High Immigrant Concentration Research Articles

Exploring cultural competence barriers in the primary care sexual and reproductive health centres in Catalonia, Spain: perspectives from immigrant women and healthcare providers

BackgroundImmigrant populations, especially women, continue facing challenges in accessing quality healthcare, particularly sexual and reproductive health services (SRH). Poor cultural competent health systems contribute to communication challenges between immigrant women and healthcare providers perpetuating health disparities. This exploratory study describes these communication barriers from the perspective of Moroccan and Pakistani immigrant women and healthcare providers within the Catalan health system and its implications to ensure an equitable provision of SRH services.MethodsAn exploratory-descriptive qualitative study was conducted in various municipalities of Barcelona with high concentration of immigrants. Eight focus groups (N = 51) and semi-structured interviews (N = 22) with Moroccan and Pakistani immigrant women were combined with key informant interviews (N = 13) with healthcare professionals. Thematic analysis and data triangulation were performed primarily using an inductive approach.ResultsLanguage barriers and cultural differences in health needs, expectations, care-seeking behaviours and understanding of quality healthcare provision hindered the ability of immigrant women and providers to interact effectively. Limited availability of intercultural mediators and inadequate cultural competence training opportunities for health staff were also identified. Findings suggest a lack of minority representation in the Catalan health workforce and leadership roles.ConclusionThis study reinforces the evidence of persistent inequities in accessing healthcare among immigrant populations by focusing on the cultural competence barriers of the Catalan health system in the provision and access to SRH services. The regularization of adequately trained intercultural mediators, quality training in cultural competence for health staff and a commitment to increase workforce diversity would contribute to improve intercultural communication between immigrant patients and providers. An urgent call to action in this direction is needed to ensure an equitable access to SRH services among immigrant women.

The tendency and affecting factors of nursing students' Xenophobia toward refugees from the perspective of ecological systems theory: A convergent parallel mixed method study

AimThis study aims to develop a comprehensive understanding of nursing students' xenophobic tendencies toward refugees and affecting factors from the perspective of Ecological Systems Theory. BackgroundNursing students' xenophobia toward refugees may negatively affect their care for patients. To effectively prevent xenophobia, it is essential to identify its underlying factors. DesignA convergent parallel mixed method. MethodsThis study was conducted with third and fourth-grade nursing students at a university in Turkey. In the quantitative phase, online surveys were used, employing convenience sampling, with 227 participants. In the qualitative phase, purposive sampling was used and data were collected through in-depth interviews with 17 participants on the Zoom platform. Data were obtained using the Participant Information Form, Xenophobia Scale and Semi-Structured Interview Form. ResultsNursing students who are male, in their third year, have low economic status, lack immigrant friends, lack immigrants in the family members, receive information about immigrants from social media and live in regions with a high concentration of immigrants have higher levels of xenophobia (p<0.05). In the qualitative phase, our study results showed that negative experiences with refugees, economic and social worries, perception of security threats, cultural conflicts and negative media messages toward refugees can lead to xenophobia. In addition, students stated that lessons about immigrants and caring for them in clinics can improve their ability to empathize with immigrants. ConclusionNursing curriculums should cover immigrant care and interaction to combat xenophobia, which can improve empathy skills and raise awareness.

Residential segregation by nationalities: A global and multilevel approach to Barcelona and Madrid (2008–2018)

AbstractThis paper analyzes patterns of residential segregation for many nationalities in Barcelona and Madrid during the 2008–2018 period. In the first year, the financial bubble burst, halting the exponential growth of immigrants and in the second, after the great recession, the arrival of immigrant population resumes. The multilevel analysis for the dissimilarity index is applied for the first time to Spanish cities. Complementing the results of global indices with the multilevel framework provides a richer and more detailed profile of segregation patterns. Based on these results, a typology of segregation patterns by nationalities was carried out. Global indices show higher segregation in Madrid than in Barcelona, and multilevel results evidence increasing and extending areas of high concentration of immigrants and mixing neighbourhoods. The cluster analysis demonstrates that, in this case, segregation patterns are not the same for continents or income levels of countries of origin. The results provide nuanced empirical evidence of place stratification and ethnic enclave models.

