Immigrant Population Research Articles

Educational Interventions in Immigrants for Asthma and COPD: A Systematic Review.

Asthma and COPD are prevalent respiratory conditions among immigrants, yet many individuals in this population do not effectively utilize available therapies, resulting in exacerbations and limitations in their daily lives. This systematic review seeks to describe asthma/COPD educational interventions specifically tailored for immigrant patients and assess their variability and outcomes, with the ultimate goal of improving self-management and achieving better asthma or COPD control in this population. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A comprehensive literature search was conducted using four electronic databases (CINAHL, PubMed, Embase and PsycInfo). Articles were included if they focused on asthma or COPD interventions conducted in immigrant populations. The Mixed Methods Appraisal Tool was used to assess the quality of included articles. Out of the initial 1173 articles identified, 812 were assessed for eligibility. Six articles met the inclusion criteria for educational interventions targeting immigrants with asthma or COPD. These studies explored the effectiveness of interventions on various immigrant populations using different methodologies including group discussion of photographs and classroom-based interventions. The interventions varied in terms of settings, educational materials, and delivery methods. Positive outcomes were observed in areas such as knowledge, understanding of instructions, and inhaler technique. However, the included studies had limitations in assessing the impact on asthma and COPD self-management and sustainability. More research is needed on asthma and COPD management in immigrants. The interventions included in this review had positive effects on outcomes like inhaler technique and asthma knowledge. However, due to variability in outcome measures, it is difficult to directly compare the interventions. Future studies should include diverse immigrant populations, consider the specific migration status of the immigrants, long-term sustainability of the intervention and use culturally tailored approaches to improve respiratory health in this population.

Cerebral microhemorrhage associations in UK immigrants from the Middle East and North Africa (MENA)

AbstractBackgroundPeople from the Middle East and North Africa (MENA) are highly underrepresented in health studies, yet, they are forecasted to contribute the most to increasing projections of dementia over the next 30 years (Nichols, 2022). Cerebral microhemorrhages, or microbleeds (CMBs) in the aging brain have been linked to small vessel disease and neurodegeneration and may provide a proxy for intervention studies to identify those at higher risk for ADRD (Charidimou, 2011). CMBs are related to hemorrhagic amyloid‐related imaging abnormalities (ARIA‐H) reported as adverse events in recent Alzheimer’s clinical trials of amyloid clearing medications (Sperling, 2011). Identifying those at elevated risk for ARIA‐H can help refine inclusion criteria for clinical trials and mitigate risk of complications from these medications. CMBs may be detected by MRI derived susceptibility weighted images (SWI) (Haacke, 2004). We’ve previously reported higher prevalences of metabolic and cardiovascular disorders in MENA compared to other immigrant populations in the UK (Jahanshad, 2022). Using a subset of these individuals with SWI (Miller, 2016), we investigated the effect of these diseases and lifestyle on the presence of CMBs detected on SWI.Method185 MENA participants with SWI were included. We used MARS criteria (Gregoire, 2009) to identify CMBs on SWI and validated our findings using other sequences to exclude CMB ‘mimics’ (Figure 1). The number and position of CMBs were reported as well as their classification including ‘definite’, ‘possible’ and ‘total’. The effects of disease and lifestyle were investigated using association rule learning, and Chi‐squared/Fisher’s exact tests were used on the most prominent associations.Result10 subjects had at least one definite CMB and 10 more had at least one possible CMB (Table 1). Combinations of male sex, diabetes, obesity, and high waist‐to‐hip ratio were found to have 100% likelihood for having a CMB. The presence of definite CMBs was associated with diabetes (p = 0.017) and overweight BMI (p = 0.017) (Figure 2).ConclusionCMBs were associated with male sex, diabetes, and abnormally high anthropometric measures in MENA populations. Future work will test a larger sample and continue to tease apart CMB associations with health markers in those from MENA countries.

