Immigrant Latinas Research Articles

The matrix of exploitation and temporary employment: Earnings inequality among Inland Southern California's blue-collar warehouse workers

The “just in time” neoliberal global consumer economy has given rise to logistics or “goods movement” hubs, reshaping regional labor markets near port cities, and increasing the demand for temporary blue-collar workers. This article provides a case study of earnings inequality among nonsupervisory warehouse workers in Inland Southern California, most of whom are Latina/o. Combining insights from labor market segmentation and intersectional feminist theories, we argue that employer discrimination against temps has become a significant axis of workplace inequality that interacts with other social inequalities to segment workers into lower and higher paying positions within a complex “matrix of exploitation.” Our statistical analysis uses data from an original survey of workers as well as the American Community Survey to analyze wages, income, and occupational segregation among Inland Southern California's blue-collar warehouse workforce. We find that, controlling for other factors, temporary employment status negatively affects hourly wages and annual earnings. Consistent with the expectations of intersectional feminist theory, the hourly wages of immigrant Latinas, and the annual incomes of immigrant Latinas who are naturalized citizens, were significantly lower than those of all other warehouse workers, controlling for the effects of other factors. Immigrant women were also disproportionately employed as temps and in the lowest paid occupation.

Are you better off? Perceptions of social mobility and satisfaction with care among Latina immigrants in the U.S.

Although the reasons for immigrating to the U.S. vary by Latino groups, many Latinos cite economic or political motivations for their migration. Once in the United States, Latino immigrants may face many challenges, including discrimination and blocked opportunities for social mobility, and difficulties in obtaining health services and quality health care. The purpose of this study was to explore how changes in social mobility from the country of origin to the U.S. may relate to Latina women's health care interactions. We examined whether self-reported social mobility among 419 Latina women immigrants is associated with satisfaction with health care. We also examined the association among social mobility and self-rated health, quality of care, and medical mistrust. Upward social mobility was associated with greater number of years lived in the U.S., and downward social mobility was associated with more years of education. Those who reported no changes in social class (stable social mobility) were older and were the most satisfied with their medical care. Multiple regression analyses indicated that downward social mobility was associated with less satisfaction with care when controlling for demographic covariates, quality of care, and medical mistrust. Results suggest that perceived social mobility may differentially predict Latina immigrants' satisfaction with the health care system, including their trust in U.S. medical institutions. We conclude that perceived social mobility is an important element in exploring the experiences of immigrant Latinas with health care in the United States.

Latina Immigrants’ Cultural Beliefs About Postpartum Depression

It is estimated that U.S. Latinas have a higher risk of developing postpartum depression (PPD) than the general population, with even higher risk among immigrant Latinas. We conducted three focus groups with immigrants from Mexico and Central America (19) inquiring about cultural messages regarding PPD. Groups were conducted in Spanish, and thematic analysis was used to uncover themes. Themes are presented within three categories: views of PPD, cultural messages and beliefs that prevent treatment seeking, and suggestions to promote treatment seeking. Community and family-led efforts to decrease stigma and normalize PPD are suggested.

Outcomes of a Culturally Tailored Partially Randomized Patient Preference Controlled Trial to Increase Physical Activity Among Low-Income Immigrant Latinas.

Almost half (47.8%) of adult Latinas report they never engage in any leisure time physical activity (PA) which is an independent risk factor for the development of cardiovascular disease and other chronic illnesses. There is a pressing need to develop and test PA interventions among Latinas. Therefore, the purpose of this study was to evaluate the effects of a PA Intervention for Latinas, a culturally tailored, promotora-facilitated 12-week PA intervention. It was hypothesized that at the completion of the intervention, participants would have (a) higher daily PA levels; (b) improved aerobic fitness, muscle strength, and flexibility; and (c) lower body mass index and percentage of body fat. A partially randomized patient preference trial design with lag group was used to test the intervention. Participants ( N = 76) attended twice weekly, low-impact aerobic/Latin dance PA classes taught by laywomen trained as promotoras. Significant improvements were measured in aerobic fitness, muscle strength and flexibility, and daily PA levels ( p < .001). Sixty percent of the participants attended at least 60% of the PA sessions. Findings suggest laywomen trained as promotoras can successfully facilitate the delivery of an intervention to increase PA among immigrant Latinas.