Who were the losers and winners during the Covid-19 pandemic? The rise of remote working in suburban areas

ABSTRACT The Covid-19 pandemic has rapidly altered the habits and lifestyles of every citizen worldwide and will have effects in the medium to long terms. The need for ‘social distancing’ has negatively affected urban areas and encouraged a rescheduling of working methods. Knowledge-intensive activities have been massively undertaken on a large scale in remote working, mainly carried out at home. Within this context, the paper explores the changes in working modalities towards remote working by focusing on the Lombardy region in north-west Italy. Specifically, it explores the renewed suitability of the municipalities outside the regional capital city of Milan with regard to remote workers during the pandemic and compares it with the period before the pandemic, and also it analyses which determinants play a role. The results show that municipalities closer to Milan with a strong broadband connection, a high concentration of knowledge workers and foreign immigrants are more suitable for hosting remote workers.

Factors associated with timely COVID-19 vaccination in a population-based cohort of patients with cancer.

In many jurisdictions, cancer patients were prioritized for COVID-19 vaccination because of increased risk of infection and death. To understand sociodemographic disparities that affected timely receipt of COVID-19 vaccination among cancer patients, we undertook a population-based study in Ontario, Canada. Patients older than 18 years and diagnosed with cancer January 2010 to September 2020 were identified using administrative data; vaccination administration was captured between approval (December 2020) up to February 2022. Factors associated with time to vaccination were evaluated using multivariable Cox proportional hazards regression. The cohort consisted of 356 535 patients, the majority of whom had solid tumor cancers (85.9%) and were not on active treatment (74.1%); 86.8% had received at least 2 doses. The rate of vaccination was 25% lower in recent (hazard ratio [HR] = 0.74, 95% confidence interval [CI] = 0.72 to 0.76) and nonrecent immigrants (HR = 0.80, 95% CI = 0.79 to 0.81). A greater proportion of unvaccinated patients were from neighborhoods with a high concentration of new immigrants or self-reported members of racialized groups (26.0% vs 21.3%, standardized difference = 0.111, P < .001), residential instability (27.1% vs 23.0%, standardized difference = 0.094, P < .001), or material deprivation (22.1% vs 16.8%, standardized difference = 0.134, P < .001) and low socioeconomic status (20.9% vs 16.0%, standardized difference = 0.041, P < .001). The rate of vaccination was 20% lower in patients from neighborhoods with the lowest socioeconomic status (HR = 0.82, 95% CI = 0.81 to 0.84) and highest material deprivation (HR = 0.80, 95% CI = 0.78 to 0.81) relative to those in more advantaged neighborhoods. Despite funding of vaccines and prioritization of high-risk populations, marginalized patients were less likely to be vaccinated. Differences are likely due to the interplay between systemic barriers to access and cultural or social influences affecting uptake.

Buying Votes across Borders? A List Experiment on Mexican Immigrants in the United States

AbstractAs international migration has grown worldwide, the issue of how to assure the political rights of citizens living abroad has attracted much scholarly attention. One concern has been that if vote-buying is widespread in home countries, this practice could be exported to external elections. Although there have been numerous studies focused on electoral participation in external voting, there has been no systematic test of whether vote-buying is occurring across borders. This study aims to address this question by focusing on the 2018 federal elections in Mexico. Our list experiment shows that in our sample, approximately 32 per cent of Mexican immigrants in the United States experienced vote-buying during the electoral campaign. Furthermore, a multivariate analysis shows that the people most susceptible to vote-buying were living in areas where there was a high concentration of Mexican immigrants. The study results point to the importance of cross-border networks, which have been built between countries sending and receiving immigrants, in facilitating vote-buying across borders.

