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2016 UCGHI Migration and Health Fellows - Update

The Center of Expertise on Migration and Health (COEMH), administered in part by the UCLA Blum Center, is one of the first multidisciplinary, university-based program in the world devoted to systematically studying the health consequences of international population movements and developing more effective strategies to address them.

The UCGHI Center of Expertise on Migration and Health (COEMH), administered in part by the UCLA Blum Center, is one of the first multidisciplinary, university-based program in the world devoted to systematically studying the health consequences of international population movements and developing more effective strategies to address them.

After a rigorous application process, The UCGHI COEMH selected the four scholars below to be a Fellow in the UCGHI COEMH program and each was awarded $3,000 to go towards research. The scholars have worked with their mentors, leading experts in the area of research and people in the region to complete their studies. Once they wrap their work in the region, their work is far from over; they will write a research paper based off of their work this summer and submit it for publication. The Fellows took some time away from their studies to reflect on things they've learned (expected and unexpected) and fill us in on some of the excitement they are experiencing.

Brittany Morey

Title: Stress and Coping among Asian and Pacific Islander Women Immigrants in the San Francisco Bay Area

Mentor: Gilbert C. Gee, PhD, Professor in Community Health Sciences at UCLA

My research funded through the Center of Expertise on Migration and Health (COEMH) Student Fellowship examines how neighborhood social and economic environments are associated with stress among Asian and Pacific Islander (API) women living in the San Francisco Bay Area. In particular, I hope to find out how having access to cultural businesses in one's neighborhood is related to stress, and how this differs by nativity and length of time lived in the US. The support of the COEMH has allowed me to gather new data on neighborhood resources, such as ethnic businesses, community organizations, social services, and health services that serve the Asian and Pacific Islander community in the San Francisco Bay Area. Ethnic enclaves may have features that are protective against psychological stress (Osypuk, Diez Roux, Hadley, and Kandula 2009). For example, studies have shown that living in neighborhoods with other co-ethnics is associated with lower stress among immigrant minorities (Portes and Rumbaut 2014; Veling, Susser, van Os, Mackenbach, Selten, and Hoek 2008). Researchers have suggested that ethnic enclaves are also places for recent immigrants have access to cultural goods and services, though fewer studies have sought to capture how these economic and cultural aspects of ethnic enclaves may impact mental well-being (Edin, Fredriksson, and Åslund 2003). This study adds to our understanding of how ethnic enclaves affect immigrant well-being by directly testing how access to neighborhood cultural, economic and health resources are associated with psychological stress. I used data from the Asian Community Health Initiative, a breast cancer case control study of API women living in the Greater San Francisco Bay Area in California. My study uses the control sample of women without breast cancer, who are representative of all API women living in the Greater Bay Area (Wong, Horn-Ross, Gee, Shariff-Marco, Quach, Allen, Bautista, La Chica, Tseng, Chang, Clarke, Yang, Le, Canchola, Irwin, Lee, and Gomez 2016). I merged the survey data with the neighborhood dataset on ethnic businesses, which was created using keyword searches of Walls & Associates? National Establishment Time-Series Database, which utilizes from Dun and Bradstreet® business listings. Perceived stress was measured in the survey using an adapted version of Cohen's Perceived Stress Scale, which assesses the degree to which the situations in one's life are appraised as stressful (Cohen, Lamarck, and Mermelstein 1983). I used multivariable linear regression, with standard errors adjusted for clustering at the Census block group-level, in order to examine the associations between neighborhood features and psychological stress.

To date, my research of 432 study participants has found that having access to cultural meeting places lowers stress for recent API immigrants, but not for immigrants who have lived longer in the US, or for APIs who were born in the US, after controlling for key individual-level and neighborhood-level factors, such as age, socioeconomic status, neighborhood-level socioeconomic status, and urbanicity. When complete, this study will shed light on our understanding of the types of neighborhood resources available that can buffer against psychological stress for API immigrants.

