Stress Among Immigrants in the United States.

BACKGROUND: Immigrants comprise a sizable proportion (15%) of the population living in the United States (U.S.). Given these proportions, it is imperative that we understand immigrant experiences of well-being and stress toward improved well-being and integration. METHODS: To examine the experiences of first- and second-generation immigrants using a comparative approach, we utilized data from two surveys collected under Trump (n = 490) and Biden (n = 306) administrations. Both studies employed non-probability quota and convenience sampling techniques. Questions about experiences of stress (PSS-4), discrimination (Everyday Discrimination Scale), resilience (Brief Resilience Scale), border stress (Border Community and Immigration Stress Scale), immigration policies (general questions) were included in the surveys. Each study sample included diverse racial groups across both immigrant generations. We report frequencies, descriptive statistics, and ANOVAs/post hoc test results. RESULTS: Findings highlight that levels of both stress and discrimination among non-White participants under the Trump administration were significantly higher than those of White participants, though neither relationship was significant under the Biden administration. Further, White participants exhibited higher resilience under the Trump administration, but not under the Biden administration. DISCUSSION AND CONCLUSION: To our knowledge, this is the first study to comparatively examine immigrant experiences under the two most recent federal administrations. This study is seminal in highlighting discussions and making policy recommendations to limit immigrant exclusion, curtail exclusionary policies regarding travel bans, and improve pathways to citizenship, enhancing immigrant integration in the U.S. Roles of social workers in supporting immigrant communities and pathways for future research with immigrants are discussed.

Politics, Pandemics, and Trauma: Understanding and Addressing Latino Health Needs Through a Culturally-Informed Lens.

Latino communities in the United States (U.S.) have long endured trauma due to multiple intersecting social and political forces. New restrictive immigration policies since 2016 and the COVID-19 pandemic have each created novel stressors for Latino communities, while escalating the risk of mental health disorders and highlighting the communities' vulnerabilities. The effects of these stressors have been particularly pronounced in southeastern states, such as Tennessee and Georgia, due to their state-level anti-immigrant legislation. Yet, we lack sufficient data to understand how these factors present among Latinos seeking services. To focus attention on the specific experiences of Latino communities living in the U.S. Southeast, the authors analyzed the perspectives of 44 service providers working with these communities in the region using qualitative data collected in an online survey administered during the COVID-19 pandemic and while President Trump's exclusionary immigration policies were in force. Four themes were identified: (1) Latino communities' strengths; (2) impact of the Trump administration on Latino communities; (3) impact of COVID-19's on Latino communities; and (4) strategies to enhance service delivery in Latino communities. Results provide meaningful data to inform micro- and macro-level service delivery in two exclusionary policy states and beyond. Findings suggest future research should include other new immigrant destinations and explore perceptions of Latino community members.

Policy stress and social support: Mental health impacts for Latinx Adults in the Southeast United States.

BACKGROUND: Latinx, and especially Mexican and Central American, adults in the United States (U.S.) have been detrimentally impacted by policies under the Trump administration that instilled continual stress associated with immigration enforcement. Both native- and foreign-born adults are affected when either they or loved ones are deported, resulting in family disruption. Though research has established a connection between Trump-era exclusionary immigration policies and mental health status of Latinx community members, data are notably lacking for Mexicans and Central Americans in the southeastern U.S., where enforcement activity is particularly high. METHODS: To inform service provision and policymaking, the current study was designed to investigate stress associated with policies under the Trump administration on two mental health outcomes (depression and anxiety) among Mexican and Central American adults in the southeastern U.S. Additionally, the mediating effect of social support on the relationship was examined. A sample of 264 Mexican and Central American adults in the southeast was surveyed via an online platform. Using structural equation modeling (SEM), we employed a two-step procedure to first test a measurement model to ensure that the latent variables were explained by the indicators. In the next step, we estimated a structural model for hypothesized direct and indirect relationships between Trump-era policy stress, social support, and two outcome variables: depression and anxiety. RESULTS: Findings suggest that Trump-era policy stress significantly and positively predicted depression and anxiety symptoms. In addition, policy stress predicted lower levels of social support, which in turn, predicted more symptoms of both depression and anxiety. CONCLUSION: Findings can inform service provision and policymaking for a vulnerable community that underutilizes mental health services.

Effects of COVID-19, Discrimination, and Social Support on Latinx Adult Mental Health.

We investigated the role of COVID-19 exposure and discrimination on depressive and posttraumatic stress symptoms among Latinx adults residing in the southeastern United States. Survey data were collected from 264 Latinx adults. Using structural equation modeling (SEM) procedures, we estimated a structural model for hypothesized direct and indirect relationships between the risk factors of COVID-19 exposure and discrimination, social support, and two mental health conditions: depression and posttraumatic stress. COVID-19 exposure and discrimination each had a significant and positive relationship with both depression and posttraumatic stress. Social support was found to have a significant and inverse relationship with depression and posttraumatic stress, as well as to mediate the relationship between discrimination and both mental health symptoms. Implications for service provision and program design are presented. Future studies should examine variation between southeastern states and consider the influence of documentation status among an immigrant-only sample.

Latino Immigrant Service Provision in Tennessee and Georgia: Provider Perceptions.