Sí, Yo Puedo Curricula and Police Departments: Educating Immigrant Latinas

ABSTRACTImmigrant Latinas experiencing incidences of interpersonal violence require services from police departments. In a mixed-methods study using a culturally specific curriculum, Si, Yo Puedo, designed to foster self-esteem and provide education on interpersonal violence and healthy relationships, two groups (n = 14) were conducted in 2015 at a precinct in a midwestern state. This group-format curriculum is a 2-hour, topic-specific educational program, conducted in Spanish, offered in 11 weeks. Participants reported an increase in self-esteem and knowledge of interpersonal violence after completing the program. Findings implicate this curriculum as a suitable service tool for police departments working with immigrant Latinas.

How can Primary Care Physicians Best Support Contraceptive Decision Making? A Qualitative Study Exploring the Perspectives of Baltimore Latinas

ObjectivesU.S. Latinas experience disproportionately high rates of unintended pregnancy and low rates of consistent contraception use. Not well known are Latinas' perspectives about how primary care physicians (PCPs) might facilitate or deter contraceptive decision making. The theory of planned behavior has been used previously to explain contraceptive behaviors. This study used the theory of planned behavior as a guide to help describe Latinas' perspectives regarding specific factors that influence their contraceptive decision making and to describe their perspectives about the role of PCPs in the decision making. Study Design and MethodsWe conducted focus groups (n = 3) and interviews (n = 8) of Latinas ages 15 to 24 years, recruited from urban primary care sites in Baltimore, Maryland. Concepts from the theory of planned behavior were used to develop a coding scheme and guide identification of themes. ResultsSixteen Latinas participated; all were immigrants. ThemesThe desire to avoid unintended pregnancy is dominant and, not surprisingly, is the main driver of contraceptive intentions. The role of PCPs in contraceptive decision making is to build strong patient relationships through heightened communication and trust. PCPs should develop trust and foster communication by using a shared decision-making approach in contraceptive counseling. Religious norms rarely operate as barriers to contraceptive use, yet positive reinforcement from family, friends, and schools is viewed as supportive. Conclusions and ImplicationsFor this group of young, immigrant Latinas, there is a pervasive desire for effective communication and trusting relationships with PCPs. Findings suggest that providers can facilitate contraceptive decision making for this population by using a shared decision-making approach to contraceptive counseling.

The impact of discrimination on mental health symptomatology in sexual minority immigrant Latinas.

The impact of discrimination on mental health symptomatology in sexual minority immigrant Latinas.

Gender and immigrant status differences in the treatment of substance use disorders among US Latinos

US Latinos have higher rates of substance use disorders (SUDs) than Latinas, but Latinas face substantial barriers to treatment and tend to enter care with higher SUD severity. Immigrant Latinas may face greater barriers to care than native-born despite lower overall SUD prevalence. This study aimed to identify how SUD treatment needs of Latinos are addressed depending on patient gender and immigrant status within an urban healthcare system serving a diverse population.MethodsData from electronic health records of adult Latino/a primary care patients (n = 29,887 person-years) were used to identify rates of SUD treatment in primary and specialty care. Treatment characteristics and receipt of adequate care were compared by gender and immigrant status.ResultsTobacco was the most frequently treated substance followed by alcohol and other drugs. Forty-six percent of SUD patients had a comorbid psychiatric condition. Treatment rates ranged from 2.52% (female non-immigrants) to 8.38% (male immigrants). Women had lower treatment rates than men, but male and female immigrants had significantly higher treatment rates than their non-immigrant counterparts. Receipt of minimally adequate outpatient care varied significantly by gender and immigrant status (female non-immigrants 12.5%, immigrants 28.57%; male non-immigrants 13.46%, immigrants 17.09%) in unadjusted and adjusted analyses.DiscussionResults indicate overall low prevalence of SUD treatment in the healthcare system. Low rates of minimally adequate care evidence the challenge of delivering integrated behavioral healthcare for Latinos with SUD. Results also demonstrate gender and immigrant status disparities in an unexpected direction, with immigrant women receiving the highest rates of adequate care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Family and cultural influences on cervical cancer screening among immigrant Latinas in Miami-Dade County, USA

Cervical cancer disproportionately affects minorities, immigrants and low-income women in the USA, with disparities greatest among Latino immigrants. We examined barriers and facilitators to cervical cancer screening practices among a group of immigrant Latino women in Florida, USA. Between January and May 2013, six focus group discussions, involving 35 participants, were conducted among Hispanic women in Miami to explore their knowledge, beliefs about cervical cancer and facilitators and barriers to cervical cancer screening using a theoretical framework. The data showed that family support, especially from female relatives, was an important facilitator of screening and treatment. Women, however, reported prioritising family health over their own, and some expressed fatalistic beliefs about cancer. Major obstacles to receiving a Pap smear included fear that it might result in removal of the uterus, discomfort about being seen by a male doctor and concern that testing might stigmatise them as being sexually promiscuous or having a sexually transmitted disease. Targeted education on cancer and prevention is critically needed in this population. Efforts should focus on women of all ages since younger women often turn to older female relatives for advice.

