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Discrimination has been identified as a major stressor and influence on immigrant health. This study examined the role of perceived discrimination in relation to other factors, in particular, acculturation, in physical and mental health of immigrants and refugees. Data for US adults (18 +  years) were derived from the National Epidemiologic Survey on Alcohol and Related Conditions. Mental and physical health was assessed with SF-12. Acculturation and perceived discrimination were assessed with multidimensional measures. Structural equation models were used to estimate the effects of acculturation, stressful life effects, perceived discrimination, and social support on health among immigrants and refugees. Among first-generation immigrants, discrimination in health care had a negative association with physical health while discrimination in general had a negative association with mental health. Social support had positive associations with physical and mental health and mediated the association of discrimination to health. There were no significant associations between discrimination and health among refugees, but the direction and magnitude of associations were similar to those for first-generation immigrants. Efforts aiming at reducing discrimination and enhancing integration/social support for immigrants are likely to help with maintaining and protecting immigrants’ health and well-being. Further research using larger samples of refugees and testing moderating effects of key social/psychosocial variables on immigrant health outcomes is warranted. This study used multidimensional measures of health, perceived discrimination, and acculturation to examine the pathways between key social/psychosocial factors in health of immigrants and refugees at the national level. This study included possibly the largest national sample of refugees.

In the public debate, immigration is often viewed as a threat to the access and the quality of health care services. The health needs of immigrants and refugees pose new challenges to health care systems. This chapter reviews the recent economic literature on immigration and health. We discuss the main methods used to study the health immigrant trajectories and the effects of immigration on demand and supply of health care in both destination and sending countries.

Public libraries can help immigrants adjust to life in the USA, including maintaining health and well-being. The purpose of this study was to understand how immigrants use public libraries and how library staff provide health-related information and services for immigrant audiences.

This study used semistructured interviews with library staff (n = 9) and immigrant library patrons (n = 10), representing multiple first languages and countries of origin from two different library locations within a large public library system in a US mid-Atlantic city.

Staff reported offering many health-related programs and services, but only one of the 10 patron respondents had used them. Patrons more commonly used the library in ways indirectly related to health (e.g. learning English) than direct health-related services. Staff reported comfort interacting with immigrant patrons, but lacked consensus on navigating language barriers and determining community needs.

This qualitative study provides insights from a specific geographic and cultural setting. It focused on immigrants using the library and may have excluded vulnerable populations of immigrants who encounter barriers to using the library. Future research and practice should focus on how public libraries can better meet the health information needs of immigrant populations, including navigating controversial social and political topics, as well as emerging health-related information during a pandemic.

Public health practitioners often overlook public libraries as community collaborators. This research identifies that while there is important and essential work happening in public libraries to improve immigrant health, more can be done, especially in collaboration with public health professionals.

The purpose of this paper is to explore health from the perspective of young immigrants in Sweden.

A total of 25 newly arrived young immigrants attending Swedish language classes in northern Sweden participated by drawing and writing open letters. They continued the open-ended sentence “Now I’ll draw and describe a day when I was feeling good, that was […].”

The phenomenological analysis resulted in three themes: longing to be in control for a better life, searching for power in the good and the bad, and striving for a sense of belonging in the new society. The findings illuminate young immigrants’ perspectives of a health-promoting everyday life consisting of agency, reflection and a sense of community. The findings also highlight the young immigrants’ experiences when health-promoting aspects are lacking, characterized by disillusionment, anxiety and loneliness. The findings are discussed with health promotion, health literacy and young immigrants in mind.

According to young immigrants, meeting basic needs such as food, sleep and housing is health promoting but easily taken for granted. Being able to have a say in matters concerning everyday life, social inclusion and finding power in memories – positive and negative – can promote health in young immigrants.

The young immigrants were able to communicate via drawings and words to overcome language barriers.

Past research on the immigrant health paradox suggests that children with immigrant parents may have a health advantage over those with US-born parents, especially if the parent is a recent immigrant. Other research emphasizes the social and economic challenges children with immigrant parents face, in part due to disadvantaged social class and racial/ethnic positions. Underlying physiological changes due to chronic stress exposures among children in immigrant families is one potential health disadvantage that may not yet be apparent in traditional health measures. To explore these biological disparities during childhood, I use national biomarker and survey data from the National Health and Nutrition Survey (NHANES) (N = 11,866) to evaluate parent nativity and educational status associations with low-grade inflammation, indicated by C-reactive protein (CRP), in children ages 2–15 years. I find that children with an immigrant parent, and particularly a low-educated immigrant parent, have higher CRP, net of birth, body mass index (BMI) and other factors, than children with a US-born parent with either a low or higher education. Comparing children with low-educated parents, those with a foreign-born parent have higher predicted CRP. The findings from this study provide new evidence that children living in immigrant families in the US may be facing higher levels of chronic stress exposure, as indicated by the increased risk of low-grade inflammation, than those with US-born parents. The physiological changes related to increased risk of inflammation, could set children in immigrant families on pathways toward mental and physical health problems later in the life course.

