Praying for More Time: Mexican Immigrants' Pandemic Eldercare Dilemmas.

Based on longitudinal research conducted with 21 Mexican immigrants between 2018 and 2021, this article examines the challenges the COVID-19 pandemic posed to undocumented immigrants in the United States attempting to provide care for aging parents in Mexico. As the United States excluded undocumented immigrants from pandemic support, the pandemic undermined their ability to provide health care for their parents even as the Mexican public health care system crumbled. Meanwhile, as the pandemic hastened their parents' demise, it thwarted immigrants' ability to time returns to see their parents before they died. While scholars have amply documented how spatial disparities exacerbated the impact of the pandemic among marginalized groups, few have examined the temporal disruptions caused by the pandemic. This article suggests that the pandemic provoked particular distress by desynchronizing the temporalities of family life across borders and preventing immigrants' abilities to coordinate care for their parents in time. [COVID-19, transnational families, eldercare, death, time].

Medical returns as class transformation: situating migrants' medical returns within a framework of transnationalism.

Because studies of migrants' 'medical returns' have been largely confined to the field of public health, such forms of return migration are rarely contextualized within the rich social scientific literature on transnational migration. Drawing on ethnographic interviews with Mexican migrants in an immigrant enclave in central California, I show that migrants' reasons for returning to their hometowns for care must be understood within the class disjunctures facilitated by migration. While migrants' Medicaid insurance confined them to public clinics and hospitals in the United States, their migrant dollars enabled them to visit private doctors and clinics in Mexico. Yet medical returns were not mere medical arbitrage, but also allowed migrants to access care that had previously been foreclosed to them as poor peasants in Mexico. Thus crossing the border enabled a dual class transformation, as Mexican migrants transitioned from Medicaid recipients to cash-paying patients, and from poor rural peasants to 'returning royalty.'

A LATINO ORAL HEALTH PARADOX? USING ETHNOGRAPHY TO SPECIFY THE BIO-CULTURAL FACTORS BEHIND EPIDEMIOLOGICAL MODELS.

This article presents evidence of a "Latino oral health paradox," in which Mexican immigrant parents in California's Central Valley report having had better oral health status as children in Mexico than their U.S.-born children. Yet little research has explored the specific environmental, social, and cultural factors that mediate the much-discussed "Latino health paradox," in which foreign-born Latinos paradoxically enjoy better health status than their children, U.S.-born Latinos, and whites. Through ethnography, we explore the dietary and environmental factors that ameliorated immigrant parents' oral health status in rural Mexico, while ill-preparing them for the more cariogenic diets and environments their children face in the U.S. We argue that studies on the "Latino health paradox" neglect a binational analysis, ignoring the different health status of Latino populations in their sending countries. We use the issue of immigrant children's high incidence of oral disease to initiate a fuller dialogue between U.S.-based studies of the "health paradox" and non-U.S. based studies of the "epidemiological transition." We show that both models rely upon a static opposition between "traditional" and "modern" health practices, and argue that a binational analysis of the processes that affect immigrant children's health can help redress the shortcomings of epidemiological generalizations.

An ethnographic study of Latino preschool children's oral health in rural California: Intersections among family, community, provider and regulatory sectors.

BACKGROUND: Latino children experience a higher prevalence of caries than do children in any other racial/ethnic group in the US. This paper examines the intersections among four societal sectors or contexts of care which contribute to oral health disparities for low-income, preschool Latino1 children in rural California. METHODS: Findings are reported from an ethnographic investigation, conducted in 2005-2006, of family, community, professional/dental and policy/regulatory sectors or contexts of care that play central roles in creating or sustaining low income, rural children's poor oral health status. The study community of around 9,000 people, predominantly of Mexican-American origin, was located in California's agricultural Central Valley. Observations in homes, community facilities, and dental offices within the region were supplemented by in-depth interviews with 30 key informants (such as dental professionals, health educators, child welfare agents, clinic administrators and regulatory agents) and 47 primary caregivers (mothers) of children at least one of whom was under 6 years of age. RESULTS: Caregivers did not always recognize visible signs of caries among their children, nor respond quickly unless children also complained of pain. Fluctuating seasonal eligibility for public health insurance intersected with limited community infrastructure and civic amenities, including lack of public transportation, to create difficulties in access to care. The non-fluoridated municipal water supply is not widely consumed because of fears about pesticide pollution. If the dentist brought children into the clinic for multiple visits, this caused the accompanying parent hardship and occasionally resulted in the loss of his or her job. Few general dentists had received specific training in how to handle young patients. Children's dental fear and poor provider-parent communication were exacerbated by a scarcity of dentists willing to serve rural low-income populations. Stringent state fiscal reimbursement policies further complicated the situation. CONCLUSION: Several societal sectors or contexts of care significantly intersected to produce or sustain poor oral health care for children. Parental beliefs and practices, leading for example to delay in seeking care, were compounded by lack of key community or economic resources, and the organization and delivery of professional dental services. In the context of state-mandated policies and procedures, these all worked to militate against children receiving timely care that would considerably reduce oral health disparities among this highly disadvantaged population.