Social and Environmental Factors Related to Smoking Cessation among Mothers: Findings from the Geographic Research on Wellbeing (GROW) Study

The current study examined associations between race/ethnicity and psychosocial/environmental factors with current smoking status, and whether psychosocial/environmental factors accounted for racial differences in smoking status in a population-based sample of mothers in California. Cross-sectional data from 542 women with a history of smoking were used. Analyses adjusted for age, partner status, and educational attainment. In models adjusted for sociodemographics, black women had significantly lower odds, and Latina immigrants had significantly higher odds of being a former smoker compared to white women. Persons smoking in the home, having a majority of friends who smoke, having perceptions of their neighborhood as being somewhat or very unsafe, and experiencing food insecurity were associated with decreased odds of being a former smoker. When these variables were entered into a single model, only being a Latina immigrant and having a majority of friends who smoke were significantly associated with smoking status. Black women demonstrated a notable disparity compared with white women in smoking status, accounted for by psychosocial/environmental factors. Immigrant Latinas demonstrated notable success in ever quitting smoking. Social networks may be important barriers to smoking cessation among women.

Sí, Yo Puedo Curricula

In 2013–2014, a mixed-method study was conducted examining the experiences of 14 immigrant Latina women using a culturally specific curriculum: Sí, Yo Puedo. The purpose of using the curriculum among participants was to assess self-esteem and knowledge of healthy relationships, dating, and domestic violence (DV). The curriculum is a 2-hr, topic-specific educational program, conducted in Spanish, offered over a period of 11 weeks in a group format. Participants reported an increase in self-esteem and knowledge of DV after completing the program. Implications include the promotion of a curriculum for mental health professionals who work with immigrant Latinas in community-based agencies.

Awareness of Cardiovascular Disease and Preventive Behaviors Among Overweight Immigrant Latinas

Low-income Latina women face increased risk for cardiovascular disease (CVD) due to high rates of obesity, diabetes, and other comorbidities. Language barriers, lack of health insurance, and lack of access to preventive health messages may further increase their risk. The purpose of this study was to evaluate knowledge about CVD of overweight, immigrant Latinas who spoke little or no English and participated in an educational intervention. Ninety participants completed a CVD knowledge questionnaire before and after 8 educational sessions based upon Su Corazón, Su Vida. The curriculum focused on understanding risk factors of CVD and prevention through heart-healthy diets, physical activity, and weight control. The questionnaire evaluated general CVD knowledge (eg, heart disease is the leading cause of death in women) and prevention measures (eg, physical activity can lower a woman's risk for getting heart disease). Data were analyzed using generalized estimating equations and correlational statistics. Participants were middle-aged, overweight Latinas, predominantly of Mexican descent, with low education and acculturation. Baseline knowledge that heart disease is the leading cause of death in women was low. A comparison of preintervention and postintervention scores on the questionnaire showed a significant change (P < 0.001), with means of 7.9 and 9.4, respectively. Scores for individual items correctly answered significantly improved for 9 of the 11 items, including questions about portion control to lose weight, physical activity, overweight, and risk for heart disease. Most participants did not recognize that men and women may experience different symptoms of a heart attack. Knowledge was not significantly related to background characteristics, body mass index, or lifestyle behaviors. Despite campaigns to increase CVD awareness, many Spanish-speaking, immigrant Latinas remain unaware that heart disease is the leading cause of death. Educational interventions may significantly improve their CVD knowledge; nonetheless, continued cardiovascular health promotion efforts are needed for this population.

Building Social Capital in Hightown: The Role ofConfianzain Latina Immigrants’ Social Networks in the New South

In this article, we examine the social networks of immigrant Latinas from two women's groups in northwestern North Carolina. We explore how participants built social capital and confidence in self through sharing knowledge and experiences in intimate, mujerista spaces. We argue that traditional analyses of social capital, framed in terms of cost–benefit obligations, are insufficient for understanding the complex relationship of commitment and trust, or confianza, that characterized the social networks the women developed.

