Search Results (164)

Approximately 10% of the US Black diaspora were born either in Latin America and the Caribbean (LAC) or Sub-Saharan Africa (SSA), projected to account for a third of the Black US diaspora by 2060. Yet, details on foreign-born Black women’s labor and delivery (L&D) characteristics, such as the type of birth attendant, remain scarce. We used the National Center for Health Statistics 2016 to 2020 Natality data (n = 2,041,880). The associations between detailed maternal nativity (DMN) and the type of attendant at birth (i.e., physician, certified nurse-midwife (CNM), certified professional midwife (CPM)) among US-born, LAC-born, and SSA-born Black women were examined using multivariate multinomial regression. The study revealed that LAC-born women were more likely to have a CNM during birth than US-born Black women, but Haitian-born and Jamaican-born women had lower odds of having a certified professional midwife (CPM) at birth. When compared to US-born Black women, Cameroonian-born women had decreased odds of having either a CNM or CPM during birth. Findings suggest that DMN could be an indicator of cultural preferences in maternity care. There is a need for further investigation beyond DMN and comprehensive data collection methods for future research to understand the specific needs and preferences of different ethnocultural groups to improve maternity care and prevent adverse maternal health outcomes. Full article

Background/Objectives: Family assistance by adolescents (e.g., cooking, cleaning, listening to family members) is a common phenomenon. However, the impact of such assistance on adolescent development remains a topic of debate. Increasingly, the importance of adolescents’ own perceptions and interpretations is being emphasized in understanding how family assistance influences their development. Adolescents in marriage immigrant families may face unique psychosocial challenges as they support their immigrant parents. This study explores the family assistance experiences of adolescents in marriage immigrant families. Methods: Data were collected through one-on-one in-depth interviews with 10 adolescents aged 13–18 years from currently married marriage immigrant families, all of whom were born in Korea. The interviews were conducted between October and November 2022. The data were analyzed using interpretative phenomenological analysis. Results: The family assistance experiences were categorized into three main themes, namely, “Old enough to help—naturally, and rightly so”, “Foreign mother whom I naturally come to help”, and “Unavoidable family assistance, even under pressure”, and 10 subordinate themes. The adolescents provided support naturally, grounded in familial obligation and empathy toward their immigrant mothers. When the native Korean father shared the responsibilities, the assistance was not perceived as burdensome. However, diminished paternal involvement, traditional gender role expectations, and unmet emotional or academic needs led to more negative perceptions and psychological stress. Conclusions: Support systems are needed to ensure that adolescents do not assume sole responsibility for both the native father’s and the immigrant mother’s roles within marriage immigrant families. Full article

Background: Previous research has examined the idea of the healthy immigrant effect and its potential application to pregnancy-related hypertensive disorders, particularly inracial and ethnic minority groups. The aim of this study is to examine how nativity, race, and ethnicity are related to prevalence of pregnancy-related hypertensive disorders. Methods: A retrospective cohort study was conducted using data from the PRAMS CDC dataset. These data were analyzed via Χ² comparisons of prevalence of pregnancy-related hypertensive disorders in foreign and US-born mothers, including subgroup analyses for Black and Hispanic women. Results: A sample size of 63,648 was analyzed, and revealed significant differences in the prevalence of gestational hypertension between US-born vs. foreign-born Black mothers (12.6% vs. 8.0%, Χ² (1, N = 12,046) = 36.92, p < 0.001), Hispanic mothers (9.5% vs. 7.2%, Χ² (1, N = 11,524) = 18.236, p < 0.001), and the larger sample of mothers across all reported racial and ethnic backgrounds (11.0% vs. 7.0%, Χ² (1, N = 63,648) = 163.835, p < 0.001). The results also revealed a significant difference in the prevalence of hypertension eclampsia between US-born and foreign-born Hispanic mothers (0.8% vs. 0.3%, Χ² (1, N = 11,152) = 8.480, p = 0.004). Conclusions: The study results showed evidence of significantly lower prevalence of pregnancy-related hypertensive disorders among foreign-born mothers as compared to their US-born counterparts, both in the full study sample and specifically in the subsamples of women who self-identified as Black and women who self-identified as Hispanic. These variances by nativity, race, and ethnicity provide further insight into how the healthy immigrant effect can apply to pregnancy-related hypertensive disorders, particularly for women of racial and ethnic minorities. Full article

