Search Results (343)

Racialised minority populations were disproportionately affected by COVID-19 and saw the highest rate of COVID-19 infections and mortality. Low socioeconomic status, working as frontline workers, temporary employment, precarious immigration status and pre-existing medical conditions were factors that contributed to disadvantaged experiences. This systematic review looked at the impact of COVID-19 on racialised minority populations globally, recognising their experiences, perspectives and the effects on their physical and mental health. Eight electronic databases were searched (MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Social Sciences Citation Index (SSCI), Social Policy and Practice (SPP), Applied Social Sciences Index and Abstracts (ASSIA), MedRxiv and Research Square) for English language qualitative studies. Reference lists of relevant literature reviews and reference lists of articles were hand-searched for additional potentially relevant articles. Duplicates were removed, and articles were screened for titles and abstracts, followed by full-text screening. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included studies (n = 70). Data were synthesised using thematic synthesis. Seven major and three minor themes were identified. The major themes related to (i) children and young people’s experiences of COVID-19; (ii) exacerbated pre-existing disparities relating to income, employment and housing security, health insurance and immigration status; (iii) lack of knowledge and information about COVID-19 and COVID-19 misinformation; (iv) racial history of medicine and treatment of racialised populations; (v) contemporary experiences of racism; (vi) impact on physical and mental health and wellbeing; (vii) concerns about safety at work. Minor themes related to (a) experiences of intercommunity mutual aid; (b) adherence to preventative guidance/COVID-19 restrictions; (c) the role of faith. Research needs to focus on developing and testing interventions that support transformation of social, cultural and economic systems towards equity of access to healthcare and healthcare knowledge. Research should be cognisant of interventions that have worked in shifting the equity dial in the past, implement these and use them to inform new approaches. Policy and practice should be mechanisms for enabling the implementation of interventions. Full article

Food insecurity (FI) is a major public health problem that disproportionately affects women, especially if they are migrants. In Chile, there is limited data on how gender and migration status intersect to explain vulnerability to FI. A cross-sectional analytical study was conducted among 2124 women of childbearing age (1062 Chilean and 1062 immigrants) residing in south-central Chile. Biosociodemographic variables were collected through a structured questionnaire, and FI was assessed using the Household Food Insecurity Access Scale (HFIAS). Multivariate logistic regression models were applied to estimate risk factors using odds ratios (OR). Overall, 39.2% of women experienced some degree of FI, with prevalence significantly higher among immigrants (49%) compared to Chileans (29%). Severe FI was twice as frequent in immigrant women (18.1% vs. 9.2%). The risk factor of FI in the total sample included immigrant status (OR = 2.61; 95% CI: 2.15–3.17), low socioeconomic status (OR = 2.25; 1.77–2.87), having children (OR = 1.82; 1.49–2.23), being head of household (OR = 1.53; 1.25–1.87), not having a job (OR = 1.27; 1.02–1.58), and suffering from depression (OR = 2.11; 1.66–2.67). Subgroup analyses confirmed similar determinants in both groups, with not having a job being relevant mainly for immigrants and age acting as a protective factor among Chileans. FI is highly prevalent among women in south-central Chile, particularly among immigrants. Structural determinants such as socioeconomic status, having children, being the head of the household, and depression increase vulnerability. Policies must integrate gender and migration perspectives, promoting access to adequate food, employment, childcare, and mental health support. Full article

This article examines how the insecure and precarious legal status of adoptees gives rise to vulnerabilities, with a particular focus on the citizenship of foreign-born adoptees. The primary objective of this work is to identify vulnerabilities associated with U.S. citizenship rules. While adoption is often assumed to guarantee both familial belonging and a legal status of citizenship, the U.S. legal framework frequently reveals gaps that leave adoptees in vulnerable positions. By tracing how administrative requirements, adoptive parents’ lack of due diligence, and fragmented legal pathways create insecurity, this article shows that the law itself may generate or exacerbate vulnerabilities it purports to resolve. Drawing on the concepts of vulnerability and navigating the intersection of family law and immigration law, the analysis highlights how citizenship is more than a legal status, affecting deeper issues of identity-building and belonging. The article concludes by underscoring the need for a protective, adoptee-centered, coherent approach to citizenship rules, one that offers better legal permanence for adoptees. Full article

