Research on mixed-status families in the United States often focuses on undocumented parents with citizen children, overlooking families with mixed-status children. While income-eligible, US-born children of undocumented parents can enroll in Medicaid nationwide, only twelve states and DC allow income-eligible, undocumented children to enroll in Medicaid, leaving them ineligible in North Carolina. We aim to understand Latina immigrant mothers' experiences accessing healthcare for their mixed-status children in North Carolina. We are conducting semi-structured interviews with Latina immigrant mothers with at least one uninsured and one insured child. Themes emerging from our eleven conducted interviews, out of a planned total of twenty, reveal costs as the key barrier to care for uninsured children, while federally qualified health centers (FQHCs) and financial assistance programs prove crucial in ensuring necessary care. Other themes include unmet, urgent dental needs, inability to provide all children with the same level of healthcare, disparities in resources available in urban versus rural counties, importance of social networks in finding and accessing care, and the negative emotional impacts of having an uninsured child. The emerging themes highlight consequences of excluding undocumented children from Medicaid, particularly with accessing routine dental care. They also demonstrate the importance of raising awareness about and funding FQHCs and financial assistance programs to meet medical needs. Policies that exclude undocumented children from health care coverage impact children’s healthcare access and could lead to inequitable health outcomes between mixed-status siblings. These findings underscore the importance of expanding undocumented children’s access to affordable care.

Introduction:

The difficulties that newly immigrated students encounter when living in a foreign country are not widely recognized in the context of higher education. This project sought to explore the barriers to health services utilization and health-seeking behaviors in international women students attending a mid-sized, private institution of higher education through photovoice.

Methods:

Participants attended three photovoice training sessions and submitted photographs and narratives in response to the research question: “What obstacles do you encounter when trying to take care of your physical and mental health in the US?”. Photographs and accompanying narratives were showcased at the university art gallery.

Results:

Ten (N=10) international women completed the trainings. An assessment of participant access to health services prior to participation in the study revealed that sixty nine percent (69%) of women depended on health services provided by the university for their health-related needs, and 85% did not have a primary care provider in the U.S. Thirty eight percent (38%) of participants reported seeking medical care only in emergencies and 25% reported utilizing the hospital emergency room for non-urgent care. Thematic analysis of photographs and narratives revealed five key themes: self-care, home, womanhood, mental health, and adjusting to life in the U.S. Social isolation and financial stress were identified as significant challenges impacting the mental health of international female students.

Conclusion:

Awareness, accessibility and affordability of institutional resources are needed to support the wellbeing of immigrant students and promote student success.

Background: Anti-immigrant rhetoric and policies have lasting impacts on immigrants’ ability to thrive. Listening sessions conducted by the Children Thrive Action Network (CTAN) in 2022-23, as well as discussions with partners, revealed that mental health and barriers to mental health access are key concerns to many immigrant populations.

Methods: The Center for Law and Social Policy (CLASP) conducted two focus groups in Michigan with 25 Bangladeshi immigrants and Bangladeshi-Americans and plan to conduct more with the same population in Texas. Additional focus groups may be conducted with Ethiopian/Eritrean and other communities. Focus group questions explore ways policymakers, advocates, and community partners can support immigrants’ mental health. Additionally, focus groups elevate immigrant voice on how they navigate their well-being. Authors employed a framework analysis and grounded theory approach to transcript analysis.

Results: Preliminary analysis reveals that immigrant participants experience a great deal of loneliness, especially as new arrivals, and feel pressured by their communities’ societal expectations. Barriers to help seeking include stigma, anxiety about their community’s perceptions, western approaches to mental health, and the cost of services. There were also differences in findings related to gender identity.

Conclusions: Policy recommendations to support immigrants’ mental health include community-centered solutions, including investment in trusted community figures and spaces for community members to connect with one another. States should consider more flexible use of Medicaid funding to cover the cost of these services and invest in trusted community organizations and leaders. Practice recommendations include a more holistic and culturally responsive approach to supporting well-being.