A Community-Engaged Research Approach to Improve Mental Health Among Latina Immigrants: ALMA Photovoice.

Recent Latina immigrants are at increased risk of poor mental health due to stressors associated with adapting to life in the United States. Existing social and health care policies often do not adequately address the mental health concerns of new Latino populations. Amigas Latinas Motivando el Alma, a community-partnered research project, seeks to improve immigrant Latinas' mental health outcomes. Using Photovoice methodology, promotoras (lay health advisors) reflected on community factors affecting mental health through photography and guided discussion. Discussions were audio-recorded, transcribed, and coded using content analysis to identify salient themes. Promotoras reviewed codes to develop themes that they presented in community forums to reach local policy makers and to increase community awareness. These forums included an exhibit of the promotoras' photographs and discussion of action steps to address community concerns. Themes included transitioning to life in the United States, parenting, education, and combating racism. Nearly 150 stakeholders attended the community forums and proposed responses to promotoras' photographic themes. Our findings suggest that Photovoice provides an opportunity for Latinas and the larger community to identify issues that they find most important and to explore avenues for action and change by creating sustainable partnerships between the community and forum attendees.

Qualitative Exploration of an Effective Depression Literacy Fotonovela with at Risk Latina Immigrants.

While depression is prevalent among immigrant Latinas, mental health literacy is low. Culturally tailored health narratives can improve mental health literacy and are now increasingly featured in Spanish language fotonovelas (i.e., booklets in a comic book format with posed photographs and dialogue bubbles). The purpose of this qualitative study is to explore why a depression literacy fotonovela proved effective with Latina immigrants at risk for depression in a quantitative randomized control study. This study is the qualitative companion of the previously published quantitative piece of a mixed methods study, the latter revealing posttest improvements in depression knowledge, self-efficacy to identify the need for treatment, and decreased stigma towards mental health care (Hernandez and Organista in Am J Community Psychol 2013. doi: 10.1007/s10464-013-9587-1 ). Twenty-five immigrant Latinas participated in structured interviews, in the current qualitative study, 3weeks after participating in the quantitative study. Results suggest depression literacy improved because participants evidenced high recall of the storyline and characters, which they also found appealing (e.g., liked peer and professional support offered to depressed main character). Further, identification with the main character was reflected in participants recalling similar circumstances impacting their mental health. Despite some improvement, stigma related to depression and its treatment remained for some women. Future research for the improvement of health literacy tools is discussed.

Violence Against Latinas: The Effects of Undocumented Status on Rates of Victimization and Help-Seeking.

This study investigated whether legal status was related to interpersonal victimization and help-seeking by comparing Latina immigrants with permanent legal status with Latina immigrants who are undocumented on rates of reported interpersonal victimization, types of perpetrators, and rates of help-seeking. Data come from the Sexual Assault Among Latinas (SALAS) study, which interviewed 1,377 immigrant Latinas about their lifetime histories of sexual assault, physical assault, stalking, and threats along with help-seeking efforts. Results did not reveal significant differences between legal status and reported victimization rates or types of perpetrators. However, undocumented Latinas (n = 91) were less likely to seek formal help than those with permanent status. Results of this study indicate that undocumented status does not independently put women at risk of victimization, but that responses to violence are related to legal status.

In our country tortilla doesn't make us fat: cultural factors influencing lifestyle goal-setting for overweight and obese Urban, Latina patients.

Obesity disproportionately affects Latina adults, and goal-setting is a technique often used to promote lifestyle behavior change and weight loss. To explore the meanings and dimensions of goal-setting in immigrant Latinas, we conducted four focus groups arranged by language ability and country of origin in an urban, public, primary care clinic. We used a narrative analytic approach to identify the following themes: the immigrant experience, family dynamics, and health care. Support was a common sub-theme that threaded throughout, with participants relying on the immigrant community, family, and the health care system to support their goals. Participants derived satisfaction from setting and achieving goals and emphasized personal willpower as crucial for success. These findings should inform future research on how goal-setting can be used to foster lifestyle behavior change and illustrate the importance of exploring the needs of Latino sub-groups in order to improve lifestyle behaviors in diverse Latino populations.

