Déprotection sanitaire des étrangers, de quoi la démission d'Aurélien Rousseau est-elle le nom ?

In late December 2023, the French parliament debated legislation that would endanger access to state medical aid (AME) for seriously ill migrants living undocumented in France. The limits of an over-restrictive approach to health care are well known: poorer access to care, additional burden on public hospitals, and the weakening of the whole system. The risks weigh particularly heavily on migrants living with HIV. Yet we know that the number of HIV-positive diagnoses continues to rise among men who have sex with men and who were born abroad. This situation raises public health concerns and risks undermining the ethical foundations of medicine. The French health minister, Aurélien Rousseau, resigned the day after the bill was passed last December, having repeatedly stated his opposition to measures abolishing or weakening AME. In doing so, he demonstrated his commitment to the humanist foundations of medicine, setting an example for all political leaders.

Corrigendum: Access to healthcare by undocumented Zimbabwean migrants in post-apartheid South Africa.

No abstract available.

Exploring risky health behaviors and vulnerability to sexually transmitted diseases among transnational undocumented labor migrants from Bangladesh: a qualitative study.

BACKGROUND: In Bangladesh, remittances constitute a substantial portion of the country's foreign exchange earnings and serve as a primary source of income. However, a considerable number of Bangladeshi citizens reside overseas without proper documentation, exposing them to significant challenges such as limited access to healthcare and socioeconomic opportunities. Moreover, their irregular migration status often results in engaging in risky health behaviors that further exacerbate their vulnerability. Hence, this study aimed to investigate the risky health behavior and HIV/STI susceptibility of Bangladeshi irregular international migrants residing across the globe with undocumented status. METHODS: Using a qualitative Interpretative Phenomenological Approach (IPA), 25 illegal migrants were interviewed who are currently living illegally or returned to their home country. The author used a thematic approach to code and analyze the data, combining an integrated data-driven inductive approach with a deductive approach. Concurrent processing and coding were facilitated by employing the Granheim model in data analysis. RESULTS: The study identified four risky health behaviors among irregular Bangladeshi migrants: hazardous living conditions, risky jobs, suicidal ideation, and tobacco consumption. Additionally, the authors found some HIV/STI risk behavior among them including engaging in unprotected sex, consuming alcohol and drugs during sexual activity, and having limited access to medical facilities. CONCLUSIONS: The findings of this study can be used by health professional, governments, policymakers, NGOs, and concerned agencies to develop welfare strategies and initiatives for vulnerable undocumented migrant workers.

"We want our freedom back, that's our only need": a qualitative study of health and social needs among asylum seekers and undocumented migrants crossing the borders from Belarus to Lithuania.