Immigrant Organizations and Neighborhood Crime

We examine the impact of immigrant-serving organizations on neighborhood crime in the Los Angeles Metropolitan area, while accounting for other community correlates of crime as well as potential endogeneity. We estimate longitudinal negative binomial regression models that test for the main, mediating, and moderating effects of immigrant-serving organizations. We found that immigrant-serving organizations generally have crime-reducing effects for all types of crime. We also find that high immigrant concentration is associated with lower levels of crime in general, and this effect is moderated by the number of organizations, which underlines the importance of accounting for these organizations when studying the nexus of immigrant concentration and neighborhood crime.

Do immigrants shield the locals? Exposure to COVID-related risks in the European Union.

This article investigates the relationship between immigration and the exposure of native workers to health and labor‐market risks arising from the COVID‐19 pandemic in Europe. Using various measures of occupational risks based on European Union labor force survey data, we find that immigrant workers, especially those from lower‐income member countries in Eastern Europe or from outside the EU, face greater exposure than their native‐born peers to both income and health‐shocks related to COVID‐19. We also show that native workers living in regions with a higher concentration of immigrants are less exposed to some of the income and health risks associated with the pandemic. To assess whether this relationship is causal, we use a Bartik‐type shift‐share instrument to control for potential bias and unobservable factors that would lead migrants to self‐select into more vulnerable occupations across regions. The results show that the presence of immigrant workers has a causal effect in reducing the exposure of native workers to various risks by enabling the native‐born workers to move into jobs that could be undertaken from the safety of their homes or with lower face‐to‐face interactions. The effects on the native‐born population are more pronounced for high‐skilled workers than for low‐skilled workers, and for women than for men. We do not find significant effect of immigration on wages and employment—indicating that the effects are mostly driven by a reallocation of natives from less safe jobs to safer jobs.

An electronic medical records study of population obesity prevalence in El Paso, Texas

BackgroundIn this study, we determine the feasibility of using electronic medical record (EMR) data to determine obesity prevalence at the census tract level in El Paso County, Texas, located on the U.S.-Mexico border.Methods2012–2018 Body Mass Index (BMI kg/m2) data from a large university clinic system in was geocoded and aggregated to a census tract level. After cleaning and removing duplicate EMR and unusable data, 143,524 patient records were successful geocoded. Maps were created to assess representativeness of EMR data across census tracts, within El Paso County. Additionally, maps were created to display the distribution of obesity across the same geography.ResultsEMR data represented all but one El Paso census tract. Representation ranged from 0.7% to 34.9%. Greatest representation were among census tracts in and around clinics. The mean EMR data BMI (kg/m2) was 30.1, this is approximately 6% less than the 36.0% estimated for El Paso County using the Behavioral Risk Factor Surveillance Study (BRFSS) estimate. At the census tract level, obesity prevalence ranged from 26.6 to 57.6%. The highest obesity prevalence were in areas that tended to be less affluent, with a higher concentration of immigrants, poverty and Latino ethnic concentration.ConclusionsEMR data use for obesity surveillance is feasible in El Paso County, Texas, a U.S.-Mexico border community. Findings indicate substantial obesity prevalence variation between census tracts within El Paso County that may be associated with population distributions related to socioeconomics.

Procedural justice, neighbourhood context, and domestic violence reporting intention among subgroups of immigrants

ABSTRACT Although research shows immigrants are less likely to report crimes to the police than native-born individuals, few studies have examined domestic violence reporting behaviours among immigrant subgroups. Empirical studies have examined the role of procedural justice and neighbourhood factors on citizens’ satisfaction and willingness to cooperate with the police. However, these studies have often ignored immigrants’ willingness to report domestic violence in their neighbourhoods. To address the research gap in the crime reporting literature, this study uses a representative sample from a major US city with high concentrations of immigrants to examine whether there are differences in reporting domestic violence across various subgroups taking into account procedural justice and neighbourhood characteristics. We found that differences between subgroups of immigrants are reduced when procedural justice is included in the multilevel models. The study highlights the importance of procedural justice in understanding immigrants’ willingness to report domestic violence to the police.