Background/Objectives: Childhood anemia remains a serious public health issue, negatively affecting cognitive and psychomotor development, with repercussions on school performance and adult productivity. This study aimed to characterize the profile of children aged 6 months to 5 years diagnosed with or at risk of anemia who attended a pediatric hospital in Lisbon, Portugal. Methods: A hospital-based, cross-sectional descriptive study was conducted from September 2023 to September 2024. Descriptive statistics, including frequency distributions and cross-tabulations, summarized participant characteristics and key variables. Results: We observed that 33.3% (74/222) of the children were either anemic or at risk of anemia. Among these, 93.2% (69/74) were confirmed anemic or at risk based on hemoglobin levels. Five children (6.8%) had normal hemoglobin but abnormal red-cell indices, with microcytic (60.0%; 3/5) or normocytic (40.0%; 2/5) patterns. Anemia rates were higher in males (55.1%), children aged 24–59 months, those residing in the Metropolitan Lisbon Area (82.6%), children whose caregivers had only basic or secondary education (58.0%), and those whose mothers were born in foreign countries (48.4%). Microcytic red-cell indices were observed in 63.1% of cases. Serum iron results indicated that 32.0% were pre-anemic and 40.0% anemic. Ferritin levels showed iron-deficiency anemia in 22.2% of tested cases. In addition, 33.3% carried the sickle cell trait, and 35.0% had elevated C-reactive protein, suggesting anemia of inflammation. Conclusions: Anemia is a moderate public health issue, mainly affecting children with less-educated caregivers and migrant mothers. Targeted public health actions, including systematic screening, caregiver education, and multiculturally sensitive interventions, are crucial to address anemia. Full article

Objective: Low birth weight is a serious public health problem even in developed countries. The objective of this study was to assess the ability of machine learning to predict low birth weight rates in big cities in the USA on an ecological/population level. Study design: The study was based on publicly available data from the Big Cities Health Inventory Data Platform. The collected data related to the 35 largest, most urban cities in the United States from 2010 to 2022. The model-agnostic approach was used to assess and visualize the magnitude and direction of the most influential predictors. Results: The models showed excellent performance with R-squared values of 0.82, 0.81, 0.81, and 0.79, and residual root mean squared error values of 1.06, 0.87, 1.03, 0.99 for KNN, Best subset, Lasso, and XGBoost, respectively. It is noteworthy that the Best subset selection approach had a high RSq and the lowest residual root mean squared error, with only a four-predictor subset. Influential predictors that appeared in three/four models were rate of chlamydia infection, racial segregation, prenatal care, percentage of single-parent families, and poverty. Other important predictors were the rate of violent crimes, life expectancy, mental distress, income inequality, hazardous air quality, prevalence of hypertension, percent of foreign-born citizens, and smoking. This study was limited by the unavailability of data on gestational age. Conclusions: The machine learning algorithms showed excellent performance for the prediction of low birth weight rate in big cities. The identification of influential predictors can help local and state authorities and health policy decision makers to more effectively tackle this important health problem. Full article

Background: The United States has the highest number of immigrants in the world, with over 46 million foreign-born residents as of 2022. A growing number of migrants originate from Latin America, driven by factors such as economic instability, food insecurity, and crime. This study explores their experiences and perceptions regarding trust in the criminal justice system (CJS) in both their home countries and the United States. Methods: This study surveyed 500 migrants at a transitional institution in a U.S.–Mexico border city in the summer of 2023. The survey assessed confidence in law enforcement, immigration officers, courts, and government institutions using a 5-point Likert scale. Results: Migrants reported significantly higher confidence in the U.S. CJS compared to that of their home countries. Multivariate analysis revealed that satisfaction with border officials, documentation status, English proficiency, and health were positively associated with confidence in the U.S. CJS, while employment status, traveling with family, and fear of crime correlated with lower confidence. Conclusions: This study highlights the stark contrast in migrants’ confidence levels between their home countries and the U.S. criminal justice system. While migrants view the U.S. system as more legitimate, challenges such as fear of crime and legal uncertainties persist. Full article