A community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: Feasibility and outcomes of a randomized controlled trial

BackgroundLow-income Latinas (Hispanics) face risk for cardiovascular disease due to high rates of overweight/obesity, sedentary lifestyle, and other factors. Limited access to health care and language barriers may prevent delivery of health promotion messages. Targeted approaches, including the integration of community health workers, may be required to promote healthy lifestyle and prevent chronic disease in underserved ethnic minority groups. The term commonly used to refer to female community health workers in Latino communities is “promotora(s).” ObjectivesThis study evaluates the outcomes and feasibility of a promotora-led lifestyle behavior intervention for overweight, immigrant Latinas. MethodsA community prevention model was employed in planning and implementing this study. A randomized controlled trial design was used. A Community Advisory Board provided expertise in evaluating feasibility of study implementation in the community and other important guidance. The sample was comprised of 223 women aged 35–64 years, predominantly with low income and ≤8th grade education. The culturally tailored Lifestyle Behavior Intervention included group education (8 classes based upon Su Corazon, Su Vida), followed by 4 months of individual teaching and coaching (home visits and telephone calls). The control group received a comparable length educational program and follow-up contacts. Evaluations were conducted at baseline and at 6 and 9 months using a dietary habits questionnaire, accelerometer readings of physical activity, and clinical measures (body mass index, weight, waist circumference, blood pressure, lipids, blood glucose). Data were collected between January 2010 and August 2012. ResultsWomen in the intervention group improved significantly in dietary habits, waist circumference, and physical activity in comparison to those in the control group. A treatment dosage effect was observed for weight and waist circumference. Knowledge about heart disease increased. High attendance at classes and participation in the individual teaching and counseling sessions and high retention rates support the feasibility and acceptability of the promotora-led lifestyle behavior intervention. ConclusionsOur findings demonstrate that lifestyle behaviors and other risk factors of overweight Latina women may be improved through a promotora-led lifestyle behavior intervention. Feasibility of implementing this intervention in community settings and engaging promotoras as facilitators is supported.

To worry or not to worry: breast cancer genetic counseling communication with low-income Latina immigrants.

The purpose of this pilot study was to describe communication practices during hereditary breast cancer genetic counseling (GC) with low-income immigrant Latina patients in a public hospital setting. We utilized qualitative ethnographic methods, including direct observation of GC appointments with Latina patients at a public hospital offering free GC and BRCA testing and in-depth qualitative interviews with patients after they had received their BRCA genetic test results. Twenty-five patients participated; 20 were observed during genetic counseling appointments, and ten participated in interviews after BRCA testing with six participating in both observations and an interview. Analyses of qualitative data from observation field notes and interviews identified both strengths and limitations of current communication practices within the following themes: (1) family health history communication, (2) education regarding genes and genetics and patient information needs, (3) the purpose of the genetic test, (4) genetic test results and cancer risk, (5) building rapport and providing support, and (6) medical interpretation for monolingual Spanish speakers. As access to cancer GC expands in the public safety net settings and for the diverse populations they serve, it is critical to ensure effective communication in order for patients, whether or not they have a BRCA mutation, to understand the nature of their cancer risk and recommended methods of screening and prevention. Intervention strategies that address both structural constraints and patient-provider communication are needed to improve GC communication with immigrant Latinas, especially monolingual Spanish speakers.

A qualitative study of acculturation and diabetes risk among urban immigrant Latinas: implications for diabetes prevention efforts.

The purpose of this qualitative study was to understand how acculturation influences diabetes risk among urban immigrant Latinas (Hispanic women). Five focus groups were conducted with 26 urban immigrant Latinas who were at high clinical risk for developing diabetes. The focus group sessions were audiotaped and transcribed verbatim. The authors independently analyzed transcripts using an inductive method of open coding and established themes by consensus. All participants were foreign born and had low levels of acculturation. During the acculturation process, they noted changes in their lifestyle behaviors and the family context in which those behaviors are shaped. They reported that since living in the United States, their improved economic circumstances led to increased consumption of less healthy foods and beverages and a more sedentary lifestyle. They also described changing family roles and responsibilities, including working outside the home, which constrained healthy food choices. However, they perceived that their position of influence within the family offered opportunities to help family members prevent diabetes. Lifestyle interventions to prevent diabetes in Latinas should address their acculturation experiences, which affect family functioning and health behaviors related to diabetes risk. For example, given the perceived link between Latinas' improved economic circumstances and their diabetes risk, prevention programs should incorporate strategies to help Latinas avoid adopting less healthy lifestyle behaviors that become affordable during the acculturation process.