The Role of Documentation Status Concerns, Perceived Discrimination, and Social Support on Latinx Adults' Physical and Mental Health.

There is a growing number of immigrants arriving in the USA, with the majority being of Latinx descent. Coupled with this increase, there has also been growing anti-immigration legislation which impacts the experiences this group faces and creates additional concerns for those who are residing in this country without documentation. Experiences of overt and covert discrimination and marginalization have been shown to relate to poorer mental and physical health outcomes. Drawing from Menjivar and Abrego's Legal Violence Framework, this paper explores the impact of perceived discrimination and social support on the mental and physical health of Latinx adults. We further observe whether these relationships differ based on participants' concerns about their documentation status. This data comes from a community-based participatory study conducted in a Midwestern County. Our analytic sample was comprised of 487 Latinx adults. We found social support to be related to fewer self-reported days of mental health symptoms for all participants regardless of documentation status concern. Perceived discrimination was found to be related to worse physical health for participants with concerns about their status. These findings point to the pernicious role of discrimination for Latinx's physical health and the importance of social support as an asset beneficial for their mental health.

How Would Low-Income Communities Prioritize Medicaid Spending?

CONTEXT: Medicaid plays a critical role in low-income, minority, and medically underserved communities, particularly in states that have expanded Medicaid under the Affordable Care Act. Yet, the voices of underresourced communities are often unheard in decisions about how to allocate Medicaid's scarce resources, and traditional methods of public engagement are poorly suited to gathering such input. We argue that deliberative public engagement can be a useful tool for involving communities in setting Medicaid priorities. METHOD: We engaged 209 residents of low-income, medically underserved Michigan communities in discussions about Medicaid spending priorities using an exercise in informed deliberation: CHAT (CHoosing All Together). Participants learned about Medicaid, deliberated in small groups, and set priorities both individually and collectively. FINDINGS: Participants prioritized broad eligibility consistent with the ACA expansion, accepted some cost sharing, and prioritized spending in areas-including mental health-that are historically underfunded. Participants allocated less funding beyond benefit coverage, such as spending on healthy communities. Participants perceived the deliberative process as fair and informative, and they supported using it in the policy-making process. CONCLUSION: The choices of participants from low-income, medically underserved communities reflect a unique set of priorities and suggest that engaging low-income communities more deeply in Medicaid policy making might result in different prioritization decisions.

'I'm going to look for you and take your kids': Reproductive justice in the context of immigration enforcement.

Prior research has shown that immigration law enforcement contributes to poor health outcomes-including reproductive health outcomes-among Latinos. Yet no prior research has examined how immigration enforcement might inhibit reproductive justice and limit individual's reproductive autonomy. We utilized data from an existing study that consisted of a partnership with a Latino community in Michigan in which an immigration raid resulted in multiple arrests and deportations midway through data collection. Using cross-sectional survey data (n = 192) where no one was re-interviewed, we used ordinal logistic regression to compare desired pregnancy timing of individuals surveyed prior to and after the raid to determine the impact of an immigration raid on desired timing of next pregnancy. We then used qualitative data-including 21 in-depth interviews and participant observation-collected in the community after the raid to contextualize our findings. Controlling for socio-demographic characteristics, we found that Latinos surveyed in the aftermath of the raid were more likely to report a greater desire to delay childbearing than Latinos surveyed before the raid occurred. Our qualitative data showed that an immigration raid has financial and psychological effects on immigrant families and that a raid may impact reproductive autonomy because people are fearful of these impacts. These finding suggest that current immigration enforcement efforts may influence reproductive decision-making, impede Latinos reproductive autonomy, and that family-friendly immigration policy reform is needed.

Health Implications of an Immigration Raid: Findings from a Latino Community in the Midwestern United States.

Immigration raids exemplify the reach of immigration law enforcement into the lives of Latino community members, yet little research characterizes the health effects of these raids. We examined the health implications of an immigration raid that resulted in multiple arrests and deportations and occurred midway through a community survey of a Latino population. We used linear regression following principal axis factoring to examine the influence of raid timing on immigration enforcement stress and self-rated health. We controlled for age, sex, relationship status, years in the county in which the raid occurred, children in the home, and nativity. 325 participants completed the survey before the raid and 151 after. Completing the survey after the raid was associated with higher levels of immigration enforcement stress and lower self-rated health scores. Findings indicate the negative impact of immigration raids on Latino communities. Immigration discussions should include holistic assessments of health.

Risk for Unintended Pregnancy Among Latino Men and Women in a Nonmetropolitan County in Michigan.

INTRODUCTION: This study characterizes the risk for unintended pregnancy among Latino men and women within a racially and ethnically diverse county in Michigan. METHODS: Latino respondents aged 18 to 50 years who reported no intention to become pregnant in the next year and no contraception use were defined as "at risk" for unintended pregnancy. Any associations between risk for unintended pregnancy and sociodemographic factors was determined through multivariate logistic regression. RESULTS: Risk for unintended pregnancy was higher among men (67%) than women (59%; P=0.046; n=341). In multivariate logistic regression analysis, English speaking ability was associated with lower odds for risk of unintended pregnancy (OR=0.73; P=0.004). Having a high school degree or less was associated with higher odds for risk of unintended pregnancy (OR=4.15, P<0.001 and OR=2.74, P=0.026, respectively). CONCLUSION: Among Latinos in a nonmetropolitan community, both men and women were at high risk for unintended pregnancy. Future studies that address the reasons behind this elevated risk may inform potential interventions among this at-risk group.

Priorities for Patient-Centered Outcomes Research: The Views of Minority and Underserved Communities.

OBJECTIVE: To learn how minority and underserved communities would set priorities for patient-centered outcomes research (PCOR). DATA SOURCES: Sixteen groups (n = 183) from minority and underserved communities in two states deliberated about PCOR priorities using the simulation exercise CHoosing All Together (CHAT). Most participants were minority, one-third reported income <$10,000, and one-fourth reported fair/poor health. DESIGN: Academic-community partnerships adapted CHAT for PCOR priority setting using existing research agendas and interviews with community leaders, clinicians, and key informants. DATA COLLECTION: Tablet-based CHAT collected demographic information, individual priorities before and after group deliberation, and groups' priorities. PRINCIPAL FINDINGS: Individuals and groups prioritized research on Quality of Life, Patient-Doctor, Access, Special Needs, and (by total resources spent) Compare Approaches. Those with less than a high school education were less likely to prioritize New Approaches, Patient-Doctor, Quality of Life, and Families/Caregivers. Blacks were less likely to prioritize research on Causes of Disease, New Approaches, and Compare Approaches than whites. Compare Approaches, Special Needs, Access, and Families/Caregivers were significantly more likely to be selected by individuals after compared to before deliberation. CONCLUSIONS: Members of underserved communities, in informed deliberations, prioritized research on Quality of Life, Patient-Doctor, Special Needs, Access, and Compare Approaches.