Background/Objectives: This paper aims to assess the unhealthy dietary habits and sedentary behaviours among adolescents and young adults simultaneously. Methods: The sample consists of 682 participants aged 10–24 years old (58.9% males and 68.2% aged 15–19 years old), recruited for the ALIMA (ALImentazione Multiculturale negli Adolescenti) study in both secondary schools and youth aggregation centres, located in Rome. The study utilizes structured questionnaires to gather data on anthropometric measurements, eating habits, alcohol consumption, physical activity, and sedentary behaviours. Data are analyzed by using the Pearson chi-squared test. Results: Excessive screen time (>3 h/day) and inadequate dietary habits (insufficient consumption of fruit, vegetables, and legumes, skipping breakfast, and a high consumption of sugar-sweetened beverages and alcohol) are observed in the total sample, but mainly in older adolescents aged 15–19 years old. The adherence to the MD, measured via the KIDMED index, is significantly different among the three age groups (p = 0.001); 47.8% of the sample has a medium adherence, while among those with a low adherence, the highest percentage is represented by older adolescents (39.8%); those with foreign-born parents have healthier diets, whereas lower parental education correlates with unhealthy behaviours. Conclusions: These results highlight the need for targeted interventions tailored to adolescents and young adults to encourage healthier lifestyle choices. Full article

Political socialization in the United States is circuitous and influenced by numerous outside sources, including parents, teachers, and peers. Moreover, civic organizations and political parties often work directly to recruit and mobilize citizens into politics. However, many foreign-born immigrants are denied these opportunities to acquire socialization. Immigrants are also often further overlooked or ignored by the civic and political organizations that incorporate most native-born Americans into politics. While a range of previous scholarship has sought to demonstrate and explain these disparities, few studies have examined alternative routes to political socialization or reconsidered the paradigm of incremental socialization as it applies to foreign-born populations. We argue that immigrants may instead become involved in the U.S. political system through religious conversion—a pivotal event in their lives. Using surveys of the two predominant U.S. immigrant groups, Asian Americans and Latinos, we show that religious conversion can catalyze the socialization process. Among both groups, religious conversion in the U.S. is associated with increased rates of political participation. These results suggest that immigrant socialization may follow different pathways than those of native-born populations, and that scholars should take into greater consideration the role of critical life events when modelling political socialization among foreign-born populations. Full article

Background: The foreign-born population in the United States has reached a record high over the last three years. Significant disparities in cancer screening rates exist among this population, resulting in later-stage diagnoses and worse outcomes. This narrative review explores the sociodemographic factors, barriers, and interventions influencing cancer screening rates among foreign-born individuals in the U.S. Methods: A comprehensive review of studies was conducted to assess colorectal, cervical, and breast cancer screening disparities among immigrants. Factors examined include length of residence, race and ethnicity, income, education, citizenship, insurance, usual source of care, language, medical literacy, and cultural barriers. Furthermore, the effectiveness of educational interventions, patient navigators, and at-home testing in addressing these screening disparities was evaluated. Results: Immigrants have lower screening rates for colorectal, cervical, and breast cancer compared to U.S.-born individuals, with the largest disparities observed in colorectal cancer. Factors influencing these gaps include shorter duration of residence, Asian ethnicity, and lower income and education levels. Lack of health insurance and of a usual source of care are currently the most significant barriers to screening. Interventions such as education, patient navigation, and at-home testing have shown moderate success in improving screening rates, though data on their effectiveness remain limited. Conclusions: Addressing cancer screening disparities within the U.S. foreign-born population is essential, especially as the immigrant population continues to reach record numbers. Targeted interventions are needed to improve screening among immigrant groups with the lowest completion rates. Future research on these interventions should prioritize larger sample sizes, longitudinal studies, and the utility of new technologies such as artificial intelligence. Full article