Background: The influx of undocumented migrants and asylum seekers into Lithuania, particularly during the COVID-19 pandemic, presents unique public health challenges. This study employs the Social Determinants of Health framework to explore the healthcare and social needs of this vulnerable population. Methods: In May 2022, we carried out a qualitative study through semi-structured interviews with asylum seekers across four centers in Lithuania. Employing both purposive and snowball sampling techniques, we selected participants for our investigation. The study comprised 21 interviews-19 conducted in Arabic and 2 in English-with durations ranging between 20 and 40 min each. We audio-recorded all interviews, transcribed them verbatim, and subsequently performed a thematic analysis using Atlas.ti software. This process of design and analysis strictly followed the principles of thematic analysis as outlined by Braun and Clarke, guaranteeing methodological precision and rigor. Findings: 21 interviews revealed critical insights into the healthcare access challenges, mental health issues, and social integration barriers faced by the participants. Key themes included 'Healthcare Needs and the Impact of the COVID-19 Pandemic 'and 'Social needs and Aspirations Amidst Pandemic-Induced Uncertainty '. The findings highlight the multifaceted healthcare and social needs of asylum seekers, juxtaposed against significant barriers they face. Access to medical services is hindered by long waiting times and financial constraints, especially for specialized care such as dental services. Communication issues during medical appointments due to language barriers and the lack of gender-specific healthcare, such as access to gynecological services, further exacerbate the challenges. Additionally, the COVID-19 pandemic introduces hurdles such as limited testing, isolation measures, language-specific information barriers, and insufficient social distancing practices. Mental health has emerged as a critical concern, with asylum seekers reporting significant stress and emotional exhaustion due to uncertainty and restrictive living conditions. Social needs extend to delayed asylum application processes, inconsistent language education opportunities, inadequate clothing, and nutrition that lacks cultural sensitivity, and living conditions characterized by overcrowding and insufficient facilities. The restricted freedom of movement within asylum seeking centres severely impacts their psychological well-being, underscoring a deep longing for autonomy and a better life despite the myriad of challenges faced. Discussion: The study illustrates the complex interplay between migration, health, and social factors in the context of a global pandemic. It highlights the need for culturally sensitive healthcare services, mental health support, and structured language education programs. Offering educational avenues alongside language courses for children and adults is essential for fostering social inclusion and securing economic prosperity. Addressing the challenge of language barriers is of utmost importance, as these barriers significantly impede undocumented migrants' and asylum seekers employment opportunities and their access to crucial services. The findings emphasized immigration as a health determinant and underscored the importance of inclusive health policies and advocacy for undocumented migrants and asylum seekers' rights and needs. Conclusion: There is an urgent need for comprehensive policies and practices that are grounded in the principles of equity, compassion, and human rights. Additionally, advocating for practice adaptations that are culturally sensitive, linguistically inclusive, and responsive to the unique challenges faced by undocumented migrants and asylum seekers. As global migration continues to rise, these findings are crucial for informing public health strategies and social services that cater to the diverse needs of this vulnerable population.

Health Care for Unaccompanied Immigrant Children in US Communities: A Guide for Pediatric Practitioners.

Children who arrived at the United States border without a parent or legal guardian (ie, unaccompanied children) are present in communities throughout the country in growing numbers. For them to receive the highest-quality medical and mental services available, pediatric practitioners should have a foundational understanding of their unique set of circumstances and experiences. However, formal education on how to care for this specific immigrant subpopulation is not routinely incorporated into pediatric training programs, and limited clinical guidance is available in the published literature. This article provides best-practice recommendations for pediatric practitioners caring for unaccompanied children after their release from government custody, incorporating guidance for clinical encounters as well as suggestions of processes to meet their health-related social needs and advocacy actions to improve their well-being. [Pediatr Ann. 2024;53(5):e178-e182.].

Pediatric Support for Children Eligible for Legal Humanitarian Relief.

Many children in immigrant families may qualify for legal protection-for themselves if unaccompanied, or as a derivative on parents' claims-on humanitarian grounds related to persecution or forced migration. Pediatric providers can offer a spectrum of multidirectional medical-legal supports to increase access to medical-legal services and support children who are undocumented or in mixed-status families. These activities can include providing trusted information, incorporating screening for health-related social needs, establishing networks for multidirectional referrals, and providing letters of support for legal protection. To expand workforce capacity for medical-legal services related to immigration, pediatric providers can also receive training to conduct specialized, trauma-informed forensic evaluations and can advocate at individual, local, state, federal, and global levels to address factors leading to persecution and forced migration while supporting individuals who may be eligible for legal protection. [Pediatr Ann. 2024;53(5):e183-e188.].

COVID-19 Vaccine Uptake in Undocumented Latinx Patients Presenting to the Emergency Department.

This cross-sectional study examines COVID-19 infection status, vaccination uptake, and perceptions about the vaccine among Latinx patients presenting to the emergency department in California.

Cardiovascular risk and access to primary care: Comparisons among Chinese documented and undocumented immigrants.