Educational achievement disparities between second-generation and non-immigrant students: Do school characteristics account for tracking effects?

The present article investigates the relationship between the degree of tracking and inequalities in reading literacy of second-generation and non-immigrant students in 28 Western countries. The article takes into account that next to between-school tracking, there are also more subtle forms of tracking, such as tracking within schools or classes. By elaborating how the distinct mechanisms of different tracking characteristics generate achievement inequalities, I assume that any negative effects of tracking on second-generation immigrant students’ achievements are primarily driven by differences in the quality of school environments. Data from the Programme for International Student Assessment 2018 are used and multilevel regression analysis with country-fixed effects are applied. The findings reveal that a higher tracking degree is related to substantial disadvantages in reading literacy for immigrant children. Furthermore, a higher immigrant concentration in schools is associated with immigrant inequalities in reading performance as the degree of tracking increases, whereas unequal distributions of teacher and instructional quality were found to generate inequalities in countries with less tracking. Even though the results are only partly in line with the theory of tracking influences on immigrant achievement disadvantages, they suggest that the interplay between institutional tracking and school characteristics are crucial for learning inequalities.

Residence in a Hispanic Enclave Is Associated with Inferior Overall Survival among Children with Acute Lymphoblastic Leukemia.

Hispanic children with acute lymphoblastic leukemia (ALL) experience poorer overall survival (OS) than non-Hispanic White children; however, few studies have investigated the social determinants of this disparity. In Texas, many Hispanic individuals reside in ethnic enclaves—areas with high concentrations of immigrants, ethnic-specific businesses, and language isolation, which are often socioeconomically deprived. We determined whether enclave residence was associated with ALL survival, overall and among Hispanic children. We computed Hispanic enclave index scores for Texas census tracts, and classified children (N = 4083) as residing in enclaves if their residential tracts scored in the highest statewide quintile. We used Cox regression to evaluate the association between enclave residence and OS. Five-year OS was 78.6% for children in enclaves, and 77.8% for Hispanic children in enclaves, both significantly lower (p < 0.05) than the 85.8% observed among children not in enclaves. Children in enclaves had increased risk of death (hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.01–1.49) after adjustment for sex, age at diagnosis, year of diagnosis, metropolitan residence and neighborhood socioeconomic deprivation and after further adjustment for child race/ethnicity (HR 1.19, 95% CI 0.97–1.45). We observed increased risk of death when analyses were restricted to Hispanic children specifically (HR 1.30, 95% CI 1.03–1.65). Observations suggest that children with ALL residing in Hispanic enclaves experience inferior OS.

Perception of Health and Well-being Among the Chinese Immigrant Population in Seville (Spain): Does Territorial Concentration Matter?

This study analyzes the relationship between the territorial concentration of the Chinese immigrant population and their perception of health and well-being in Seville, a city in southern Europe, where this ethnic community has seen one of the fastest growth rates in recent times. An ethnographic design and a merging strategy by data transformation were adopted. The results show that there is a greater perception of good health and well-being among the Chinese population, who live mainly in neighborhoods with a high concentration of Chinese immigrants with a high socioeconomic status. However, this territorial concentration does not result in a lower perception of integration, affection or support from the host society. This apparent contradiction could be explained by the importance of relations with their fellow nationals at work as a key element in the socialization of the Chinese population.

Caulking the Social Fabric: How National and Local Identities Promotes Pro-Social Attitudes in European Diverse and Disadvantaged Neighbourhoods

This paper focuses on controversial but uncharted neighborhoods in European welfare states that feature in the general debate over alleged ‘no-go’ zones. The paper seeks to identify factors promoting pro-social attitudes among residents in these diverse and disadvantaged neighborhoods. We explore the extent to which identification with the neighborhood (local identity) and the nation-state (national identity) generates pro-social attitudes among residents. That is, to what extent is identification with the local or national communities related to social and institutional trust, as well as positive affects towards ethnic out-groups. This paper utilizes findings from an original panel survey of residents in two Swedish neighborhoods with high concentrations of immigrants. The findings suggest that identities are related to pro-social attitudes, but that local and national identities are distinct and have different consequences.