Immigrants and Inequality: Evidence from a Minor-Emerging Gateway Metropolitan Area in NC

abstract: Socioeconomic inequalities among foreign-born populations in the United States in minor-emerging gateways are rarely discussed in existing inequality literature. This study helps to fill that gap by examining inequality and spatial integration among immigrant, US–born White, and Black populations in a minor gateway metropolitan area of Greensboro–High Point, NC. The 2020 Census five-year (2016–2020) estimate of American Community Survey (ACS) housing and demographic data, the location quotient (LQ), Lorenz curve, and Gini Index are utilized. The LQ values suggest immigrant groups are more concentrated with Black populations than White populations, but US–born Black and White populations are far more segregated than immigrant groups. Lorenz curve and Gini coefficients confirm that White populations experience the least inequality while the greatest income inequality exists among US–born Black populations, followed by immigrant populations. Further, disparities in income are greater for immigrants living in their underrepresented communities than those who live in overrepresented neighborhoods. The study concludes that immigrant populations living in segregated neighborhoods with a higher proportion of racial and ethnic minorities have lower education and English language competency than those living in neighborhoods with a higher percentage of US–born residents, and hence have lower income inequality among populations.

Abstract A062: Intersecting acculturation and decision making about cancer screening among sub-Saharan African immigrant men: A qualitative study

Abstract Background: Sub-Saharan African immigrant (SSAI) men constitute one of the fastest-growing immigrant populations in the United States and a large heterogeneous group in cancer survivorship. Yet research has ignored decision making about health and behavioral risk factors among SSAI communities. Intersecting acculturation and culture-specific perceptions about cancer screening within decision-making frameworks may be an essential step towards developing meaningful interventions for immigrant men’s healthcare. Objectives: This study aimed to gain insight into cancer-related beliefs and health decision-making practices among sub-Saharan African immigrant men. Methods: A qualitative design intersecting grounded theory analysis was employed using 16 semi-structured, in-depth individual interviews with SSAI men residing in Georgia and Florida. Participants were recruited from health fairs, community events, and by snowball effect. The average age of participants was 51 years with country of birth including Cameroon, Ethiopia, Ghana, Kenya, and Nigeria. An interview guide was prepared with emphasis on SSAI’s perspectives on lifestyle factors for cancer and decision making about cancer screening. Data were audio-recorded, transcribed, and analyzed using open, inductive, and axial coding via NVivo 12 qualitative data analysis software. Results: Findings identified key cultural factors impacting barriers to and facilitators of SSAI men’s decision-making processes and health-seeking behaviors. Most participants making positive decisions reflected on intercultural health practices made in collaboration with clinicians, significant others and community partnerships. Most participants with negative decisions tended to consider socio-cultural barriers and shortcomings in US health-care system. Participants’ preventative care decisions about cancer screening differed. Conclusions: This qualitative study illuminated key cultural factors among SSAI men that influenced their decision making about cancer screening and health-seeking behaviors. Future research should investigate longitudinal and quantitative studies to test decision-making outcomes. Funding Source: This study is funded by the National Institute on Minority Health and Health Disparities (1R15MD017012-01A1). Keywords: Cancer health disparities, Decision-making, Immigrant men, Intersectionality, Qualitative study Citation Format: Assata Kokayi, Gladys Asiedu, Kaitlin Van Voorhis, Rae Walker, M.E. Young, Folakemi Odedina, Motolani Ogunsanya, Ernie Kaninjing. Intersecting acculturation and decision making about cancer screening among sub-Saharan African immigrant men: A qualitative study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A062.

Perceived social status modifies associations of plasma Alzheimer’s disease biomarkers on cognitive performance among Foreign Born Hispanic/Latinos

