Racial and Ethnic Disparities: Essential Workers, Mental Health, and the Coronavirus Pandemic.

Evidence is emerging of the pandemic disproportionately impacting communities of color. This study investigates mental health distress among essential workers during the coronavirus pandemic across race and ethnicity. We evaluate individual responses to the patient health questionnaire and general anxiety disorder questionnaire using a unique, nationally representative data set. Our findings suggest that essential healthcare workers reported the highest rates of mental health distress at the beginning of the coronavirus pandemic. However, when evaluated across race and ethnicity, we find that Black essential healthcare workers disproportionately report symptoms of anxiety; while, Hispanic essential healthcare workers disproportionately report symptoms of depression. Additionally, we find that being a Black or Hispanic essential nonhealthcare worker is associated with higher levels of distress related to anxiety and depression. These findings highlight the additional dimensions to which Black and Hispanic Americans may be disproportionately affected by the coronavirus pandemic. Furthermore, it calls into question how the essential worker classification, compounded by US unemployment policies, is potentially amplifying the mental health distress experienced by workers.

Latino parents' links to deportees are associated with developmental disorders in their children.

AIMS: To examine how Latino parent's personal connection to immigrants is linked to their children's risk of being referred/diagnosed with a developmental disorder. METHODS: Using the 2015 Latino National Health and Immigration Survey (n = 548), we asked adults about their connections to immigrants. We also asked if their child has been referred/diagnosed with a developmental disorder. We estimated a series of regressions to predict increases in the probability of a child being referred/diagnosed for a developmental disorder. RESULTS: Respondents who know a deportee are 2.4 times more likely (p = 0.009) to report that their child has been referred or diagnosed with a developmental disorder. Additionally, knowing more deportees, and having a closer family tie with deportees, are all statistically associated with developmental problems. CONCLUSIONS: This study adds to the emerging research on stress and child health, by examining the intersections of immigration policy, mental health, and child development.

Fear by Association: Perceptions of Anti-Immigrant Policy and Health Outcomes.

The United States is experiencing a renewed period of immigration and immigrant policy activity as well as heightened enforcement of such policies. This intensified activity can affect various aspects of immigrant health, including mental health. We use the Robert Wood Johnson Foundation 2015 Latino National Health and Immigration Survey (n = 1,493) to examine the relationship between immigration and immigrant policy and Latino health and well-being. We estimate a series of categorical regression models and find that there are negative health consequences associated with Latinos' perceptions of living in states with unfavorable anti-immigration laws, including reporting poor health and problems with mental health. This article builds on the work of public health scholars who have found a link between this heightened policy environment and the mental health of immigrants, yet expands on this research by finding that the health consequences associated with immigration policy extend to Latinos broadly, not just immigrants. These findings are relevant to scholars of immigration and health policy as well as policy makers who should consider these negative effects on the immigrant community during their decision-making process.

Language bias and self-rated health status among the Latino population: evidence of the influence of translation in a wording experiment.

PURPOSE: This research uses a translation experiment to assess the Spanish translation of the "fair" response in the self-rated health measure among a representative study of the Latino population in the USA. METHODS: Using a unique Latino-specific survey (n = 1200), researchers built in a split sample approach in the self-rated health status measure where half of the Spanish-speaking respondents (n = 600) were randomly given "regular" and the other half were given "Mas o Menos" in translating the English "fair" response. We first estimate a logistic regression model to estimate differences across language categories on the probability of reporting poor and fair health and then estimate a multinomial logistic regression to test whether respondents who took the survey in Spanish and given "regular" are more likely to rate their health as fair compared to English speakers and Spanish-speaking respondents who are given the "Mas o Menos" version. RESULTS: From our logistic regression model, we find that Spanish-speaking respondents given the "regular" response are more likely to report poor health relative to English-speaking respondents and Spanish-speaking respondents who were randomly given "Mas o Menos." The results from our multinomial logistic models suggest that Spanish respondents provided with "Mas o Menos" are more likely to rate their health as good relative to the base category of fair and relative to both English and Spanish speakers given "regular." CONCLUSION: This research informs the study of racial and ethnic disparities by providing a detailed explanation for mixed findings in the Latino health disparities literature. Researchers interested in self-rated health should translate the general self-rated health option "fair" to "Mas o Menos" as our wording experiment suggests that the current wording "regular" overinflates the reporting of poor health.

