Culturally-Protective Health Practices

ABSTRACT

Everyday pregnancy care may play an important role in explaining why Mexican immigrant women have positive birth outcomes despite relatively low incomes, low formal education levels, and lack of access to medical care. The paper is based on findings from a qualitative study utilizing in-depth ethnographically-in-formed interviews with 41 Mexican immigrant women in Chicago who had recently given birth. Results indicate that everyday pregnancy care guides maternal behaviors in pregnancy and has important effects on birth weight. Implications for the design of prenatal health care and social services for immigrant women are discussed.     

Explaining immigrant naturalization

"Prior research on immigrant naturalization has focused mainly on the effects of immigrants' adaptation experiences and demographic characteristics on their propensity to naturalize. This article proposes a broader analytical framework which incorporates immigrants' individual characteristics and larger social contexts in the country of origin and the country of destination to explain the likelihood of citizenship acquisition. The framework is tested for a cohort of recent immigrants, using the PUMS data from the 1980 U.S. census. The results show that economic, political, social, cultural and geographical conditions in the country of origin, and immigrants ethnic communities and urban concentration in the country of destination, to a large extent influence immigrants' propensity for naturalization and that, net of the contextual factors, many of the immigrants' adaptation and demographic characteristics are also significant predictors of citizenship acquisition."     

Undocumented Latina immigrants in Orange County,California: a comparative analysis

"This article examines a unique data set randomly collected from Latinas (including 160 undocumented immigrants) and non-Hispanic white women in Orange County, California, including undocumented and documented Latina immigrants, Latina citizens, and non-Hispanic white women. Our survey suggests that undocumented Latinas are younger than documented Latinas, and immigrant Latinas are generally younger than U.S.-citizen Latinas and Anglo women. Undocumented and documented Latinas work in menial service sector jobs, often in domestic services. Most do not have job-related benefits such as medical insurance.... Despite their immigration status, undocumented Latina immigrants often viewed themselves as part of a community in the United States, which significantly influenced their intentions to stay in the United States. Contrary to much of the recent public policy debate over immigration, we did not find that social services influenced Latina immigrants' intentions to stay in the United States."     

Diaspora and Health? Traditional Medicine and Culture in a Mexican Migrant Community

As members of the Mexican diaspora acculturate/assimilate to life in the United States they gain skills that help them improve their socioeconomic status and overcome barriers to the mainstream American healthcare system. Thus, we might expect better health among more acculturated Mexicans. However, most of the research conducted during the past 20 years shows that the health of Mexicans living in the United States deteriorates as acculturation increases. This suggests that certain health promoting aspects of Mexican culture are lost as migrants adapt to and adopt American ways of life. This paper is the first step in testing the hypothesis that declining health among acculturated people of Mexican descent is related to a loss of traditional medical knowledge. During an ethnographic study of women’s medical knowledge in an unacculturated Mexican migrant community in Athens, Georgia, I observed many ways low‐income, undocumented migrants maintain good health. Migrant women encourage health‐promoting behaviors and treat sick family members with a variety of home remedies that appear to be effective according to chemical and pharmacological analyses. Additionally, migrant women in Athens learn how to navigate the American medical and social service systems and overcome barriers to professional healthcare services using information provided through social networks. Nevertheless, migrant women often prefer to treat sick family at home and indicated a preference for Mexican folk medicines over professional medical care in most situations. This case study suggests that migration and diaspora need not always lead to disease. The maintenance of a Mexican culture that is distinct from the rest of American society helps ensure that traditional medical knowledge is not lost, while the social networks that link Mexicans to each other and to their homeland help minimize threats to health, which are usually associated with migration. Thus, increased access to professional medical care may not improve the health of migrants if it comes with the loss of traditional medical knowledge.     

Does Citizenship Status Matter in Canadian Agriculture? Workplace Health and Safety for Migrant and Immigrant Laborers

This article explores how precarious legal status circumscribes differential inclusion in the agricultural labor market and affects workers' lives through a comparative study of workplace health and safety among temporary migrant guest workers and immigrants in Canada. Original, multimethod research with South Asian immigrant and Mexican migrant farmworkers examines employment practices, working conditions, and health‐care access. We find that both groups engage in precarious work, with consequences for their health and safety, including immigrant workers with citizenship. Nevertheless, migrant guest workers are subject to more coercive forms of labor discipline and a narrower range of social protection than immigrants. We argue that while formal citizenship can mitigate some dimensions of precariousness for farmworkers racialized as non‐white, achieving a more just, safer food system will require broader policies to improve employer compliance and address legislative shortcomings that only weakly protect agricultural labor.     