The UNHCR reported that over 123.2 million people were forcibly displaced worldwide by the end of 2024, with the mental health of refugees emerging as a critical issue. In the UK, asylum seekers and refugees make up around 13% of immigrants and the number is increasing year on year. The Immigration and Asylum Act 1999 aimed to ensure that most cases of asylum seekers would be decided fairly, and within six months. However, it has been argued that long wait times and systemic inequalities and inequities within the asylum system have contributed to heightened mental health problems among refugees even once they gain refugee status. The present study aimed to examine the factors that refugees perceive as limiting their ability and willingness to access mental health services in the UK. A systematic review of 15 relevant articles followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results highlight intersecting perceived limitations to accessing mental health services, such as language difficulties, cultural disconnection regarding mental health including stigma and prejudice, mistrust of services as well as structural barriers including general service limitations and the involuntary transient nature of many refugees’ lives. Policy recommendations emphasize integrating ethnic minority organizations into services, developing culturally adapted services that take into consideration the views of refugees, and ensuring holistic approaches to address socio-economic determinants. Full article

In this article, I build on liminal legality to highlight how 1.5-generation Latinx immigrant young adults who benefited from Deferred Action for Childhood Arrivals (DACA) confronted an additional dimension of uncertainty, which I describe as temporal liminality. Temporal liminality captures the way time itself––through bureaucratic cycles, political threats, and temporary protections––was moralized and weaponized, producing waiting, deferral, and arrested development. Drawing on interviews with DACA recipients in North Carolina and Massachusetts, I show how temporal liminality shaped three central domains: work and career, family and intimate relationships, and travel and mobility. These findings reveal how the state’s regulation of time foreclosed opportunities, reordered life trajectories, and deepened the strains of precarious legality. By centering temporality, this article advances scholarship on immigrant incorporation by demonstrating how moralized timelines, stolen opportunities, and bureaucratic timelines structured the everyday lives and futures of immigrants with uncertain legal status. Full article

Given world immigration patterns, understanding immigrant children’s social inclusion is crucial, especially the role of school characteristics. The current study examines how individual- and school-level factors shape immigrant children’s peer relationship In Ireland, a context that has experienced rapid demographic change by remains underexplored in the literature. Drawing on social network theory, we analyse data from 2244 primary school children across 98 schools, using measures of peer group size, friendship nominations, and network centrality to capture social inclusion. Multilevel regression models show that immigrant children report smaller peer groups compared to non-immigrant peers, while minority language use is consistently associated with lower levels of social centrality. Contrary to expectations, school size and urbanicity had limited effects, and classrooms with a higher proportion of immigrant students were associated with reduced inclusion overall, although immigrant children themselves benefitted somewhat from greater classroom diversity. Family affluence was positively associated with all measures of inclusion, highlighting the role of socioeconomic inequalities alongside migration background. The findings underscore the complex and multifaceted nature of social inclusion, showing that both structural and interpersonal dynamics shape immigrant children’s experiences in Irish schools, and pointing to the need for targeted strategies to address linguistic and socioeconomic barriers. Full article

Background: Haemoglobinopathies are among the most common monogenic disorders worldwide. Early identification of asymptomatic carriers through reliable screening and molecular diagnostics is crucial for prevention programmes, especially in high-prevalence regions such as Southern Italy. Methods: A total of 5243 individuals were analysed between 2013 and 2024 using both biochemical and genetic parameters. First-level screening included full blood count, iron status, and high-performance liquid chromatography (HPLC) for haemoglobin variant quantification. Molecular analyses were performed using next-generation sequencing (NGS) for the HBA1, HBA2, and HBB genes. Results: We identified 267 individuals (11.2%) as carriers of α-thalassaemia and 473 individuals (16.7%) as carriers of β-thalassaemia. Among them, 5 were compound heterozygotes and 3 homozygous for the α-3.7 deletion. A rare case of HbG Philadelphia in association with a triplicated α-gene was also observed. The most common β-globin mutations included c.118C>T (β⁰39, 44%), IVS-I-110 (17.7%), IVS-I-6 (12.7%), and IVS-I-1 (12.3%). Among α-globin mutations, the most prevalent were -α^3.7 (48%), α2 IVS1 -5nt (15.4%), -20.5 Kb (14.2%), and triplicated α (11%). In total, 18.7% of individuals were found to carry either α- or β-thalassaemia traits. Conclusion: Our findings highlight the limitations of traditional diagnostic methods—such as the osmotic fragility test—and the importance of integrating haematological, biochemical, and molecular data to accurately identify thalassaemia carriers. The variability of genotype–phenotype correlations, especially in the context of immigration and genetic diversity, underscores the need for comprehensive molecular analysis. We propose a three-step diagnostic algorithm combining first-level screening, iron status assessment, and NGS-based sequencing for inconclusive cases. Full article