AIMS: The aim of this study was to examine main risk factors of undocumented Chinese migrants living in Italy when compared with Chinese migrants registered with National Health Service (NHS). METHODS: A cohort of 3435 Chinese first-generation immigrants living in Prato underwent blood pressure (BP) measurement and blood tests. Hypertension was diagnosed for BP ≥ 140/90 mmHg at 2 visits, and/or antihypertensive drug use; type 2 diabetes (T2DM) for fasting glucose ≥ 126 mg/dL at 2 visits, and/or use of hypoglycemic drugs; hypercholesterolemia (HC) for cholesterol ≥ 240 mg/dL and/or statins use. Subjects diagnosed with hypertension, T2DM, or HC unaware of their condition were considered newly diagnosed. Comparisons were performed using multivariable adjusted logistic regression analysis. RESULTS: A large proportion of Chinese migrants were undocumented (1766, 51 %); newly diagnoses of risk factors were performed especially among undocumented migrants; registration with NHS was associated with higher level of awareness for hypertension and T2DM and with 6 times higher rate of treatment for T2DM. Only a small minority of subjects with high cholesterol were treated with statins. CONCLUSIONS: Undocumented immigrants had high prevalence of risk factors with lower levels of awareness than migrants registered with the NHS. Health policies targeting this hard-to-reach population needs to be improved.

Navigating a climate of administrative burden: the perspectives of young adult undocumented immigrants in applying for COVID-19 disaster relief assistance for immigrants in California.

Undocumented immigrants experienced high levels of economic insecurity during the COVID-19 pandemic while being excluded from government-based relief and unemployment benefits. In April 2020, California became the first state to offer financial aid to undocumented immigrants through the innovative Disaster Relief Assistance for Immigrants (DRAI) program in collaboration with several community-based organizations (CBOs). However, the process of applying for aid was marked by many implementation challenges, such as intake and language access; however, little data exists on the direct experiences of the undocumented community. This qualitative study examines the experiences of undocumented Asian and Latinx young adults living in California in applying for DRAI through framework of administrative burden. Themes distilled from participant experiences highlight how administrative burden via learning, psychological, and compliance costs shape the ways in which undocumented immigrants navigate policies and programs, such as DRAI. These experiences highlight the need for policymakers to address structural and programmatic administrative burdens in policy development; failure to do so result in detrimental impacts that outweigh financial benefits or cause communities to forgo needed resources.

Enriching Thinking Through Discourse.

Great effort is invested in identifying ways to change people's minds on an issue. A first priority should perhaps be enriching their thinking about the issue. With a goal of enriching their thinking, we studied the views of community adults on the DACA issue-young adults who entered the United States illegally as children. A dialogic method was employed, offering dual benefits in providing participants the opportunity to further develop their own ideas and to consider differing ideas. Yet, participants engaged in dialog only vicariously by observing the talk of a pair of actors who held opposing positions on DACA. The effect on participants' thinking was greatest in the condition in which they viewed a dialog between the two actors, rather than a comparison condition in which the actors individually expressed their positions. In control conditions, no presentation was observed. Probing questions included in all conditions encouraged a participant to examine and clarify for themselves their own position, potentially enriching it. This condition proved unsuccessful in enriching thinking; participants' justifications for their own positions in fact became simpler and less qualified. In contrast, observing a video of a like-minded and opposing other did enrich observers' thinking, yet to a greater degree in the dialogic than nondialogic condition. The findings thus suggest observed dialog as a promising practical approach in promoting deeper thinking.

Everyday discrimination and risk for clinical depression among a community sample of undocumented Latino immigrants in the United States.

Undocumented Latino immigrants in the United States face pervasive discrimination that increases their risk for experiencing depressive symptomatology. Although research has linked discrimination to depressive symptoms more broadly, we do not know whether everyday forms of discrimination are associated with elevated risk for clinical depression among this population. Using data collected from a community sample of undocumented Latino immigrants during the 2015 Trump campaign, we found that everyday discrimination was associated with significantly higher odds of being classified as higher risk for clinical depression. Findings indicate everyday discrimination as a risk factor for clinical depression among undocumented Latino immigrants.

The Transplant Experience for Undocumented Immigrant Patients Formerly Receiving Emergency Dialysis and Caregivers.