“The Politics of the HealthCare Reform Debate: Public Support of Including Undocumented Immigrants and Their Children in Reform Efforts in the U.S.”

Although U.S. immigration and health care policies appear to be highly correlated, scholarship has yet to gauge the public's views toward providing undocumented immigrants with health coverage at the state level. We analyze support for including undocumented immigrants in health care reform in New Mexico. Utilizing an original public opinion survey of New Mexico adults, we find that individuals are more supportive of the state providing health care to the children of undocumented immigrant than to their parents. Multivariate logistic regression analyses suggest that factors such as liberal ideology and perceptions of commonalities with Latinos increase support levels. Despite a lack of support among a majority of respondents, the influence of perceived commonalities with immigrants suggests that reform advocates and political elites who mobilize along ethnic or human solidarity may be successful in creating conditions for the inclusion of undocumented immigrants in the public provision of health care at the state level.     

Immigrants' health in Europe: a cross-classified multilevel approach to examine origin country, destination country, and community effects

In this study, we examined origin, destination, and community effects on first- and second-generation immigrants' health in Europe. We used information from the European Social Surveys (2002–2008) on 19,210 immigrants from 123 countries of origin, living in 31 European countries. Cross-classified multilevel regression analyses reveal that political suppression in the origin country and living in countries with large numbers of immigrant peers have a detrimental influence on immigrants' health. Originating from predominantly Islamic countries and good average health among natives in the destination country appear to be beneficial. Additionally, the results point toward health selection mechanisms into migration.     

From refugees to immigrants: the legalization strategies of Salvadoran immigrants and activists

"The legalization strategies pursued by Salvadoran immigrants and activists from the 1980s to the present demonstrate that migrants' and advocates' responses to policy changes reinterpret law in ways that affect future policy. Law is critical to immigrants' strategies in that [U.S.] legal status is increasingly a prerequisite for rights and services and that immigration law is embedded in other institutions and relationships. Immigration law is defined, however, not only when it is first formulated but also as it is implemented, enabling the immigrants who are defined according to legal categories to shape the definitions that categorization produces. Immigrants and activists also take formal legal and political actions, such as lobbying Congress and filing class action suits. Through such formal and informal policy negotiations, immigrants seek to shape their own and their nations' futures."     

Immigrants and their occupational absorption: the Israeli case

This paper examines immigrants' occupational absorption by using 1) immigrants' satisfaction with their work in Israel, 2) similarity between jobs held abroad and in Israel, and 3) degree of occupational status persistence. In 1982, 41.9% of the Israeli population was foreign-born, and 84.2% were either immigrants or immigrants' children. 1972-1982 showed 1) a decrease in full-time employed persons and an increase in women's labor force participation; 2) higher educational levels; 3) an increase in scientific, academic, professional, technical, administrative, managerial, and clerical workers; and 4) lower unemployment. These trends, with Israel's high rate of inflation, make the adsorption of immigrants difficult. 80% of immigrants find work within 1 year; and, within 3 years, 78.7% report satisfaction with their work. 1) Status persistence, 2) ascent, 3) selectivity, 4) descent, and 5) random models describe immigrants change in socio-occupational status, before and after immigration. Data from the Statistical Abstract of Israel 1983 show downward mobility for immigrants in their first year. More than 1/3 of scientific and academic professionals in 1975-78, 45.2% in 1978/79, and 56.2% in 1979/80 were not employed in their previous occupations. After 3-5 years, however, most immigrants find employment in their fields. Women have lower status persistence, and hence, higher job mobility, than men; immigrants from European USSR and Western countries have higher status maintenance.     