AbstractBackgroundForeign born (FB) adults from Latin America are projected to account for the largest proportion of the aging immigrant population in the United States (U.S.) Migration related stressors may increase vulnerability for impairments of stress regulatory systems that are vital in maintaining brain health. We assessed how subjective social status, an individual’s perceived sense of standing in society may be associated with brain health and cognitive performance among community dwelling FB Hispanic/Latinos.MethodAnalyses included 133 FB adults (ages 22‐85) with beta‐amyloid (Aβ42, Aβ40), phosphorylated tau (p‐tau181), neurofilament light (NfL), glial fibrillary acidic protein (GFAP), cardiometabolic, sociodemographic, sociocultural data and concurrent cognitive scores, assessed with the NIH Cognition Toolbox. Participants used the McArthur Scale, a 10‐rung ladder representative of social status in the U.S., to indicate their standing relative to all others. Descriptive statistics were calculated to examine differences by perceived social status tertiles, (i.e., Low (1‐3), Average (4‐5), High (6‐10). Cross sectional multivariable linear regression models estimated the independent effects of biomarkers on outcome scores for episodic memory, processing speed, and total cognition. Model one included age, sex. Model two added education, income, employment, and health insurance. Model three adjusted for covariates in model two and included biological indicators associated with brain health (i.e., glucose, systolic blood pressure, triglycerides). Model four included nativity factors (i.e., age of migration, years of acculturation). An interaction term between plasma biomarker and perceived status examined whether perceived status modified the relationship between plasma biomarker and cognitive outcome.ResultOver 27.1% of FB Hispanic/Latinos reported low perceived status. Compared to those with average and high status, participants categorized as low status, reported fewer years of residence in the U.S. (P = 0.020) In multivariable adjusted models, perceived status modified associations between GFAP (P<0.001) and NfL (P<0.001) on composite scores of total cognition (P<0.001) and NfL (P<0.001) and Aβ42/40 (P<0.0001) on episodic memory and processing speed (P<0.001).ConclusionPerceived status among undocumented FB Hispanic/Latino adults was associated with lower scores on cognitive tasks sensitive to stress, age related decline and neurological impairments. Future studies should explore biological mechanisms through which perceived status may influence brain health and cognitive aging.

Spirituality and Mental Health Among South Asians in the United States

Spirituality and psychiatry have had a complex relationship, with much debate on the inclusion of spiritual and religious concepts in guiding psychiatric care. South Asians in the United States (US) are the largest growing immigrant population with a heterogeneous mix of many religions including Hinduism, Buddhism, Islam, Jainism, Sikhism, and Christianity. South Asians are more vulnerable to mental health disorders compared to the US general population in general, yet have much lower health care utilization rates. This article aims to address the unmet needs in mental health care for South Asians and address the knowledge gap among mental health care practitioners, to enable spiritually integrated care. [ Psychiatr Ann . 2023;53(12):550–555.]

Environment matters: How are neighborhood structural indexes associated with parenting stress among Asian immigrant families?

The Asian immigrant population is the fourth largest immigrant population in the United States, and its parenting stress issues have been consistently recognized in previous studies. However, little attention has been paid to neighborhood-level factors and their parenting stress. Using the Study of Asian American Families and 2016 American Community Survey 5-year estimates, this study examined the association between neighborhood structural indexes and Asian immigrant parents' parenting stress, along with the mechanism driving the relationship. We found that cultural orientation and social support fully mediated the effects of economic disadvantages on parenting stress among Asian immigrant parents. Only cultural orientation mediated the direct effects of ethnic heterogeneity on Asian parents' parenting stress. Improving Asian immigrants' living environment, including economic status and ethnic diversity, would be critical to relieve the parenting stress of Asian immigrant families. Interventions and preventions to increase social support, and inform cultural orientation and acculturation are emphasized.

Biased beliefs about immigration and economic concerns: Evidence from representative experiments

We investigate the causal relationship between biased beliefs about immigrants and the host country's attitudes towards immigration. Using representative survey experiments with over 7000 respondents, we find substantial biases in respondents' beliefs about the immigrant population in several domains. Exposure to different types of information about immigrants reduces concerns about negative effects of immigration on the welfare state. On the contrary, different types of information offset their effects on concerns about increased competition in the labor market. Using a data-driven approach to uncover systematic heterogeneity in treatment effects, we find that prior beliefs about immigration and their distribution in the host country's population are crucial for the effectiveness of information interventions. We conclude that different distributions of beliefs therefore require appropriately targeted information policies.