Importance: Individuals of undocumented immigration status with kidney failure face barriers to receiving transplants due to lack of health insurance despite no regulatory barriers. Little is known about the perspectives on kidney transplant among individuals with undocumented immigration status with kidney failure who relied on emergency hemodialysis. Objective: To examine the overall experiences of transplant among transplant recipients of undocumented immigration status who previously relied on emergency hemodialysis and their family caregivers. Design, Setting, and Participants: In this qualitative study, semistructured 1-to-1 interviews were conducted with transplant recipients who had previously received emergency hemodialysis and transitioned to scheduled dialysis and their primary caregivers living in Denver, Colorado, between May 1, 2022, and March 31, 2023, in English or Spanish. Main Outcomes and Measures: Themes and subthemes regarding the experience of transplant as an undocumented immigrant previously receiving emergency hemodialysis were identified. Interview transcripts were translated, deidentified, and then analyzed using thematic analysis. Results: A total of 25 participants including 15 transplant recipients (5 [33.3%] female and 10 [66.7%] male; mean [SD] age, 49.5 [9.8] years) and 10 caregivers (7 [70.0%] female and 3 [30.0%] male; mean [SD] age, 44.5 [22.3] years) participated. Six themes were reported: limited kidney replacement therapy education while receiving emergency hemodialysis (lack of awareness of kidney disease and treatment options and discriminatory kidney replacement therapy education due to immigration status), hope for transplant once receiving scheduled dialysis (prospect of transplant through scheduled dialysis, family and quality of life as transplant motivators), transplant education and health insurance after transition to scheduled dialysis (inadequate transplant education in dialysis clinic, peer-to-peer transplant education, and peer-to-peer communication regarding availability of private health insurance), uncertainty during transplant evaluation (difficulty navigating the evaluation and wait-listing process, lack of communication regarding timeline, and concern for family limiting living donation), posttransplant improvements (ability to work after transplant is critically important given immigration status, autonomy with transplant improves mental health, and vigilance in maintaining transplant), and transplant facilitators (self-advocacy, spirituality and optimism, and peer support). Conclusions and Relevance: This qualitative study of transplant recipients of undocumented immigration status and their caregivers found that individuals formerly receiving emergency dialysis are excluded from education and access to transplant, and peer support throughout the transplant process helped with education and motivation to pursue transplant. These findings may be used to implement improvements in access to support and education for patients of undocumented immigration status with kidney failure, especially in areas where scheduled dialysis is not available.

Exploring the Effect of Anti-immigration Rhetoric on Emergency Department Use by Undocumented Adults.

An unwelcoming policy climate can create barriers to health care access and produce a 'Chilling Effect' among immigrant communities. For undocumented immigrants, barriers may be unique and have a greater impact. We used administrative emergency department (ED) data from 2015 to 2019 for a Midwestern state provided under a data use agreement with the state hospital association. General linear modelling was used to estimate the impact of anti-immigrant rhetoric on ED visit intensity among non-elderly adults who were likely Hispanic/Latino with undocumented status. Compared to 2015, the average ED visit intensity among adults who were likely Hispanic/Latino with undocumented status was significantly higher during 2016-2019 when anti-immigrant rhetoric was heightened. The magnitude of this change increased over time (0.013, 0.014, 0.021, and 0.020, respectively). Additionally, this change over time was not observed in the comparison groups. Our findings suggest that anti-immigrant rhetoric may alter health care utilization for adults who are likely Hispanic/Latino with undocumented status. Limitations to our findings include the use of only those likely to be Hispanic/Latino, data from only one Midwestern state and the loss of data due to non-classification using the NYU ED algorithm. Further research should focus on validating these findings and investigating these identification methods and anti-immigrant rhetoric effects among other undocumented groups including children and adults of different race or ethnicity such as black, both those that identify as Hispanic/Latino and those that do not. Developing strategies to improve health care access for undocumented Hispanic/Latino adults also warrants future research.

"I Can Never Feel Safe": Latinx Youth Voices on Psychosocial Impacts of 287(g) in Georgia.

