Meet the 2016 UCGHI Migration and Health Fellows
Migration is a global phenomenon involving hundreds of millions of people, with major social and economic impacts on both countries of origin and destination. In the United States, California is the most affected by these population movements. The Center of Expertise on Migration and Health is devoted to systematically study the health consequences of global population movements and develop strategies to address them. To further these goals, the COEMH is excited to offer the COEMH Graduate Fellowship Program. This program aims to provide UC graduate students an opportunity to work on migration and health projects. The objective of the Migration and Health Student Fellowship is to encourage UC graduate students to engage in activities that will enhance their understanding of health outcomes that impact migrant populations around the world.
This year, the application process proved competitive as the COEMH received an overwhelming number of applications for limited slots. In evaluating submissions, the COEMH leadership team reviewed the following components:
- Understanding of the impact of migration and immigration on health
- Explanation of how the project aligns with career goals in global health
- Description of a scientifically sound project that aligns with the mission of the Center of Expertise on Migration and Health
- Likelihood of the applicant publishing a manuscript or submitting a successful grant application based on the project
After a rigorous application process, the four fellows (listed below) were selected with each fellow receiving a total of $3,000 to implement their project this summer. We extend our congratulations to these outstanding individuals and look forward to hearing about the project outcomes.
Brittany N. 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
Project Rationale: According to the Stress-Exposure Disease Framework, stressors occur at multiple levels to impact health, and may include features of neighborhood environment. Many immigrant groups, such as Asian Pacific Islanders (APIs), tend to live together in neighborhoods with high concentrations of people with similar ethnic and cultural identity. These ethnic enclaves may be affected by neighborhood stressors, such as crime, poverty, and other safety concerns. Research shows that greater exposure to neighborhood crime, poverty, and poor physical infrastructure leads to more mental disorders.
On the other hand, ethnic enclaves may have resources that are beneficial to immigrants, such as culturally sensitive social services and shared places to congregate for recreation or worship. These neighborhood assets may provide immigrant groups with important social supports and access to resources that promote health and mental well-being.
The Stress-Exposure Disease Framework suggests that when neighborhood stressors outweigh the benefits of neighborhood resources, individuals are more vulnerable to developing poor physical and mental health. Understanding how the physical and social features of neighborhood environments impact the health of racial/ethnic minorities is vital to the promotion of well-being.
It is not currently known how neighborhood environments impact stress for APIs. Understanding how social contexts influence health for APIs is essential to protecting health among APIs and forming programs and policies that will promote well-being.
Aims: The aims of this project are to examine the effects of negative neighborhood conditions and the benefits of positive factors found in neighborhood enclaves where API women live. Additionally, I plan to test whether greater access to cultural meeting places and culturally sensitive social services is protective against overall stress levels for API women.
Methods: This research will involve secondary data analysis of the Asian Community Health Initiative (Asian CHI), a case control study of breast cancer risk factors among API women living in the San Francisco Bay Area. The Asian CHI includes items that measure overall stress reported over the past 12 months, neighborhood safety, neighborhood problems, and perceived collective efficacy (i.e. social trust). I will use this data to identify culturally-sensitive social services and cultural meeting places in the San Francisco Bay Area.
Expected Outcomes: I expect that less neighborhood safety, more neighborhood problems, lower collective efficacy, a more neighborhood socioeconomic disadvantage will be associated with greater overall stress among API women. I also anticipate that greater access to cultural meeting places and culturally sensitive social services will buffer against stress for these women. My research will highlight the important role of neighborhood social environments on immigrant health and provide insight into sources of neighborhood resilience for immigrants.
Daniel Millan Ovando
Title: Understanding the Impact of Mass Immigrant Detention and Deportation
Mentor: Rocío Rosales, Assistant Professor, Department of Sociology, UC Irvine
Project Rationale: Within the United States, a historically and contemporary primary destination for many immigrants, migrant health is of concern to public health leaders. In this country's past, ports of entry-whether Ellis Island in the east, Angel Island in the west, or stations along the US-Mexico border-became important spaces in which gatekeepers assessed and inspected the health of unknown foreigners. While health inspections of migrants have changed over time, the United States continues to create spaces of confinement in which newcomers, i.e. asylum seekers, are held. Due to current immigration laws and practices, asylum seekers must be placed in a detention facility through parts or the entirety of the asylum process.
The well-being of asylum-seeking detainees and their access to medical care is largely unknown and few studies have grappled with this issue. This project calls attention to the use of detention centers and the impact on the physical and mental wellbeing of these vulnerable migrant populations confined within them.
Aims: To assess the state of detainee mental and physical health and to assess the state and quality of care received while in detention.