Out-mobility from Stockholm’s immigrant-dense neighbourhoods – a study of two cohorts

ABSTRACT The central themes of this study are how housing tenure affects moving away from neighbourhoods with differing degrees of immigrant concentration in Stockholm and, comparing two cohorts, how the relationship between housing tenure, ethnic background and residential mobility develops over time. The findings reveal that the effect of housing tenure on moving varies marginally between neighbourhood types, and differences between housing tenures are reduced over time. Residential mobility is increasingly associated with higher income levels and members of the non-western, foreign-born group are less likely to move when the housing market is increasingly owner dominated. These ethnic hierarchies also apply to residential sorting. The sorting of out-movers from neighbourhoods with high concentrations of immigrants is increasingly affected by income. However, the non-western, foreign-born group is also increasingly dependent on housing assets in order to leave immigrant-dense neighbourhoods, which is not the case for other groups. The results show a shift in the necessary resources for residential mobility trajectories for those at the bottom end of the ethnic hierarchy and indicate that the place-stratification framework needs to differentiate between different types of assets and population groups to enable a better understanding of residential sorting in a changing housing market.

Foreign Nationals in Yekaterinburg: At the Dawn of the City’s Social Organisation

The intensive development of metallurgy in the Urals in the 1720s is closely associated with the construction of Yekaterinburg, which became not only the largest and most diversified metallurgical plant city in Russia, but also the administrative centre of the mining industry in the east of the empire. The construction of the city under the leadership of an outstanding specialist and personal representative of Peter the Great, Georg Wilhelm de Gennin (Wilim Ivanovich Gennin), took into account the latest Western trends in industrial and fortification architecture. This affected the spatial planning and functional zoning of this mining city. It also had an important impact on its social organisation. A striking feature of Yekaterinburg was the high concentration of immigrants from European countries. Foreign nationals worked in the local administration and held a majority among the officers who commanded army units during the construction of the plant city. Also, the first doctors, the founders of the medical service in the Urals, were non-Russian. However, most specialists dealt with metallurgy and mining. Yekaterinburg became both their place of residence and a staging post on their way to other factories and mines in the region. The contribution of these people to the formation and development of the industry in the region can hardly be overestimated. Nevertheless, there is still no special comprehensive study of this population category in early Yekaterinburg. This article is an attempt to consider the history of foreign immigrants as a social whole in Yekaterinburg society during the first decade of its existence. The author identifies their features and the factors that promoted and hindered intra-community integration, concluding that by the end of the first decade of Yekaterinburg’s life, it had failed to form an influential and relatively homogeneous colony of foreign nationals: their number had noticeably decreased compared to the 1720s. The formation of a full-fledged community was hampered by marked differences in the legal status of foreigners and a lack of corporate privileges. Other factors were a minimised sphere of private life (which made it impossible for them to create stable internal organisation) and internal professional competition. However, the most important thing was high geographic mobility, which gave rise to quantitative and qualitative instability in the community.

Immigration and far-right voting: evidence from Greece

In this paper, we analyze the impact of immigration on Greek politics over the 2004–2012 period, exploiting panel data on 51 Greek regional units. We account for the potential endogenous clustering of migrants into more “tolerant” regions by using a shift-share-imputed instrument, based on their allocation in 1991. Overall, our results are consistent with the idea that immigration is positively associated with the vote share of extreme-right parties, though the effects appear to be stronger during the Greek fiscal crisis. This finding appears to be robust to alternative controls, sample restrictions and different estimation methods. We do not find supportive evidence for the conjecture that natives “vote with their feet,” i.e., move away from regions with high immigrant concentrations. We also find that the political success of the far-right comes at the expense of “Leftist” parties, thereby rejecting the idea that migration divides the society into different camps. Importantly, our analysis suggests that labor market concerns play a significant role in shaping native attitudes toward immigration.