Increasingly, immigration policies are understood as structural determinants, rooted in racism, nativism, and ethnocentrism, which raise serious public health concerns for Latinx adolescents' mental health. Our objective was to examine how immigration policy enforcement affects mental health of Latinx youth raised in a county with an aggressive interior immigration enforcement program. From 2009 to 2021, Gwinnett County, GA, led the nation in deportations under the 287(g) program as a "universal enforcement model," where local law enforcement were deputized to detain undocumented immigrants, primarily through traffic violations. From June to July 2022, we followed a participatory action research approach with two groups of Latinx youth who grew up in Gwinnett County. In total, 10 youth took photos related to the research question, and engaged in facilitated dialogue using photovoice guide SHOWED/VENCER for four, 2-hour sessions that were audio-recorded and transcribed. Transcripts were analyzed following grounded theory principles to arrive at a conceptual model codeveloped and validated by youth. Youth described how 287(g) led to policing and deportation in their communities, fueling stereotypes, and discrimination that criminalized Latinx immigrants. Youth linked immigration enforcement policies like 287(g) to exclusionary systems that contributed to fear, marginalization, and loss in their communities, bringing experiences of sadness, grief, isolation, hopelessness, and low self-worth. From youth-driven research, we identified mental health implications of the 287(g) program among Latinx youth. The cascading harms of immigration enforcement policies highlight the need to address these policies and identify immediate strategies to promote Latinx youth mental health.

Implications of Undocumented Status for Latinx Families During the COVID-19 Pandemic: A Call to Action.

BACKGROUND: A disproportionate number of COVID-19 cases and deaths have been reported among Latinxs in the U.S. Among those most affected by the pandemic are marginalized families, including those that are undocumented and mixed-status, in which some, but not all members are undocumented. Undocumented and mixed-status families face multiple and chronic daily stressors that compromised their health and wellbeing. Salient stressors faced by undocumented Latinx families include poverty, social disadvantage, discrimination, dangerous living and working conditions, and limited access to healthcare. These stressors are frequently compounded with trauma, fear of detention, deportation, and family separation. PURPOSE: Informed by the literature and insights from our community-based work to address the health needs of undocumented and mixed status Latinx families during the pandemic, this paper uses a social determinants of health lens to present a narrative summary that highlights four primary psychosocial stressors faced by these families and their implications for mental health. DISCUSSION: These include stressors pertaining to (a) anti-immigrant rhetoric and actions; (b) family stressors and disruptions in family dynamics; (c) economic changes and financial losses; and (c) limited access to healthcare. Implications of the aforesaid stressors on the mental health of undocumented families and youth are also discussed. In addition, recommendations are provided for the provision of mental health services, best practices, and resources from a strengths-based approach.

Immigrant Parent Legal Status and Children's Health in the Hispanic Community Health Study of Latino Youth (SOL Youth).

We assess how immigrant parent legal status shapes children's physical and mental health. Using the Hispanic Community Health Study of Latino Youth-a multi-site dataset-we evaluated mean differences in multiple physical and mental health indicators and parents' and children's stress and resilience by parents' (primarily mothers') legal status (N = 1177). We estimated regression models of two overall child health outcomes-allostatic load and any internalized disorder. Average allostatic load was 28% higher (0.36 standard deviations) and average prevalence of any internalizing disorder was 16% points greater for children of foreign-born unauthorized versus US-born parents. Higher levels of socioeconomic and acculturative stress contributed to children of foreign-born unauthorized parents' heightened health risk, while resilience factors-parental health and familial support-protected their health. Children with unauthorized immigrant parents experience both negative physical and mental health outcomes that can have potential long-term costs.

Barriers to Disclosure of Intimate Partner Violence Among Undocumented Spanish-Speaking Immigrants in the United States.

Undocumented monolingual Spanish-speaking immigrants are one of the most vulnerable and marginalized groups to experience intimate partner violence (IPV) in the United States. This paper explores the barriers that prevent IPV disclosure in healthcare settings. Qualitative interviews (n = 14) were conducted with previously undocumented Spanish-speaking legal clients of a community domestic violence agency. The major barriers expressed by the interviewees regarding IPV screening and disclosure include limited opportunities for IPV screening, misinformation about legal rights from abusers, fear of deportation and separation from children, and lack of knowledge about resources.