Methods: This migrant health study will be nestled within a larger ongoing study of immigrants in detention. Data for the ongoing study is collected through in-depth interviews with immigrants in detention at three facilities in Southern California and ethnographic observations. Data for this migrant health study would be drawn from the use of two instruments: a holistic survey on health and an in-depth interview on health and health care during detention.
Expected Outcomes: The issues we will examine will inform larger policy concerns over the use of detention as a practice that may be inadvertently experienced as a punishment rather than a civil procedure. Through our rigorous methodological approach outlined above, we will gain a sense of what immigrants experience while in detention and begin to document the undocumented.
Title: Social and Cultural Influences on Health Risk Behaviors among Generations of Migrant Latino Adolescents
Mentor: Jan Wallander, Ph.D., Professor and Chair, Psychological Sciences, University of California Merced
Rationale: Health risk behaviors among U.S. youth include, among others, sexual risk behaviors and substance use. They are of special concern due to racial/ethnic differences in associated negative health outcomes. Specifically, Latino adolescents' birth rates are the highest of any major racial/ethnic group in the U.S. and their STI prevalence is more than twice that of Whites. Moreover, epidemiological studies suggest that Latino teens are at a high risk for early initiation of drinking, smoking, and drug use.
One characteristic that may change across migration generations is the relative loss of traditional Latino cultural values, such as familismo, which is a value emphasizing family unity and the collectivistic spirit of the family that stays together. This in turn may influence the likelihood of youth engaging in health risk behaviors. Also, familismo may interact with adolescent social development to influence health risk behaviors. Yet, the interaction between the cultural values of familismo and typical adolescent social development in health risk behaviors has not been examined across migration generational status in Latino youth. Moreover, research has not investigated how these processes might change across adolescent development.
Study Aim: I will examine the role of familismo and social-emotional competence in the link between poor neighborhood quality and health risk behaviors across migrant Latino adolescents. The specific aims of the research are to explain: 1) the epidemiological paradox for health risk behaviors across migration Latino adolescents of different generationsÂ ;and 2) how social and cultural factors moderate and/or mediate differences across generational status.
Methods: We will use a longitudinal design and analysis approach to test the conceptual model of familismo. I will use already collected data from a longitudinal cohort study on health behaviors and outcomes and associated risk and protective factors. Data for the project was collected across sites in California, Alabama, and Texas. The cohort of 5,000 youth, evenly distributed among Black, Latino, and White, were followed from ages 10 to 16 years across three generational waves.
Expected Outcomes: The results of this study will illuminate the role social and cultural processes have for health risk behaviors among Latino youth. Moreover, understanding the complexity of underlying mechanisms at work within the epidemiological paradox will inform efforts to reduce or prevent health risk behaviors and associated negative outcomes among Latino youth.
Title: Building Capacity to Improve Tomato Workers' Occupational Health
Mentor: Susan Ivey, MD, MHSA, Adjunct Professor, School of Public Health, UC Berkeley
Rationale: Although the poor health status of immigrant farmworkers is well-established, health and social service providers often lack detailed knowledge of the specific work processes that cause farmworkers' occupational health problems. The proposed project will help address this lack of research on work organization
Study Aims: Tomato workers will be interviewed in California and Tennessee. These locations are significant because California is the second-largest producer of fresh-market tomatoes after Florida, and Tennessee is a seasonal work destination for Florida tomato workers during Florida's off-season (USDA, 2015; Silver, 2014). Trends of similarities or differences between workers' experiences in different regions may generate new research questions regarding the influence of these particular environments on workers' health.
Methods: I plan to conduct focus groups and interviews with tomato workers during the summer of 2016. Questions will be tailored to elicit their insight on topics that are not readily available in currently published literature on farmworkers' occupational health. I am currently completing a literature review on tomato workers' occupational health that will inform interview and focus group guides, ensuring that valuable time with workers is used to gather information that is less familiar to health care workers
This summer I will finish work I began last year to interview health care workers in rural East Tennessee about their perceptions of the nature and causes of tomato workers' health concerns. Using findings from these interviews, I will identify trends in health care workers' understandings of the etiologies of tomato workers' occupational health issues.
Expected Outcomes: Using the findings of the literature review, focus groups and interviews with tomato workers, and interviews with health care workers, I will write a "Guide to Tomato Workers' Occupational Health" that can serve as the basis for trainings of health care workers.
Details about tomato industry work organization and associated occupational hazards will provide specific content that could be used to create a "structural competency" curriculum. Such curricula are currently being developed, and their aim is to shift explanations of health disparities away from previous emphasis on patients' cultures and behaviors toward social forces that operate at the levels beyond the individual. If such curricula can affect such a shift, they have the potential to generate support for expanded public health and social services; studies have shown that people are more likely to consider others to be "deserving" of publicly-funded services if they are seen as vulnerable victims of injustices outside of their control.