Background/Aims: Immigrant populations face unique dietary challenges influenced by food security and acculturation, particularly regarding sugar-sweetened beverages (SSBs). This study examines the interplay of nativity and food security on SSB consumption patterns. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2007–2020 (N = 23,331) were analyzed in this cross-sectional study. SSB consumption was assessed through 24 h dietary recalls. Food security was categorized as high/marginal or low/very low, and nativity as U.S.-born or foreign-born. Stratified regression models by sex evaluated associations between nativity, food security, and SSB consumption. Results: U.S.-born adults with low food security had the highest sugar intake (men: β = 27.5, 95% CI [14.8, 40.3]; women: β = 30.4, 95% CI [11.0, 49.7]) and SSB consumption (men: β = 14.7, 95% CI [11.2, 18.3]; women: β = 23.6, 95% CI [15.2, 31.9]). Conclusions: The findings highlight associations that suggest the importance of culturally tailored interventions targeting vulnerable groups to address disparities in SSB consumption influenced by food security and nativity. Full article

Background: Exposure to traumatic experiences has been positively associated with college students’ academic difficulties and psychological distress. However, little is known about the traumatic events experienced by Hispanic college students. This study examined the types of lifetime traumatic events experienced by Hispanic college students, including immigration enforcement-related events, and the association between events and psychological distress. Methods: College students (N = 1112) completed self-reported measures assessing lifetime traumatic experiences, post-traumatic stress disorder (PTSD) symptoms, and depression symptoms. Results: Most participants (81%) were born in the US, and most (84%) reported that at least one parent was foreign born. Hispanic students reported similar types of traumatic events reported by the general population of college students in previous studies. In addition, many students reported immigration-related potentially traumatic events. The following types of traumatic events were most strongly associated with greater levels of psychological distress: sexual assault or molestation, life-threatening illnesses or accidents, verbal abuse, physical or verbal bullying or mistreatment, directly experienced immigration enforcement events, and having witnessed physical or verbal abuse of someone close. Conclusions: It is important that clinicians use a broad definition of potentially traumatic events in the identification and treatment of Hispanic college students who may have experienced PTSD or depression symptoms following major life events, including immigration enforcement events. Full article

This study uses data from the 2006–2012 Health and Retirement Study (HRS) genetic sample (N = 11,667) to explore the “immigrant health paradox” from a novel perspective by examining the nativity differences in genetic predisposition to health-related outcomes. Polygenic indices (PGIs) were used to evaluate whether older non-Hispanic white foreign-born individuals have genotypes that predispose them to better health profiles compared to their U.S.-born counterparts. The results show an immigrant advantage with respect to genetic predisposition to cognitive function, BMI, and smoking frequency. There are no significant differences in genetic predisposition to height, smoking initiation, and depression. Including respective PGIs in multinomial regression models partially explains an immigrant advantage with respect to cognitive function and obesity. The findings are consistent with the “healthy immigrant effect” or selective migration of individuals with a favorable genetic predisposition to health as one of the explanations of the immigrant health paradox. Full article

For the United States, detailed estimates of the number of resident migrants and the rates of migrant arrival are valuable for understanding population dynamics and for determining the impact of economic and political changes that influence migration. The goal of this analysis was to derive estimates of the U.S. foreign-born population and how this population has changed in recent years, as well as estimates of recent and historical immigration volumes. Using data from large population surveys (the 2000 U.S. decennial census and 2001–2019 American Community Survey (ACS)), a Bayesian evidence synthesis was conducted to pool survey data across years while accounting for various biases and logical constraints that apply to these data. This analysis produced highly disaggregated estimates of the foreign-born population residing in the United States over the period 2000–2019, as well as estimates of immigration volume for 1950–2019. These population estimates demonstrated high in- and out-of-sample predictive performance, with substantially greater precision than that for raw survey estimates. Estimated immigration flows tracked other available time series, although with higher precision and with the potential to include undocumented immigration not represented in other immigration data. This study documents immigration from 100 countries of origin into the United States and demonstrates how the results of repeated cross-sectional population surveys can be used to infer migration dynamics that are difficult to measure directly. Full article