Age at migration is commonly utilized as a proxy measure for assimilation in health behavior research. We reconsider this approach by examining the role of continued connection with places of origin on alcohol use, an important marker of health behavior and overall population health. Cross-border connections may buffer the association between earlier age at migration and alcohol use by providing an alternative channel of influence for behavioral norms. Alternatively, a stress and coping perspective on cross-border ties suggests potentially countervailing adverse impacts of these connections on alcohol use. We used data from the 2002/2003 National Latino and Asian American Study (NLAAS) (n = 1,641/1,630 Asian and Latino origin respondents, respectively). We first estimated the association between age at migration (child/adolescent versus adult migrant) and any past-year alcohol use. We subsequently tested the interaction between age at migration and two measures of cross-border connections. All models were stratified by region of origin and gender. For Latin American-origin women, cross-border ties were associated with increased risk of past-year alcohol use among those who migrated early in life. In contrast, Asian-origin men and women who migrated as adults and had contact with family and friends abroad had the lowest predicted probabilities of past-year alcohol use. The results among Asians support the idea that cross-border ties may be alternative influences on health behavior outcomes, particularly for adult migrants. Overall, we find qualified support for both transnational and assimilationist perspectives on alcohol use behaviors among US immigrants – as well as the interaction between these two frameworks. The joint influences of cross-border ties and age at migration were observed primarily for immigrant women, and not always in expected directions. We nevertheless urge future research to consider both US and country of origin influences on a wider range of health and health behavior outcomes for immigrants, as well as the potential intersection between US and cross-border connections.

Purpose: Fear of deportation and its relationship to healthcare access has been less studied among immigrant Latinx men who have sex with men (MSM), a population at risk for HIV and characterized by their multiple minority statuses. The first step is to accurately measure their fear of deportation.

Approach: We used an exploratory sequential mixed methods design. Eligibility criteria were that research participants be ages 18–34 years; Latinx; cisgender male; having had sex with another male; residing in the District of Columbia metro area; and not a US citizen or legal permanent resident. In Study 1, we used in-depth interviews and thematic analysis. Using participants' interview responses, we inductively generated 15 items for a fear of deportation scale. In Study 2, we used survey data to assess the scale's psychometric properties. We conducted independent samples t-test on the associations between scale scores and barriers to healthcare access.

Findings: For the 20 participants in Study 1, fear of deportation resulted in chronic anxiety. Participants managed their fear through vigilance, and behaviors restricting their movement and social network engagement. In Study 2, we used data from 86 mostly undocumented participants. The scale was internally consistent (α = 0.89) and had a single factor. Those with higher fear of deportation scores were significantly more likely to report avoiding healthcare because they were worried about their immigration status (p = 0.007).

Originality: We described how fear of deportation limits healthcare access for immigrant Latinx MSM.

Research implications: Future research should examine fear of deportation and HIV risk among immigrant Latinx MSM.

In this chapter we examine how micro- and macro-level issues including access to child-only or family public health insurance shape low-income immigrant families’ health care experiences in two policy contexts in the Washington, DC metropolitan area.

This qualitative study includes 40 in-depth interviews with first-generation, low-income immigrant Latin American and African mothers in DC and Northern Virginia.

The majority of families living in Virginia had child-only health insurance, whereas most of the families living in Washington, DC, had family health insurance. Regardless of these insurance differences, all mothers had access to free health care for prenatal care. Pregnancy, for most, was their entry into the U.S. health care system. Families’ ongoing health care experiences differed in relation to insurance access, and culture, including parents’ previous experiences with health care in their countries of origin.

Future research should consider the experiences of other immigrant groups, mental health experiences of immigrants, and fathers’ experiences with health care.

Future initiatives to address health care should focus on providing family health care to low-income immigrant families across the country, improving access to mental health services for immigrant families, and creating more culturally and linguistically appropriate health care services.

This study points to the importance of family health care for immigrant families, as well as care that is culturally and linguistically competent.

This study illustrates the need for public family health insurance for low-income immigrant families, and the importance of culturally competent health care for immigrants.

Canada has a globally recognized universal health-care system. However, immigrants experience a number of obstacles in obtaining primary health care (PHC) that may differ within various communities due to the intersection of culture, gender and other identities. To date, no research has been done on the difficulties Nepalese immigrant women in Canada may face accessing PHC. The purpose of this study was to learn about their perceptions of barriers to PHC access and to share the findings with a wide range of stakeholders, including health-care providers and policymakers.

The authors conducted a community-engaged qualitative study in Calgary, Alberta, Canada. A total of six focus group discussions (FGD) among 34 participants (each FGD consisted of 5–7 participants) were conducted. The authors collected demographic information before each focus group. The FGDs were audio recorded and transcribed verbatim. The transcriptions were coded and analysed thematically.

The focus groups identified long wait times as a major barrier to receiving PHC services. Long wait times in emergency rooms, unable to see family doctors when they were sick, tedious referral procedures, long waits at the clinic even after scheduling an appointment, family responsibilities and work all impacted their access to PHC. Further, a lack of proficiency in English was another significant barrier that impeded effective communication between physicians and immigrant women patients, thus compromising the quality of care. Other barriers mentioned included lack of access to medical records for walk-in doctors, insufficient lab/diagnostic services, a lack of urgent care services and unfamiliarity with the Canadian health-care system.

Accessible PHC is essential for the health of immigrant populations in Canada. This study recognizes the extent of the barriers among a relatively less studied immigrant population group, Nepalese immigrant women, which will help effectively shape public policy and improve access to PHC for the versatile immigrant population fabric in Canada.