Compared to studies in school settings, little attention has been paid to bullying in the child protection system (PS), even though these children, adolescents, and youth are one of the most vulnerable groups, with the highest prevalence of bullying. This study aims to analyze, according to gender and nationality, the perception of adolescents and youth in the Spanish PS of the bullying and gender-based bullying situations that take place in their protection facility, as well as their response to these situations and the relationship with the training they received in gender equality, sexual diversity and bullying. Two hundred forty-nine adolescents and youth from 58 centers/facilities of the PS in Spain, with an average age of 16.38 years, participated. Of these, 37.3% had Spanish nationality. A correlational study was conducted using a cross-sectional random sample survey. It was found that 30.9% of the participants identify bullying situations, which reached 34.9% for LGBTIQ-phobic bullying and 37.7% for sexist bullying. Girls identify situations of both bullying and sexist bullying more, and girls and both male and female Spanish adolescents and youth attribute greater severity to these problems and respond more positively in favor of the victims. Those who have received more training in gender equality, sexual diversity, and bullying support bully victims more significantly. According to our current knowledge, this study addresses for the first time the phenomenon of bullying and gender-based bullying in the context of the PS from a perspective of gender, nationality, and the formative dimension. It also highlights the need for mandatory training in gender-equality and sexual diversity for adolescents/youth and educational professionals of the PS, as well as the creation of specific anti-bullying protocols with an inclusive approach. Full article

Adolescent school victimization is a socially regulated experience, making it important to consider classroom-level compositional effects beyond individual characteristics. This study investigated the role of classroom characteristics, specifically, classroom socioeconomic status, average academic achievement, sex composition, immigrant density, and class size, in shaping students’ experiences of school victimization. Victimization was analyzed using a doubly latent multilevel modeling approach, which accounts for measurement error at both individual and classroom levels. The analyses drew on the entire Italian 10th grade student population (N = 254,177; M_age = 15.58 years; SD_age = 0.74) and a considerable number of classrooms (N classrooms = 14,278), a sample size rarely available in the social sciences. Results indicated that classroom characteristics played a significant role in victimization, beyond individual-level variables. The most important factors were sex and prior academic achievement: classrooms with a higher proportion of male students experienced greater victimization, whereas higher average achievement was associated with lower victimization. A greater proportion of second-generation immigrant students, but not first-generation students, was also associated with increased victimization. By contrast, classroom socioeconomic status and class size were not significant predictors of victimization. In conclusion, these findings highlight the importance of considering the additional influence of the classroom context for school-based interventions, particularly the composition of classrooms in terms of sex and academic achievement, when addressing student victimization. Full article

Background: Health system literacy is crucial for immigrants to navigate health care systems and access necessary services. Little is known about how well immigrants understand and use the healthcare system in Canada. This study aimed to adapt and validate a health system literacy scale for the Canadian context (HSL-CAN). Methods: A cross-sectional online survey was conducted from March 11 to July 19, 2024, among Chinese individuals aged 30 or older who have lived in Canada for at least 6 months. The HSL-CAN was developed through a literature review, patient and provider consultation, and adaptation of the European Health Literacy Population Survey 2019–2021 for navigational health literacy measurement (HLS₁₉–NAV) and was then translated into simplified and traditional Chinese. Content validity was evaluated via stakeholders’ feedback, and structural validity was evaluated via exploratory and confirmatory analyses (EFA/CFA). Convergent and discriminant validity, as well as known-group validity, were tested using correlations with the HLS₁₉-SF12, ANOVA (or t-test), and effect size. Internal consistency was measured with Cronbach’s alpha coefficient and composite reliability. Results: Initially, HSL-CAN contained 25 items developed using a five-point Likert response scale. Some minor revisions were made according to the stakeholders’ feedback (n = 12). Five redundancy items were removed based on the EFA. CFA supported a one-factor model with good fit indices (CFI = 0.960, TLI = 0.955, SRMR = 0.033, RMSEA = 0.025),${\chi }^2$/df = 1.41). The scale showed a solid internal reliability (Cronbach’s alpha = 0.81; composite reliability = 0.812). The HSL-CAN is highly correlated with the “health care” construct but lowly with the “health prevention and promotion” construct of HLS₁₉–SF12. Known-group validity showed large mean differences by education, income, and non-cancer chronic comorbidities and small to moderate mean differences by gender, age groups, employment status, self-rated health, and assistance needed to see a healthcare provider. Conclusions: The HSL-CAN is the first validated instrument to evaluate health system literacy in the Chinese population in Canada. Given strong validity and reliability, the instrument can be useful for research and practice, although further refinement is recommended before using this scale on the general population in Canada. Full article