Nativity,Duration of Residence,and the Health of Hispanic Adults in the United States1

This article examines subgroup differences in the health status of Hispanic adults in comparison to non‐Hispanic whites and non‐Hispanic blacks. We pay particular attention to the influences of nativity and duration of residence in the United States. Data are pooled from the National Health Interview Survey (NHIS) for 1989–94. Puerto Ricans exhibited the worst health outcomes of any group (including whites and blacks) for each of the three health measures. Persons of Central/South American origin exhibited the most favorable outcomes for activity limitations and bed sick days, advantages that were eliminated when controlled for nativity/duration. For two of the three health status variables, Mexican Americans were very similar to non‐Hispanic whites in baseline models and were more favorable than non‐Hispanic whites once socio‐economic factors were controlled; this was not the case, however, for self‐reported overall health. Immigration also helped to explain the relatively positive outcomes among Central/South American origin individuals, Cubans, and Mexican Americans. For most Hispanic groups (as well as non‐Hispanic whites and non‐Hispanic blacks), immigrants reported better health than the U.S. born, which is consistent with a selectivity hypothesis of immigrant health. In addition, this advantage tended to be significantly smaller among immigrants with ten or more years' duration in the United States. Although the latter finding is consistent with the negative acculturation hypothesis, alternative interpretations, including the generally more limited access of immigrants to the formal health care system, are suggested.     

Nativity,Duration of Residence,Citizenship, and Access to Health Care for Hispanic Children

This article examines differences in access to a regular source of health care for children of Hispanic subgroups within the United States. Particular attention is paid to the impact of the immigration status of the mother – including nativity, duration in the United States, and citizenship status – and its affect on access to health care for Hispanic children. Data are pooled from the National Health Interview Survey for 1999–2001 and logistic regression models are estimated to compare Mexican American, Puerto Rican, Cuban, and Other Hispanic children with non‐Hispanic whites and blacks. While initial disparities are recorded among the race/ethnic groups, in the final model, only Mexican American children display significantly less access to health care than non‐Hispanic whites. The combined influence of the mother's nativity, duration, and citizenship status explains much of the differentials in access to a regular source of care among children of Hispanic subgroups in comparison to non‐Hispanic whites.     

The Mexico of "the other side": Mexican immigrants in the United States

"The purpose of this work is to explore the advantages and disadvantages of... Mexican immigrant workers for the economy and the political and cultural status quo of the United States. The Mexican immigrant workers pose a dilemma for the United States. On the one hand, the United States needs them for a better functioning of its economy. On the other, the Mexican immigrant workers represent a racial, cultural and political challenge to the American 'establishment'.... Given the magnitude of the problem which the Mexican immigrants represent and the intense debate surrounding it, the cheap labour they represent for the economy of the United States and the unsolved conflicts this provokes, are fertile ground for the analysis of the economic, political and cultural interests competing for the degree of flexibility or the amount of policing the Mexican border should have." (SUMMARY IN ENG AND FRE)     

The Marital Status of Recent Mexican Immigrants in the United States in 1980 and 19901

Using Public Use Microdata Samples, we analyze the temporal marriage patterns of recent Mexican immigrants in the United States, and relate these patterns to socioeconomic and political events, such as U.S. immigration reform, increasing returns to skill, and rising incentives for unattached Mexicans to migrate during the 1980s. Our findings indicate that recent Mexican immigrants (particularly men) were less likely to be married within five years of migrating in 1990 than their counterparts had been in 1980. An empirical extension further suggests that the relative endogamy odds among Mexican immigrants who migrated to the United States by 1980 increased during the next decade. Such demographic changes may affect policies involving issues such as education, welfare and retirement.     

Safe Motherhood in the Context of Nepal

ABSTRACT

Nepal ranks low on the Human Development Index and has a high maternal mortality rate. Various factors contribute to the high rate of maternal mortality and include a shortage of health care professionals, limited access to basic maternal health care, poverty, illiteracy, women's low social status, a poorly developed transportation system, a limited communication system, political conflict, and a diverse population. Interviews with pregnant women, observational data, and national statistics provide the basis for suggestions provided by the author. These include upgrading and opening new maternal care facilities, integrating midwives into local health services, providing education on women's health needs during pregnancy, and improving public awareness of the availability of maternal care services.     