Prior research demonstrates that the 2020 elections increased stressors among working-class, Latine youth of immigrant backgrounds. In addition, research has well documented the multi-generational impact of restrictive immigration policy among mixed status families. Santa Ana, California is a predominantly Latine immigrant community within Orange County, a historically conservative County. Youth at one high school in the city prioritized the need to support immigrant families during the politically charged and anti-immigrant rhetoric that is anticipated to rise in the 2024 cycle. Through participatory methods, five youth leaders were engaged in co-developing and facilitating platicas to explore the implications of immigration policy and politics on the health and well-being of youth. Qualitative data from these platicas were twice-coded first through grounded theory and subsequently using codes guided by a socioemotional development framework (Perez, 2010) to identify stressors and their health implications. Themes included: 1) mental health; 2) access to health and social services; 3) fear as a mediator of social participation, and; 4) youth's resolve to engage in advocacy and action as representatives of their families and to ensure their family's well-being. Understanding youth's perception of immigration policy and politics as well as the implications for their health and well-being can enhance support systems within schools, health systems, and other safety net systems. It can also provide pathways for engaging youth in narrative solutions as well as community initiatives that can foster their agency in public health solutions.

Background: The SEA US, HEAR US Study is a research project that aims to capture COVID-19 experiences among Southeast Asian American (SEA) groups (Cambodian, Filipino, Thai, Vietnamese) often not represented in research.

Purpose: To examine and report on generational similarities or differences in changes in stress due to COVID-19 among SEAs.

Methods: An electronic or paper 30-45 minute survey was administered to eligible participants (18 years of age or older, self-identify as Cambodian, Filipino, Thai, and/or Vietnamese, and living in the Greater LA area). Data was collected on COVID-19 infection, testing, vaccination, and other health-related measures. One item asking about changes in stress was used as a proxy for resilience.

Results: Survey respondents (n=701) had an average age of 40.72 (SD 16.96), were 70.9% female and 35.1% were born in the US. Chi-Square analysis shows an association between immigrant generation and self-report stress level change due to COVID-19 (χ2=21.13, df=6, p<0.05). The proportion of first generation/immigrant reporting no change in stress due to COVID-19 (35.2%) is significantly larger than for second generation participants (19.9%). The proportion of first generation reporting having moderate stress change due to COVID-19 (19.1%) is significantly lower than for second generation (32.0%). There were no differences across generations reporting mild and severe stress change due to COVID-19.

Conclusions: Our findings show that first generation/immigrants reported less stress due to COVID-19 suggest higher resilience compared to second generation participants, which may indicate the need to further review the risk/protective factors that contribute to low/high resilience among SEAs.

Background: As the immigrant population in rural America expands, they encounter increasing barriers to preventive health care, from socioeconomic and linguistic obstacles to limited health services and restrictive health policies. This scoping review examines these challenges and their implications, underscoring the urgent need for solutions to close gaps in health care access and inform policy decisions, ultimately aiming to improve health outcomes for rural immigrants.

Methods: A search across MEDLINE, APA PsycInfo, and CINAHL databases yielded peer-reviewed articles on immigrant preventive health care access in rural America post-Affordable Care Act. Inclusion was limited to empirical studies, excluding reviews and curative-focused work. Two researchers independently analyzed the articles, with data then charted and synthesized for findings.

Results: In reviewing 1,083 articles, 30 were selected, primarily detailing Latinx immigrants’ health care in agricultural communities. Participants spanned from immigrants to health workers, highlighting services like cancer screenings and vaccinations. However, these groups encounter layered obstacles: educational and literacy limitations at the individual level, communication gaps and cultural misunderstandings at the interpersonal level, and systemic issues like insurance exclusions and anti-immigrant sentiments. Notably, some studies pointed to positive interventions like longer clinic hours and state-supported programs.

Conclusion: This scoping review demonstrates the lack of sufficient and appropriate resources and services catering to the special needs of immigrants in rural areas. Further research is needed to capture diverse experiences from other racial and ethnic groups. Future policies and program should address the multi-level barriers and develop innovative interventions to promote inclusive healthcare in rural areas.

