaviors in this vulnerable group which tends to suffer various health disparities and limited access to health insurance. Results support the hypotheses related to how the various cultural, social, and economic resources that comprise CHC affect market choices. This research has significant implications for understanding how border residents may mitigate a lack of accessibility and affordability for healthcare, developing transnational health policy, and aiding healthcare providers to understand their patients' choice(s) of healthcare markets.

The Implications of Health Disparities: A COVID-19 Risk Assessment of the Hispanic Community in El Paso.

Since the outbreak of the COVID-19 pandemic in the United States, Latinos have suffered from disproportionately high rates of hospitalization and death related to the virus. Health disparities based on race and ethnicity are directly associated with heightened mortality and burden of illness and act as underlying causes for the staggering impacts of COVID-19 in Latin communities in the United States. This is especially true in the city of El Paso, Texas, where over 82% of the population is Hispanic. To ascertain the level of danger that COVID-19 poses in El Paso, we constructed a point-in-time risk assessment of its Latin population and assessed a Latin individual's likelihood of hospitalization or death related to COVID-19 by comparing relevant health profiles with high-risk co-morbidities that the Centers for Disease Control (CDC) identified in 2020. Data for this risk assessment come from 1152 surveys conducted in El Paso. The assessment included comprehensive demographic, socioeconomic, and health data to analyze disparities across Hispanic sub-populations in the city. Results revealed that around 49.3% of Hispanics in the study had been previously diagnosed with a high-risk co-morbidity and therefore have an increased likelihood of hospitalization or death related to COVID-19. Additional factors that led to increased risk included low income, homelessness, lack of U.S. citizenship, and being insured. The findings from this study additionally demonstrate that structural inequality in the U.S. must be addressed, and preventive measures must be taken at local and state levels to decrease the mortality of pandemics. Baseline population health data can help with both of these goals.

Deservingness: migration and health in social context.

This article brings the social science concept of 'deservingness' to bear on clinical cases of transnational migrant patients. Based on the authors' medical social science research, health delivery practice and clinical work from multiple locations in Africa. Europe and the Americas, the article describes three clinical cases in which assumptions of deservingness have significant implications for the morbidity and mortality of migrant patients. The concept of deservingness allows us to maintain a critical awareness of the often unspoken presumptions of which categories of patients are more or less deserving of access to and quality of care, regardless of their formal legal eligibility. Many transnational migrants with ambiguous legal status who rely on public healthcare experience exclusion from care or poor treatment based on notions of deservingness held by health clinic staff, clinicians and health system planners. The article proposes several implications for clinicians, health professional education, policymaking and advocacy. A critical lens on deservingness can help global health professionals, systems and policymakers confront and change entrenched patterns of unequal access to and differential quality of care for migrant patients. In this way, health professionals can work more effectively for global health equity.

Hispanic health disparities and housing: Comparing measured and self-reported health metrics among housed and homeless Latin individuals.

Previous studies argue that Hispanics are healthier and less likely to experience homelessness than other populations in their same socioeconomic position. However, earlier studies have not explored the relationship between housing status and health for Latin individuals. This study examines 1) the health disparities between homeless and housed Hispanics in El Paso, Texas, and 2) the Hispanic health and homelessness paradoxes using an intersectional framework to understand health risks. A large number of Hispanic residents of El Paso (N = 1152) were surveyed. Demographic, health, and housing data were collected. We contribute to the literature by providing detailed health indicators for homeless Hispanics. To our knowledge, this is the first study to examine health disparities between housed and homeless Hispanics. Bivariate analysis, as well as data coded from interviews, indicated that homeless Hispanics were more likely to have barriers to care, less likely to have health insurance, slightly more likely than housed Hispanics to experience mental illness, alcoholism, and addiction, and more likely to be underdiagnosed for health problems, including hypertension. This study shows how certain traditional methods for collecting health data, including self-rated health and reported diagnoses, can be ineffective at revealing health disparities. This paper calls for innovative, mixed-methods approaches to understand the social and structural determinants of health for marginalized populations.

Substance Use by Immigrant Generation in a U.S.-Mexico Border City.

Immigrant generation status has an impact on substance use, with lower use rates for recent immigrants. Substance use surveillance data are reported at the national and state levels; however, no systematic collection of data exists at the city level for the general population. In particular, rates of substance use have not been published for El Paso, Texas. The aims of this study are to estimate the prevalence of substance use among Hispanics in El Paso and to determine the association between substance use and immigrant generation. Hispanic residents of El Paso (N = 837) were interviewed. Demographic, immigration, and substance use data were collected. Bivariate analysis indicated that substance use increased as immigrant generation increased, while perceived problems with substance use decreased. In comparison to Texas and national data, our data showed that the rates of tobacco, marijuana, and illicit drug use were lower among young adults in El Paso.

Health, hope, and human development: building capacity in public housing communities on the U.S.-Mexico border.

In this paper we highlight results from our recent survey of public housing residents living in the U.S.-Mexico border region. Our data inform our interdisciplinary (public health, education, environmental engineering, sociology) efforts to improve health and educational equity in our community, and provide ripe opportunities for policy advocacy.