Daniel Millan

Title: Understanding the Impact of Mass Immigrant Detention and Deportation

Mentor: Rocío Rosales, Assistant Professor, Department of Sociology, UC Irvine

In the course of my fieldwork and interviews with people in detention, I have learned that immigrants often face a difficult process with their immigration cases. The detention process can be lengthy and few resources are available. Transgender immigrants are a particularly vulnerable population and some have communicated that limited health care is provided, especially mental health services. Paradoxically, detention facilities have the responsibility to care for immigrants but the detention process itself can be taxing and may serve to further exacerbate existing health conditions and/or introduce new ones. I hope to further explore how detention introduces unintended consequences in terms of wellbeing while exploring what facilities do (and fail to do) to care for immigrants in confinement. In the next step of my research, I will explore these factors by asking questions in interviews with people currently detained that focus on how medical care is experienced while considering health and wellbeing prior to detention in the home country and in the United States.

Patricia Cabral

Title: Social and Cultural Influences on Health Risk Behaviors among Generations of Migrant Latino Adolescents

Mentor: Jan Wallander, PhD, Professor and Chair, Psychological Sciences, University of California Merced

My project examines the longitudinal link between neighborhood quality, familismo, social-emotional competence, and health risk behaviors among Latino adolescents of different acculturation levels from the Healthy Passages study. In this project, I am creating a structural equation model that captures the early protective influence of socio-cultural factors in health risk behaviors among Latino adolescents. This model estimates the influence of familismo in the development of social-emotional competence skills, and the protective role these factors have in the link between neighborhood quality and subsequent sexual risk behaviors and substance use. This model will allow us to examine if these associations differ across acculturation.

Using a large dataset, such as the Healthy Passages data, can sometimes be challenging but it has also inspired numerous research questions and helped me develop critical research and statistical skills.

While my project is focused on the importance of acculturation in the health of Latino adolescents, I have realized that many more factors need to be examined as possible explanatory mechanisms of the immigrant paradox. In fact, I plan to explore another element, decision-making processes of adolescents, to help explain the paradoxical health outcomes of Latino youth across acculturation. I will also study how social and cultural factors influence adolescents? decision-making of health behaviors. By examining mechanisms that are possibly underlying the link between acculturation and health risk behaviors, future prevention efforts can utilize social and cultural factors that are protective against engaging in risky behaviors.

Rachel Kelley

Title: Building Capacity to Improve Tomato Workers; Occupational Health

Mentor: Susan Ivey, MD, MHSA, Adjunct Professor, School of Public Health, UC Berkeley

This summer, the focus of my research has been to interview California and Tennessee workers who have experience in the US tomato industry. Through this research, I expect to develop a "Guide to Tomato Workers' Occupational Health," which can serve as a reference for health and social service professionals seeking to better support tomato workers' health. Through interviews and focus groups, I am gathering information on how these workers do their jobs and how it impacts their health and will use these findings to inform the Guide. So far I have conducted in-person interviews and focus groups in Spanish or, with the help of an interpreter, in Haitian Creole, with over 30 people. People were invited to participate with the help of community organizations. Interviews and focus group questions were semi-structured in order to respond to the unique experiences and perspectives of the participants. Questions covered three main themes: how do you do your job, how does your work impact your health, and what recommendations do you have regarding how to improve health at work and health care services for tomato workers.

Grocery store shoppers may not think about it, but someone handpicked every tomato sitting in the produce section. That person may have also done a number of other jobs involved in tomato production, including preparing the soil, planting tomato plants, hammering stakes, and tying twine supports. Each of these jobs requires a great deal of physical exertion in sunny, hot fields.

Many interviewees are proud to be working in tomato production because it allows them to support their families. Some have been working in the industry for well over a decade, while others have just a few years of experience. They describe their work as very heavy, often painful, and physically demanding. While several interviewees have suggested that workers become accustomed to this kind of work, including associated heat exposure and musculoskeletal pains, others have suggested that simple modifications, such as cleaner bathrooms, more extensive health and safety trainings, improved communication with supervisors, and more easily available protective or assistive equipment (such as lifting aids or back braces) could go a long way toward improving their occupational health. Several interviewees expressed a need for and appreciation of health care services, and suggested that clinics strive to reduce copays and provide transportation to appointments to facilitate improved access to care.