Immigrant and mixed-status families comprise a growing population in the United States, facing numerous barriers to accessing essential health and social services. This study examines service access barriers within the unique context of New Mexico’s borderlands, where constitutionally protected bilingualism and welcoming local policies contrast sharply with restrictive federal border enforcement. Using a qualitative approach, we conducted five focus groups with 36 immigrant caregivers in Doña Ana County, New Mexico, with the objective of understanding the factors that facilitate and hinder immigrant families’ access to health, behavioral health, and social services in this socio-politically complex border environment. Thematic analysis revealed three overarching themes: (1) structural and organizational limitations, including language barriers and transportation challenges exacerbated by border checkpoints; (2) the persistence of “chilling effects” on service use despite a Democratic presidency and post-pandemic policy shifts; and (3) community-defined recommendations for improving service access. The findings demonstrate how federal immigration enforcement undermines local inclusion efforts, creating enduring barriers to service access even in historically bilingual, immigrant-friendly regions. The participants proposed specific solutions, including mobile service units and integrated service centers, that account for both geographic and socio-political barriers unique to border regions. These community-generated recommendations offer practical strategies for improving immigrant service access in contexts where local welcome and federal enforcement create competing pressures on immigrant families. Full article

The COVID-19 pandemic disrupted progress towards global HCV elimination goals by interrupting essential health services in Canada and globally. We aimed to evaluate the effect of the pandemic on hepatitis C virus (HCV) testing rates in a population-based cohort study in Ontario using health administrative data. All residents with records of either HCV antibody or ribonucleic acid (RNA) tests were included. Monthly testing rate per 1000 population were compared during the pre-pandemic (01/01/2015–29/02/2020) and pandemic (01/03/2020–31/12/2022) periods using interrupted time series models, stratified by sex, homelessness, human immunodeficiency virus (HIV), and immigration status, and people who inject drugs (PWID). The HCV testing rate followed a statistically significant upward trend before the pandemic, dropping at its onset with 1.38/1000 fewer individuals initiating testing monthly. Compared to counterfactual estimates, the observed monthly number of people tested per 1000 population was lower by 1.41 (95% CI: 1.18–1.64) in 2020 (May–Dec), 1.17 (95% CI: 0.99–1.36) in 2021, and 1.41 (95% CI: 1.22–1.59) in 2022, corresponding to relative reductions of 47%, 34%, and 41%, respectively. Testing rates remained below expected levels across all subgroups throughout 2020–2022, with the greatest absolute declines observed among people co-infected with HIV, people experiencing homelessness, and PWID. Tailored, equity-focused interventions are needed to address these persistent gaps in HCV testing, without which Canada’s progress toward its 2030 elimination targets remains at risk. Full article

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article

This study examines how U.S. immigration policies enact legal violence and multigenerational punishment through the spousal reunification process, particularly in mixed-status, transnational families. Building on the concept of “deportability,” we introduce “importability” to describe a beneficiary’s potential to secure permanent residency, which varies according to social markers such as race, gender, and region of origin. Drawing from a content analysis of threads on the Immigration Pathways (IP) web forum, we analyze discussions among U.S. citizen petitioners navigating marriage-based green card applications, with a focus on experiences involving administrative processing (AP) (i.e., marriage fraud investigations). Our findings show that couples who do not align with the state’s conception of “proper” family—particularly U.S. citizen women petitioning for Black African partners—face intensified scrutiny, long delays, and burdensome requirements, including DNA tests and surveillance. These bureaucratic obstacles produce prolonged family separation, financial strain, and diminished sense of belonging, especially for children in single-parent households. Through the lens of “importability,” we reveal how legal violence and multigenerational punishment of immigration policies on mixed-status families beyond deportation threats, functioning as a gatekeeping mechanism that disproportionately affects marginalized families. This research highlights the understudied consequences of immigration policies on citizen petitioners and contributes to a broader understanding of inequality in U.S. immigration enforcement. Full article

This essay examines two hybrid poetic texts that emerged from a period of feminist activism in U.S. and global poetry communities from 2014 to 2017: the collaboratively, anonymously authored “No Manifesto” (2015) and the radically revised second edition of the book of poetry and visual art YOU DA ONE by Jennif(f)er Tamayo. “No Manifesto” and YOU DA ONE embrace the hybrid tactics of collectivity, incongruity, and nonresolution as ways of protesting sexism and sexual violence in poetry communities. Synthesizing theories of hybridity from poetry criticism as well as immigrant and borderlands studies, the essay defines hybridity as a literary representation of cultural positions forcefully imposed upon subjects. Born out of the domination of sexual and state violence, hybridity marks the wound that remakes the subject, who develops strategies for resistance. By refusing to play by the rules of poetic or social discourse—the logics of domination that would have them be singular, cohesive, and compliant—Tamayo and the authors of “No Manifesto” insist on alternative ways of performing activism, composing literature, and entering the public sphere. These socially engaged, hybrid poetic texts demonstrate the power of the collective to disrupt the social and literary status quo. Full article