Equity and Resource Allocation: The Case for Allogeneic Transplant in Emergency Medicaid Patients

Background:When an uninsured, undocumented immigrant presents with an emergency medical condition, they may qualify for Emergency Medicaid. Notably, the care and services related to HSCT are not covered, except in California and Washington state. Therefore, many patients with MRD-positive or relapsed ALL who may otherwise be good candidates for HSCT are unable to receive it. This may lead to months of resource-intensive treatment without the chance of cure. Here we present 3 such patients and their course of treatments and outcomes. Patient 1:A28-year-old male from Mexico was diagnosed with Ph+ B-ALL and treated with three cycles of hyper-CVAD + dasatinib. BCR-ABL PCR remained elevated at 27.9% and the patient was switched to nilotinib for 5 more cycles of hyper-CVAD; nilotinib was continued until later relapse. He began maintenance BCNU/cytoxan, then several cycles 6-MP/MTX/vincristine. On day +554 after diagnosis, he relapsed and started decitabine/venetoclax, then decadron + dasatinib, then MVP, followed by 3 cycles of inotuzumab. Later, he started blinatumomab on day +648, which was discontinued after 22 days due to increasing peripheral blasts. He then started SMILE, then CCE. As his condition worsened he was put on ponatinib, then asciminib before expiring on day +940. Patient 2: A37-year-old male from Mexico was diagnosed with CML and started on nilotinib. On day +212 he progressed to lymphoid blast phase CML with CNS involvement and received hyper-CVAD/dasatinib; was switched to nilotinib on cycle 4 due to concerns about pleural effusion while hospitalized for PNA. On day +447 he started blinatumomab + IT MTX + nilotinib. A brain MRI on day +544 suggested carcinomatous meningitis and he got 4 cycles RMVP. He then switched to ponatinib and HiDAC for 8 cycles despite continued ALL in CSF. He was admitted for worsening ALL-induced headache on day +1016 and imaging discovered multifocal pneumonia. He then had seizure-like activity consistent with metabolic encephalopathy and expired on day +1055. Patient 3: A28-year-old male from Ecuador was diagnosed with Ph+ mixed phenotype (B/myeloid) acute leukemia. The patient underwent leukapheresis and started HiDAC + mitoxantrone + etoposide + dasatinib. Subsequent bone marrow biopsy showed 1% blasts, with BCR-ABL PCR at 1.4%. He was admitted on day +170 with Ph+ B-ALL relapse and underwent leukapheresis + 2 cycles hyper-CVAD. On day +255 he began blinatumomab for 3 cycles. He continues to receive treatment for his B-ALL at this time. See table 1 below. Discussion: There is an increasing population of undocumented immigrants entering the United States and receiving treatment for ALL while on emergency Medicaid. It is important to understand the special considerations in this population, including the inability to have HSCT authorized as a treatment option. Studies comparing the costs of HSCT to chemotherapy have found that chemotherapy is cheaper at the expense of patient mortality. Therefore, HSCT's incremental cost-effectiveness ratio, measured as cost per quality-adjusted life years, may still be favorable. As our case series demonstrates, extensive resources including traditional chemotherapies, immunotherapies like blinatumumab, and targeted oral drugs, can further increase the costs relative to HSCT. Moreover, the National Bureau of Economic research has calculated that undocumented workers add about $45,000 per worker to the US GDP annually. Therefore, offering HSCT and allowing them to continue to work may be a reasonable financial option. Likewise, many undocumented adults are the parents of US citizen minors who would benefit economically from their survival. For consideration we will explore cost analysis to further elucidate the potential benefit of allowing coverage of HSCT.

Distinctive biochemistry profiles associated with hyperuricemia between Tibetans and Hans in China.

We sought to identify distinct risk factors for hyperuricemia in native Tibetan and immigrant Han populations in Tibet, China. Three cohorts of male participants aged between 20 and 40 years were enrolled in this study. Biochemical parameters including serum uric acid (UA), fasting plasma glucose, insulin, lactate dehydrogenase (LDH), thyroxin, blood cell count, aminotransferase, and lipid profiles were analyzed. The association of risk factors with UA levels was evaluated using a multivariable line regression model. The effect of UA level on the biochemical parameters between the Hans and Tibetans was evaluated by two-way ANOVA. The prevalence of hyperuricemia (≥420 μmol/L) was 24.8% (62/250) in the Hans, similar to 23.8% (29/136) in the Tibetans. In the regression analysis, the risk factors that were significantly associated with UA in Hans did not apply to Tibetans. Tibetans had higher fasting insulin (P<0.05) and LDH (P<0.01) levels, in contrast with lower levels of triglycerides (P<0.05), total cholesterol (P<0.01), and low-density lipoprotein-cholesterol (P<0.01) than Hans in normal UA populations. Biochemistry analysis revealed lower albumin levels (P<0.001) and higher levels of all aminotransaminase and especially alkaline phosphatase (P<0.01) in Tibetans than in Hans in both populations. Compared with Hans, Tibetans had lower serum levels of urea, creatinine, and electrolytes in the normal UA population, which were further exacerbated in the high UA population. Tibetans had comparable white blood cell counts as Hans in both normal and high UA populations. In contrast, the red blood cell count and hemoglobin concentration were much lower in Tibetans than in Hans under high UA conditions. The distinctive biochemistry between Tibetans and Hans may underlie the different etiologies of hyperuricemia in Tibet, China.