Child support and mixed-status families an analysis using the Fragile Families and Child Wellbeing Study.

A large body of literature documents the importance of child support for children's wellbeing, though little is known about the child support behaviors of mixed-status families, a large and rapidly growing population in the United States. In this paper, we use data from the Fragile Families and Child Wellbeing Study to investigate the impact of citizenship status on formal and informal child support transfers among a nationally representative sample of parents who have citizen children. Probit regression models and propensity score matching (PSM) estimators show that mixed-status families are significantly less likely to have child support orders and child support receipt compared to their citizen counterparts. We found that mothers' knowledge of the child support system increases the probability of establishing paternity. However, cultural differences in knowledge of and perception about the U.S. child support system between mixed-status families and citizen families do not have an impact on the probability of getting a child support order, child support receipt, or in-kind child support. Rather, institutional factors such as collaborations between welfare agencies and child support enforcement agencies as well as state child support enforcement efforts have a significant impact on formal child support outcomes. The results are robust against different model specifications, measure constructions, and use of datasets. These findings have important policy implications for policy makers and researchers interested in reducing child poverty in complex family structures and underscore the need to revisit child support policies for mixed-status families.

Taking a Closer Look at Group Identity: The Link Between Theory and Measurement of Group Consciousness and Linked Fate.

Scholarship in the area of group identity has expanded our understanding of how group consciousness and linked fate operate among racial and ethnic minority populations in the United States. What is yet to be tested is whether the measures employed adequately capture the multi-dimensional theoretical constructs associated with group consciousness across racial and ethnic populations. To address this question we make use of the 2004 National Political Study (n=3,339) and apply principle components analysis and exploratory factor analysis to assess whether measures used for both group consciousness and linked fate are interchangeable, as well as whether these measures are directly comparable across racial and ethnic populations. We find that the multidimensional approach to measuring group consciousness is a sound strategy when applied to African Americans, as the dimensions fit the African American experience more powerfully than is the case for Non-Hispanic Whites, Hispanics, and Asian populations. Our analysis suggests that scholars interesting in exploring group identity among the African-African population have fewer analytical concerns in this regard than those working with other populations where the underlying components associated with group consciousness appear to be operating differently.

IMMIGRATION ENFORCEMENT AND MIXED-STATUS FAMILIES: THE EFFECTS OF RISK OF DEPORTATION ON MEDICAID USE.

As Congress priorities the immigration debate on increased border security, the fate of an estimated 11 million undocumented citizens remains uncertain. Stuck in between partisan politics and practical solutions are mixed-status families in which some members of the family are U.S. citizens while other members are in the country without proper authorization. This paper, examines the relationship between risk of deportation and Medicaid use drawing from a nationally sample of mothers from the Fragile Families and Child Wellbeing Survey. These data are then merged with data from the U.S. Citizenship and Immigration Services to create a contextual risk of deportation measure. Findings suggest that an increase in risk of deportation is associated with a decrease in Medicaid use. The implications of this work have tremendous impacts for health service providers and policy makers interested in preventing and reducing health disparities in complex family structures.

Perceived Anti-Immigrant Climate, Health Care Discrimination, and Satisfaction with Care Among US Latino Adults.