Background: Refugees are at risk of chronic diseases like type 2 diabetes mellitus (T2DM) because of physical and emotional trauma in their home countries, poor living conditions in overcrowded official or makeshift refugee camps, and stressors during and after resettling in the host country. As the largest refugee group in the US, the Burmese—including Karen, Karenni, and Chin ethnicities—have been understudied in terms of T2DM self-management (SM). This qualitative study aimed to explore the meanings, beliefs, practices, and the barriers and facilitators related to T2DM-SM among them.

Method: Data were collected through clinically ethnographic interviews (CEI), with 15 Burmese adults with T2DM in Texas, conducted in their preferred language and analyzed with applied thematic analysis (ATA).

Result: The study reveals that unexpected T2DM elicits negative emotions and indifference among Burmese refugees, due to unfamiliarity, yet resilience and hope persist. Participants face cultural, dietary, and financial barriers to SM, with jobs or chores acting as exercise and a mixed response to medication. T2DM-SM was further complicated by traditional diets, financial constraints, low health literacy, and language barriers. However, spiritual practices and strong support networks were key to effective T2DM-SM.

Conclusion: The study emphasized the necessity for comprehensive, culturally sensitive healthcare, incorporating preventive care, early screening, health education, digital tools, and trauma-informed practices. It stresses mental health support, overcoming language and literacy challenges and building community support, proposing recommendations for nursing education, practice, research, and health policy to enhance care for one of the US's largest refugee groups.

Background: Internally Displaced Persons are subjected to tremendous challenges, increasing their proclivity for various types of mental challenges and social problems as a result of the trauma they encountered before and during their relocation from their particular homes. The insufficiency of information concerning the mental health and the quality of life of IDPs in Nigeria is the reason for this study

Methods: A qualitative study design was employed using a cluster sampling technique to conduct 2 Focus Group Discussions among young male adults and females between the ages of 18- 40 purposively selected. Data were transcribed and analyzed with the "Open Code" software.

Results: The respondents of this study had good knowledge of mental health and also highlighted several factors that may enhance good mental health. Some of the reported factors that enhance good mental health include the ability to think less, the influence of religion and education, while influence of the environment, lack of communication with family and friends, and frustration with life's affairs are the reported factors that negatively affect one's mental health. The suggested coping strategies include; taking suspected fellows to a psychiatric hospital, and the use of religious and traditional healing approaches. Other findings include the unhygienic condition of the camp as they struggle with poor environmental conditions that were due to a lack of access to toilet facilities, waste disposal, and potable water.

Conclusion: The overall mental health and quality of life of respondents in this study were reportedly poor and this requires urgent attention.

Background: Loneliness and discrimination have increased risks for physical and mental health problems, reduced quality of life, and mortality. Vulnerable groups, including immigrants, those who experienced discrimination, and with poor mental health, are more burdened with loneliness. However, no studies examined discrimination effects on loneliness through mental health among immigrants, a population largely understudied. We examined the mediation effects of anxiety/depression on the relationship between discrimination and loneliness based on immigration status.

Methods: We used population-based cross-sectional survey data on adults aged > 18 years (N= 4,740). We conducted mediation analyses with multivariable linear regression and bootstrapping. We analyzed loneliness (Scores= 3-9; >4 as higher loneliness) as the dependent variable; discrimination (Scores= 0-20; >1 as higher discrimination) as the independent variable; and anxiety/depression (Scores= 0-12; >1 as higher anxiety/depression) as the mediator.

Results: In the immigrant sample (n= 1,029), the total (not accounting for anxiety/depression) (β= 0.124, p< 0.001), direct (after accounting for anxiety/depression) (β= 0.055, p< 0.001), and indirect (discrimination effect explained by anxiety/depression) (β= 0.069, p< 0.001) discrimination effects on loneliness were significantly positive. Anxiety/depression mediated 55.65% of the total effect of discrimination on loneliness.

In the non-immigrants (n= 3,711), the total (β= 0.161, p< 0.001), direct (β= 0.059, p< 0.001), and indirect (β= 0.102, p< 0.001) discrimination effects on loneliness were positive. Anxiety/depression mediated 63.35% of the total effects.

Conclusions: Anxiety/depression mediates discrimination effects on loneliness, especially among non-immigrants. Mental health and immigration status should be considered in efforts aimed at reducing disparities in discrimination and loneliness.