Individual English Proficiency, Community Language Resources, and Immigrants’ Employment in Western New York: Evidence from the American Community Survey

This study examines associations between the ability to speak English, community language resources, and employment among immigrants in Western New York, United States. Building on existing literature that demonstrates the importance of individual human capital (English proficiency), social networks, and ethnic community resources in immigrants’ labor market outcomes, we introduce the concept of community-level language resources as a facilitator of immigrants’ economic integration. Using data from the American Community Survey and a measure of community language resources (the percentage of bilinguals among people speaking the same language in a community), we find that greater community language resources are associated with a significant increase in the likelihood of being employed for immigrant men with limited English proficiency. Regression analyses also show that neither individual English proficiency nor community language resources are significantly associated with immigrant women's probability of being employed. This study calls for attention to community language resources and individual human capital when designing research on and developing policies for immigrant populations. Findings also show the need for a gender-aware approach to research and practice with immigrant communities.

Exploring cross-cultural perspectives on adolescent mental health among Congolese immigrant adults in the USA and Belgium

Purpose This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population. Design/methodology/approach Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns. Findings Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors’ findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way. Research limitations/implications Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors’ findings are not reflective of new immigrants’ experiences. Parents’ perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo’s (DRC’s) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth’s perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors’ findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors’ study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community. Practical implications The authors’ findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures. Originality/value This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC.

Away from Home or Returned Home? What Iranian Participants with Dementia Experience while Living in a Culturally Profiled Nursing Home in Sweden

This study explores Iranian immigrants with dementia living in a culturally profiled Swedish nursing home and what it means to be at “home.” The meaning given to a place, in general, is understood to be generated and formed by experiences, expectations, hopes, and chains of events, and its significance can change over time. Life changes will mainly affect the understanding of what constitutes “home.” Such a concept can be challenging to define, especially amongst some immigrant populations and those with dementia, for whom parameters change and choice can be limited. This qualitative research study is based on ethnographic fieldwork following ten participants. The data was analyzed, and three main categories that contribute to understanding “home” as part of the delivery of care to elderly immigrants with dementia, namely “a place to escape to”, “a place to be”, and “a place to live”, were identified. The findings show that living in a culturally profiled nursing home in Sweden gave residents a feeling of self-rule, although the institution did have its codes and rules. Considering the feeling of home, none of the participants felt at home; instead, they stated that the culturally profiled nursing home was merely a place to live. Factors that strengthened their independence were the ability to speak the language they were familiar with and receiving medical help without relying on their children.

Immigration and C-sections incidence: Maternal care and perinatal outcomes in the context of the pandemic in Chile