Latinos and Latino immigrants are increasingly settling in new immigrant destinations, such as Tennessee and Georgia, that have historically lacked sufficient infrastructure for delivery of culturally and linguistically competent health and social services. This cross-sectional survey study was designed to assess providers' (n = 109) perspectives of the service provision landscape in each state. Descriptive analyses and t-tests (by state) were conducted to explore service concerns, access barriers, and organizational capacity to address concerns and barriers. Among most prevalently reported concerns were income/wages and fear of deportation. Key access barriers included language, lack of driver's license and insurance, and fear of deportation. Most (63%) organizations had sufficient Spanish language proficiency, though building trust was a notable barrier within 58% of organizations. Results provide meaningful data to inform existing strengths and service gaps in two exclusionary policy states. Future research should include perspectives of Latino community members.

Identifying Risk and Resilience Factors Impacting Mental Health among Black and Latinx Adults following Nocturnal Tornadoes in the U.S. Southeast.

Prior research has found that Black and Latinx communities in the U.S. face significant disparities that impact both preparedness for severe weather events and the support received after a disaster has occurred. In the current study, we examined key risk and protective factors that impacted mental health among 221 Black and Latinx adult respondents exposed to the 2-3 March 2020 nocturnal tornado outbreak in the U.S. state of Tennessee. Key factors that adversely affected mental health among participants were encountering barriers for receiving tornado warning alerts and tornado-related exposure. Key factors that served a protective mechanism against adverse mental health included having access to physical resources, supportive relationships, and adaptive coping skills. These findings may assist National Weather Service (NWS) personnel, emergency managers, and mental health providers with the development of policies and practices to address barriers and promote protective strategies for future nocturnal tornado events.

Predictors of Latinx Youth Health and Emotional Well-being: Social Determinants of Health Perspective.

Latinx youth disproportionately experience numerous negative social determinants of health (SDOH) that can have deleterious impacts on health outcomes. Yet, limited research is available on the role of SDOH on the well-being of Latinx adolescents. Utilizing data from the Fragile Families and Child Wellbeing Study, this study examined the association between variables representing five discrete domains of SDOH and health and emotional well-being outcomes among youth of Latinx mothers (N = 745). The study included 15-year-old youth of Latina mothers who were retained in the most recent wave of data collection (wave 6). Using Mplus8, we performed structural equation modeling to determine whether exogenous indicators of five domains of SDOH (economic stability, education, neighborhood and built environment, social and community context, and health care access) predicted adolescent health status and emotional well-being. SDOH specific to social, educational, and neighborhood factors emerged as significant predictors of health and well-being. Yet, variation existed in regard to which SDOH were most important for each outcome variable. Findings suggest that several SDOH, including economic stability, education, neighborhood and built environment, and social and community context, are particularly important for Latinx adolescent well-being. Implications for social work practice and policy are presented. Future studies should examine the longitudinal impact of SDOH and should examine Latinx youth by nativity.

Climate of Fear: Provider Perceptions of Latinx Immigrant Service Utilization.

Latinx immigrants endure stressors throughout the immigration process that detrimentally impact their health and wellbeing. Yet, they also face substantial barriers to accessing and utilizing services. These barriers might be heightened under the Trump administration, which has implemented policies facilitating increased immigration enforcement and punitive immigration practices. This study utilizes data collected from providers who serve Latinx immigrants in the border state of Texas to better understand current immigrant service utilization behaviors. Individual interviews and focus groups were conducted shortly after the last presidential election to inquire about recruitment, retention, program completion, and resources to address key client risk factors. Applying grounded theory analysis strategies, interviews, and focus group recordings were coded for key themes. Data demonstrated central concerns held by providers serving immigrants, and especially those who are undocumented or in mixed-status families. Concerns were related to the following three themes: (1) undocumented immigrant stressors, (2) limited resources for undocumented immigrants, and (3) service utilization barriers. Lack of services for undocumented immigrants and fear related to service utilization were prominent subthemes. These findings extend our knowledge of stressors and barriers of access and utilization for immigrants during this time period of increased immigration enforcement which have valuable implications for practice and future research. Providers can take concrete actions to educate immigrants, regardless of documentation status, on how their clients' identities will be protected. In addition, intentional trust-building strategies are essential to help overcome fear of utilizing services. Future research should ascertain perspectives of immigrant families, as this study drew perspectives only from providers.

The Relationship Between Country of Origin and Prenatal Care Among Unauthorized Mexican and Guatemalan Immigrants.

This study examined how country of origin (Mexico or Guatemala) correlates with prenatal care utilization among unauthorized Latina immigrants, who encounter disparate access to health care. Logistic regression and negative binomial regression analyses were used to examine prenatal care adequacy and number of visits among a sample of 4188 unauthorized Latina immigrants. Findings suggest that originating from Guatemala predicted increased likelihood of inadequate prenatal care and fewer prenatal care visits. Implications can inform policy and practice to strengthen prenatal care utilization, especially for unauthorized Guatemalan immigrants. Future research should examine independent predictors of prenatal care for Mexican and Guatemalan women.

Assessing the legacy of a legislative Workgroup for bidirectional integration of services.

Across the USA, health care systems are recognizing the value of integrating behavioral health services and primary care. The Texas Legislature took a unique approach to integration, passing legislation creating a Workgroup to explore key issues, identify best practices, and recommend policy and practice changes. This article situates the Workgroup in a rapidly evolving policy environment, describing the passage of integrated health care legislation in Texas, the Integration of Health and Behavioral Health Services Workgroup that was created by the legislation, and the policy recommendations that emerged from the Workgroup. The article analyzes how the Workgroup process intersected with a changing policy environment in Texas and nationally, opening the door for essential collaboration and partnership. The Workgroup ultimately laid the groundwork for integration's key role in a comprehensive Medicaid transformation waiver designed to expand access, improve population health and satisfaction with treatment, while better managing costs.