Disadvantaged neighborhoods and the spatial overlap of substantiated and unsubstantiated child maltreatment referrals

BackgroundConsiderable debate exists on whether the substantiation decision is a reliable measure for rates of maltreatment. Studies have shown that risks among children victims of maltreatment versus children investigated but unsubstantiated are similar. ObjectiveThis paper aims to respond to two research questions: (1) Do most child maltreatment referrals, substantiated and unsubstantiated, come from the same neighborhoods? (2) Do substantiated and unsubstantiated referrals share the same neighborhood risk factors? Participants and settingsWe used geocoded data from substantiated (n = 1799) and unsubstantiated (n = 1638) child maltreatment referrals in Valencia, Spain (2004–2015). As the neighborhood proxy, we used 552 Census block groups. Neighborhood characteristics analyzed were: socioeconomic status, immigration concentration, residential instability, and public disorder and crime. MethodsTo study the geographical overlap of child maltreatment referrals, a Bayesian joint modeling approach was used. To analyze the influence of neighborhood-level characteristics on risk, we used a Bayesian random-effects modeling approach. ResultsFor substantiated child maltreatment referrals, 90 % of the total between-area variation in risk is captured by the shared component, while for unsubstantiated child maltreatment referrals, the shared component was 88 %. The correlation between substantiated and unsubstantiated risks of child maltreatment referrals was .80. These risks were higher in neighborhoods with low levels of socioeconomic status, higher immigrant concentration, public disorder and crime. ConclusionsChild maltreatment referrals, regardless of whether substantiated or unsubstantiated, overlap in the same disadvantaged neighborhoods. This suggests that in these neighborhoods, families are at a higher risk of being investigated by child protective services suggesting a potential reporting bias.

The Role of Neighborhood Poverty in the Association between Foreign-Born status and HIV Care Continuum Outcomes in Alameda County, California.

Foreign-born persons living in the US have an increased risk of exposure to HIV and higher rates of HIV diagnosis (Patel-Larson et al. in Poster presented at the 2007 National HIV Prevention Conference, pp 2-5, 2007; Prosser et al. in JAMA 308:601-607, 2012). Foreign-born persons also tend to live in areas with high concentration of immigrants and more often neighborhoods of high poverty, for at least some time (Jargowsky in J Ethn Migr Stud 35:1129-1151, 2009). Using HIV surveillance data in Alameda County, California, we examined whether the association between immigrant status and the four outcomes on the HIV care cascade (late diagnosis, linkage to care within 30days of diagnosis, retention in HIV care, and viral load status a year after diagnosis) differed by census tract poverty level. We used generalized estimating equations (GEE) adjusted for sex at birth, age, race, and transmission mode. Of 1235 individuals with HIV diagnosis reported between 2011 and 2016, 29% were foreign-born. Foreign-born status was significantly associated with late HIV diagnosis but not with linkage, retention in care, and achievement of undetectable viral load a year after diagnosis. Neighborhood poverty modified the association between immigrant status and retention in care, but not late diagnosis, linkage or viral load status. Our findings suggest that neighborhood resources may buffer against disparities in retention. Thus, immigrants in poorer neighborhoods may require more support to stay in care.

The complex relationship between immigrants’ concentration, socioeconomic environment and attitudes towards immigrants in Europe

ABSTRACT Research has shown that positive attitudes towards immigration are often associated with a higher presence of immigrants at the local level; however, this relationship might not apply everywhere. While a higher presence of immigrants might be positive for attitudes in areas with better socioeconomic resources – via the development of more cooperative intergroup contacts – it might bring no or even a negative effect on attitudes in poorer areas – due to an enhanced competition for (scarce) resources and poorer social cohesion. This article combines data from the European Social Survey with NUTS3 aggregated data of twelve European countries to study this relationship. We find that a higher concentration of immigrants is associated with more positive attitudes towards them; in line with our expectations, this effect decreases as the socioeconomic conditions of areas worsen. In the most deprived areas, however, a higher concentration of immigrants does not have an effect on attitudes.