A growing body of evidence has documented the effects of discrimination among Latinos. However, little is known about the impacts a noxious sociopolitical climate can have on their health and health care outcomes. The present study explored the associations between perceived anti-immigrant climate, health care discrimination, and satisfaction with care among US Latino adults. We used data from the 2015 Latino National Health and Immigration Survey (n = 1,284), a nationally representative sample of US Latino adults (ages 18 and older). Key predictors included living in a state whose policies are unfavorable towards immigrants, perceived anti-immigrant climate and/or anti-Hispanic climate, and health care discrimination. Ordered logistic regression models evaluated the associations between these predictors (adjusting for other relevant covariates) and satisfaction with care. Latinos living in state that is unfavorable towards immigrants were less likely to be satisfied with medical care they receive. Also, we found that Latinos living in anti-immigrant and anti-Hispanic climates were less likely to be satisfied with care. In both cases, experiencing health care discrimination significantly reduced the odds of satisfaction with care. Latinos' perception of an anti-immigrant & anti-Hispanic climate and state policies can have detrimental effects on their health and health care outcomes. These results highlight the importance of addressing both community-wide and interpersonal discrimination specific to health care settings, which can have concurrent impacts on the health and well-being of Latino and other minoritized populations.

Legal Status, Worries About Deportation, and Depression Among Asian Immigrants.

Although legal status and worries of deportation have been identified as key factors in immigrant health inequities for Latinx immigrants, how they impact health of Asian immigrants is largely unknown. Using 2016 Collaborative Multiracial Post-Election Survey, we used sets of logistic regressions to examine the relationships among legal statuses, worries about deportation, and depression for Asian immigrants (n = 1371). Asian immigrants who are in the process of applying for citizenship, those with visas, and those who are ineligible to apply for citizenship were significantly more likely to be depressed compared with naturalized citizens. The significant associations between legal status and depression were mediated by worries about deportation. Legal status and worries of deportation are important determinants of health for Asian immigrants. The results point to a critical need for systematic investment in data collection for data disaggregation.

COVID-19 Is Having a Devastating Impact on the Economic Well-being of Latino Families.

Latino Americans are more likely than non-Hispanic whites to contract COVID-19 and to face disproportionately high mortality rates when they contract the virus. What has not been well understood is the impact COVID-19 is having on the economic well-being of Latino families. Using the Abriendo Puertas/Latino Decisions National Parent Survey (1195), we asked Latino respondents how the pandemic has impacted their employment, savings, and finances and we also asked them how they have been coping to make ends meet. Using descriptive analysis and ordinal least squares regression, we find that Latinos are experiencing high job loss and business closures. We also find that young parents (18-29-year olds) and those with income levels of $25,000 or lower are experiencing the most economic stress. We also find that Latinos are having difficulty making housing payments and postponing educational and health-related services to make ends meet. We also find that just over half of Latinos have emergency savings under $1000 which is important given that unemployment benefits expired on July 31, 2020. In conclusion, this research finds that Latinos are experiencing economic stressors and are engaging in coping strategies that are deeply concerning and which require explicit attention from policymakers. Given that Latinos took the longest to recover from the Great Recession, policymakers should keep this in mind as we continue to monitor the implications of the recession, ideally looking at mechanisms to reduce the stress for Latino families and encourage policies which target low-income working class Americans and small business owners.

Health Implications of Black Lives Matter Among Black Adults.

OBJECTIVE: The current study examined whether knowledge, understanding and support of the Black Lives Matter movement were positively linked to self-reported physical health among a representative sample of Black American adults. METHODS: The 2016 Collaborative Multiracial Post-election Survey (CMPS) examined attitudes about the 2016 US election, immigration, policing, racial equality, and racial discrimination among Asian American, Black American, Latinx, and White adults. The current study used the Black American sample, which included 3102 individuals (69% female) older than 18 years of age. We used a set of logistic regression models to assess the associations of knowledge, support, and understanding of Black Lives Matter with overall physical health. RESULTS: Although knowledge of Black Lives Matter was not a significant predictor for physical health, understanding and supporting Black Lives Matter significantly predicted positive physical health among Black American adults. CONCLUSIONS: Black American adults who understand and support Black Lives Matter reported more positive overall physical health.

Correction to: Health Implications of Black Lives Matter Among Black Adults.

The names of two coauthors of this article were updated following the article's original publication.