Background/Objectives: Human papillomavirus (HPV) is linked to multiple cancers that can be prevented through vaccination. While the optimal age for vaccination is in childhood and adolescence, vaccination recommendations include adults through age 26 who missed childhood/adolescent vaccination. There are limited data about disparities among adults eligible for catch-up HPV vaccination. We conducted a comprehensive examination of HPV vaccination among US young adults, disaggregating the group by race/ethnicity and nativity status to identify subgroups that may require additional interventions. Methods: We analyzed 2019 and 2022 data of individuals aged 18–26 years from the National Health Interview Survey. Generalized linear models using Poisson regression with log link were used to examine the receipt of 1+ dose of HPV vaccine, race/ethnicity, and nativity (i.e., US- versus foreign-born) status. Results: The overall receipt of 1+ doses of HPV vaccine was 47.5%. The vaccination rate among the US-born group was 49.7% versus 31.9% among the foreign-born group with an adjusted prevalence ratio (APR) of 0.72; (95% CI, 0.62–0.82). Foreign-born non-Hispanic (NH) Black individuals (APR 0.31; 95% CI, 0.13–0.70) were less likely to be vaccinated against HPV than foreign-born NH White individuals, while US-born NH Asians (APR 1.27; 95% CI, 1.09–1.48) had a higher prevalence of the vaccination than the US-born NH White group. Additionally, foreign-born NH Asian (APR 0.60; 95% CI, 0.46–0.77), NH Black (APR 0.27; 95% CI, 0.12–0.61), and Hispanic (APR 0.76; 95% CI, 0.60–0.97) populations were less likely to be vaccinated than their respective US-born counterparts. Conclusion: Profound HPV vaccination inequalities exist among US young adults with particularly low vaccine coverage among racially and ethnically minoritized immigrant populations. Full article

Background/Objectives: Spain has been in a measles elimination phase since 2014. No evidence exists about the distribution of measles cases among the population born outside Spain. The aim of this study was thus to describe the epidemiological situation of measles, stratified by place of birth, during the post-elimination period in Spain. Methods: This is a retrospective study of confirmed measles cases reported to RENAVE between 2014 and 2022. A descriptive analysis of case characteristics (sex, age group, vaccination status, imported case) was performed, was well as an analysis of temporal trends and geographic distribution in measles incidence rate (IR; cases/million inhabitants). All analyses were stratified by place of origin (Spain born vs. born outside Spain). We then performed a sensitivity analysis of those born outside Spain, with the representation of Kaplan–Meier curves taking into account the year of arrival in the country until the onset of measles. Results: Between 2014 and 2022, 951 measles cases were reported in Spain (overall IR: 2.3). Among these, 18.6% (177 cases, IR: 3.0) were born outside Spain. The IRs show differences (p < 0.001) in terms of distribution by age group and origin. By age group, children under 5 years had the highest IR, but adults aged 30 years and older reported the highest proportion of cases. The incidence rate ratio (IRR) was 5-fold higher among foreign-born children under 5 years than among native-born children. The measles time trend shows the highest peak in 2019 for foreign-born and native-born (IR: 8.6 and 5.4, respectively), consistent with the European-wide scenario, while only one case of measles was reported in 2022. Geographical variability in incidence rates by region was observed: Catalonia and the Valencian Community accumulated the highest proportion of cases throughout the study period. Among those born outside Spain, the median time from arrival to onset of rash was 6 years. Conclusions: The incidence of measles is 40% higher in Spain’s foreign-born population than in its native-born population. Taking into account the increasing migrant population in Spain, we consider that public health efforts need to be directed towards susceptible groups of people. In this context of advanced elimination, specific interventions for identifying and attending the most vulnerable populations should be designed and implemented. Full article