The Role of Information and Communication Technologies in Addressing Safe Motherhood in South Asia

ABSTRACT

As it is recently recognized in academic and policy circles, limited access to information and limited knowledge are among key factors contributing to worldwide poverty, especially in low developed countries. Consequently, access to “knowledge” has become an integral part of discussions about global development, improvement of societal well-being, and empowerment of women. This article addresses the problem of the limited spread of information about maternal health and available maternal care services across impoverished South Asian countries. Lack of knowledge greatly contributes to underutilization of medical services and available maternal care that leads to high rates of maternal and infant mortality and pregnancy-related complications which, with proper medical care, could be avoided.     

The Patient Transit Assistance Scheme: A case for social work advocacy!

Abstract

The Patient Transit Assistance Scheme is one of Queensland Health's initiatives designed to facilitate equity of access for Queensland residents to essential health care services. The purpose of the scheme is to help all Queenslanders, irrespective of where they live, to have access to specialist medical services. It provides direct financial assistance to patients and in some cases their carers, to facilitate access to specialist medical services irrespective of geographic location.

The findings of recent research conducted on social worker involvement with PTAS for patients diagnosed with leukaemia and associated haematological disorders will be used to argue that the problems in relation to the administration of this scheme require serious attention at the level of patient care and health policy.     

A survey of Colorado's migrant farmworkers: access to health care

This report utilizes data collected in a 1986 sample survey of 329 adult (18 to 50 years old) migrant farmworkers in Colorado to determine their health needs, health services utilization, and overall access to care. Health needs include selected indices of medical, dental, nutrition, and reproductive health. About 1/4 of the population had no usual source of health care. Upstream states such as Colorado are responsible as the primary providers of health services for those who either have no source of health care at their home base or experience a variety of barriers in their attempts to access services. Women are most likely to have had a medical visit over the past 12 months and are more likely to have experienced hospitalization. Unfortunately, although their contact with medical professionals is more frequent, the family planning needs of women are not being met. A large disparity exists between ideal family size and number of pregnancies and live births. The findings of this survey document the inferior health status of the migrant farmworker population in Colorado. Hunger, poverty, and environmental hazards increase the risk of illness, while at the same time, barriers to care often prevent migrants from accessing needed health services. Recommendations include 1) promoting and funding family planning and reproductive health services for migrant farmworker women and their partners, 2) incorporating trained family planning promoters in the migrant health delivery system, 3) maintaining successful models of restorative dental care for adults, 4) increasing access to services in nontraditional settings, 5) increasing use of ancillary personnel to provide services, especially dental services, 6) maintaining outreach programs in the available food programs, and 7) encouraging migrant health programs to provide leadership in the development of alternative food sources.     

The politics of health in the fourth world: a northern Canadian example

This paper describes the major structural and historical dimensions of health ideology and praxis in the Canadian Arctic. It examines the problems that occur when primary care services exclude their clients from meaningful involvement in planning and administration. It argues that the structure of health services in northern Canada reflects an internal colonial political economy which is characteristic of most Fourth World situations.     

The invisibility of adolescent sexual development in foster care: Seriously addressing sexually transmitted infections and access to services

Adolescents residing in foster care are at higher risk for acquiring sexually transmitted infections (STIs) and human immune deficiency virus (HIV) compared to their non-foster care peers. A literature review was conducted to determine whether youth residing in foster care face different barriers to sexual health care compared to their peers in the general population and, if so, what those barriers are. The review revealed barriers common to adolescents in general as well as additional barriers specific to the ecosystem of adolescents in foster care. Systemic issues that decreased access to sexual health services included child welfare policies that were either missing or implemented without fidelity; complicated financial factors; barriers to service utilization; lack of collaboration between child welfare and medical professionals; and limited information provided to foster youth on their sexual health and development. Consent and confidentiality issues that foster youth face in seeking sensitive health services also need to be resolved. More research is needed on how to facilitate development of coherent policies and effective practices that promote sexual health care access for adolescents in foster care.     

Health for immigrants and refugees in the 1990s. A comparative study in seven receiving countries

Health policies for immigrants implemented in seven receiving countries (France, United Kingdom, Switzerland, Italy, Sweden, United States, and Canada) have been comparatively reviewed, taking into account the structure of the health system as well as immigration policy. Countries where immigrant communities have access to political representation, and whose health systems are comprehensive in scope and coverage, tend to have adopted specific health policies for immigrants, which, in turn, led to better access to health services and more information for planning and evaluation.