Latinos' Connections to Immigrants: How Knowing a Deportee Impacts Latino Health.

This manuscript examines how personally knowing a deportee and/or undocumented immigrant affects the mental health of Latina/o adults. Utilizing a new survey sponsored by the Robert Wood Johnson Foundation Center for Health Policy at the University of New Mexico (n=1,493), we estimate a series of logistic regressions to understand how personal connections to immigrants are affecting the mental health of Latinos using stress process theory. Our modeling approach takes into consideration the socio-political, familial, cultural, and personal contexts that make up the Latina/o experience, which is widely overlooked in data-sets that treat Latinos as a homogeneous ethnic group. Our findings suggest that knowing a deportee increases the odds of having to seek help for mental health problems. The significance of this work has tremendous implications for policy makers, health service providers, and researchers interested in reducing health disparities among minority populations especially under a new administration, which has adopted more punitive immigration policies and enforcement.

What's Your "Street Race"? Leveraging Multidimensional Measures of Race and Intersectionality for Examining Physical and Mental Health Status Among Latinxs.

Using the 2015 Latino National Health and Immigration Survey (N= 1,197) we examine the relationship between physical and mental health status and three multidimensional measures of race: 1) "street race," or how you believe other "Americans" perceive your race at the level of the street; 2) socially assigned race or what we call "ascribed race," which refers to how you believe others usually classify your race in the U.S.; and 3) "self-perceived race," or how you usually self-classify your race on questionnaires. We engage in intersectional inquiry by combining street race and gender. We find that only self-perceived race correlates with physical health and that street race is associated with mental health. We also find that men reporting their street race as Latinx1 or Arab were associated with higher odds of reporting worse mental health outcomes. One surprising finding was that, for physical health, men reporting their street race as Latinx were associated with higher odds of reporting optimal physical health. Among women, those reporting their street race as Mexican were associated with lower odds of reporting optimal physical health when compared to all other women; for mental health status, however, we found no differences among women. We argue that "street race" is a promising multidimensional measure of race for exploring inequality among Latinxs.

U.S. Citizen Children of Undocumented Parents: The Link Between State Immigration Policy and the Health of Latino Children.

We examine Latino citizen children in mixed-status families and how their physical health status compares to their U.S. citizen, co-ethnic counterparts. We also examine Latino parents' perceptions of state immigration policy and its implications for child health status. Using the 2015 Latino National Health and Immigration Survey (n = 1493), we estimate a series of multivariate ordered logistic regression models with mixed-status family and perceptions of state immigration policy as primary predictors. We find that mixed-status families report worse physical health for their children as compared to their U.S. citizen co-ethnics. We also find that parental perceptions of their states' immigration status further exacerbate health disparities between families. These findings have implications for scholars and policy makers interested in immigrant health, family wellbeing, and health disparities in complex family structures. They contribute to the scholarship on Latino child health and on the erosion of the Latino immigrant health advantage.

The Impact of Punitive Immigrant Laws on the Health of Latina/o Populations.

This study examines how anti-immigrant policies affect the physical health of Latina/os in the United States. Merging two unique datasets: sum of anti-immigrant policies by state from 2005-2011 and a 2011 Robert Wood Johnson Center for Health Policy nationally representative sample of Latina/os (n=1,200), we estimate a series of logistic regressions to understand how anti-immigrant legislations are affecting the health of Latina/os. Our modeling approach takes into consideration Latinos' diverse experience, context that is widely overlooked in datasets that treat Latina/os as a homogeneous ethnic group. Our findings suggest that an increase in anti-immigrant laws enacted by a state decreases the probability of respondents reporting optimal health, even when controlling for other relevant factors, such as citizenship status, language of interview, and interethnic variation. The implication and significance of this work has tremendous impacts for scholars, policy makers, health service providers and applied researchers interested in reducing health disparities among minority populations.

Civic engagement and political participation among American Indians and Alaska natives in the US.

Within the growing literature seeking to understand civic and political engagement among racial and ethnic minorities, our understanding of political behavior among American Indian and Alaska Native's (AI/AN) remains limited. We use the Current Population Survey Civic Engagement and Voting and Registration supplements (2006-2012) to compare AI/AN voter registration, voting, and overall civic engagement to other racial and ethnic groups and to assess whether factors that predict higher levels of civic engagement vary across these populations. We find a few key socio-economic status indicators that predict civic and political engagement uniquely for AI/ANs, but they are not consistently significant across all years or all types of political participation. We find marital status, age, household size, education, and veteran status to be important in predicting civic engagement for AI/ANs. However, for voting and registration, we find that family income, age, marital status, household size, and residential stability to be important contributors. Although we find AI/ANs are less likely to register and vote compared to non-Hispanic whites, we find that the difference is not statistically significant in congressional years, which may suggest that AI/ANs are engaged in local politics and vote for representatives that will represent their tribal interests in national politics.

MIXED-STATUS FAMILIES AND WIC UPTAKE: THE EFFECTS OF RISK OF DEPORTATION ON PROGRAM USE.

OBJECTIVE: Develop and test measures of risk of deportation and mixed-status families on WIC uptake. Mixed-status is a situation in which some family members are U.S. citizens and other family members are in the U.S. without proper authorization. METHODS: Estimate a series of logistic regressions to estimate WIC uptake by merging data from Fragile Families and Child Well-being Survey with deportation data from U.S.-Immigration Customs and Enforcement. RESULTS: The findings of this study suggest that risk of deportation is negatively associated with WIC uptake and among mixed-status families; Mexican origin families are the most sensitive when it comes to deportations and program use. CONCLUSION: Our analysis provides a typology and framework to study mixed-status families and evaluate their usage of social services by including an innovative measure of risk of deportation.

Latina/o or Mexicana/o?: The Relationship between Socially Assigned Race and Experiences with Discrimination.

Discrimination based on one's racial or ethnic background is one of the oldest and most perverse practices in the United States. While much of this research has relied on self-reported racial categories, a growing body of research is attempting to measure race through socially-assigned race. Socially-assigned or ascribed race measures how individuals feel they are classified by other people. This paper draws on the socially assigned race literature and explores the impact of socially assigned race on experiences with discrimination using a 2011 nationally representative sample of Latina/os (n=1,200). While much of the current research on Latina/os has been focused on the aggregation across national origin group members, this paper marks a deviation by using socially-assigned race and national origin to understand how being ascribed as Mexican is associated with experiences of discrimination. We find evidence that being ascribed as Mexican increases the likelihood of experiencing discrimination relative to being ascribed as White or Latina/o. Furthermore, we find that being miss-classified as Mexican (ascribed as Mexican, but not of Mexican origin) is associated with a higher likelihood of experiencing discrimination compared to being ascribed as white, ascribed as Latina/o, and correctly ascribed as Mexican. We provide evidence that socially assigned race is a valuable complement to self-identified race/ethnicity for scholars interested in assessing the impact of race/ethnicity on a wide range of outcomes.

The Enhanced Self-Reported Health Outcome Observed in Hispanics/Latinos Who are Socially-Assigned as White is Dependent on Nativity.

A growing body of research seeks to conceptualize race as a multi-dimensional construct, attempting to move beyond a dummy variable approach to study social disparities. This research uses 'socially-assigned race', 'ascribed race', or 'what race others think you are' as opposed to self-identified race to assess self-rated health status among a representative study of the Latino population (n = 1,200). Our analysis shows how important the lived experience of Latinos and Hispanics (as measured by ascribed race and a host of control variables, including nativity and national origin) is on self-reported health. Using a series of logistic regressions, we find support for the 'white advantage' in Latino health status that is suggested in the literature, but this finding is sensitive to nativity, citizenship, and national origin. This research informs the study of racial and ethnic disparities, providing a detailed explanation for the 'white health advantage' finding within the socially-assigned race and health disparities literature.