IntroductionImmigration has increased significantly in Chile. Despite that all pregnant women, regardless of nationality and immigration status, have the right to access to all healthcare services during pregnancy, childbirth, and postpartum, inequities in health care outcomes and health provision have been reported. During COVID-19 pandemic, these inequities are completely unknown.ObjectiveThe aim of this study was to compare the incidence of c-sections according to mother's migration status, as well as other maternal care and perinatal outcomes in women giving birth at San José Hospital in Santiago, Chile, during the COVID-19 pandemic.MethodsA retrospective cohort study was designed including 10,166 registered single births at the San José Hospital between March 2020 and August 2021. To compare between groups, statistical tests such as Chi-square and Fisher's exact were used. Log Binomial regression models were performed adjusted for potential confounding variables. To estimate the strength of association the relative risk was used.ResultsImmigrant mothers account for 48.1% of the registered births. Compared to non-immigrant women, immigrants exhibit a higher proportion of c-section, specifically, emergency c-section (28.64% vs. 21.10%; p-value &amp;lt; 0.001) but a lower proportion of and having a preterm birth (8.24% vs. 13.45%; p &amp;lt; 0.05), receiving personalized childbirth care (13.02% vs. 14.60%; p-value &amp;lt; 0.05), companion during labor and childbirth (77.1% vs. 86.95%; p-value &amp;lt; 0.001), And postpartum attachment to newborn (73% vs. 79.50%; p-value &amp;lt; 0.001). The proportion of COVID exposure was not significant between groups, not the severity also. Haitians had a highest risk of undergoing emergency c-section (aRR = 1.61) and Venezuelans had a highest risk of elective c-section (aRR = 2.18) compared to non-immigrants.ConclusionThis study reports high rates of c-sections in the entire population, but in immigrant populations it is even higher. Additionally, it found gaps in maternal care and perinatal outcomes between immigrants and non-immigrants. More studies are needed to elucidate the possible causes of these differences and establish new regulations to protect the reproductive rights of the immigrant population.

Like parent, like child: how attitudes towards immigrants spill over to the political inclusion of their children

ABSTRACT Across Europe, citizenship is traditionally attributed at birth through descent only. As immigrant populations grow, policy-makers have come under pressure to extend citizenship rights to the children of immigrants born in the country. While such inclusive measures often counter political opposition, public attitudes on this question remain remarkably underexplored. In this study, we report on the results of an original choice-based conjoint survey experiment designed to examine which parental attributes affect respondents’ willingness to grant citizenship to newborns. We implement the survey experiment in Italy, where over one million children do not have Italian citizenship, yet reform proposals have so far been unsuccessful. In line with our pre-registered expectations, we find that respondents are more likely to support birthright citizenship for children born to parents who are economically, legally and socially integrated in society. These attitudes vary little by political background, education and age-category of respondents. Our findings suggest that incorporating immigration-related conditionality in birthright citizenship proposals is key to convincing sceptical publics of the legitimacy of such measures.

Are public green spaces distributed fairly? A nationwide analysis based on remote sensing, OpenStreetMap and census data

Green space (GS) is a crucial resource in urban areas, but not spatially uniformly distributed. We compare the availability of GS on a national scale using green land cover (GLC) and public green space (PGS). Using spatial census data we analyse GS availability and accessibility for the German population. The average GS availability differs by a factor of three between GLC and PGS. 19.2 % of Germans find less than the WHO defined target for PGS in their neighbourhood. PGS is less equally distributed among the population than GLC, and green space equity varies significantly between rural and urban areas. In areas with multi-family homes, a higher share of the population has access to sufficient PGS than in areas with predominantly single-family homes. We find a negative relation between GLC availability and share of immigrant population, which does not extend to PGS.

Distribution Characteristics and the Influencing Factors of High Altitude Deterioration in People Working in Tibet

To comprehensively investigate and analyze the distribution characteristics of high altitude deterioration (HADT) among people working in 7 cities of Tibet Autonomous Region, to examine the relevant influencing factors, and to provide baseline survey data for further research on HADT. A self-designed questionnaire was used to conduct a self-administered survey among employees in seven prefectures or cities (Lhasa City, Qamdo City, Shigatse City, Nyingchi City, Shannan City, Naqu City, and Ngari Prefecture) in Tibet. The respondents were selected through random cluster sampling. The survey covered 21 symptoms involving 4 systems of the human body, including the respiratory, nervous, circulatory, and digestive systems. The distributive characteristics of HADT (as manifested by maladaptation to high altitude) were described and Spearman's correlation was used to examine the influencing factors of maladaptation to high altitude. A total of 3 901 respondents were included in the sample analyzed in the study, including 2 107 (54%) native Tibetans and 1 794 (46%) immigrant Han people. There were 1 994 males (51%) and 1 907 females (49%). Their age ranged from 20 to 57 years, averaging (34.45±8.11) years. The subjects lived at a high altitude for a duration of 0.5 to 54 years, averaging (19.51±13.84) years. The overall rates of maladaptation for the 21 symptoms among native Tibetans and immigrant Han people were 60.10% (26 578/44 247) and 73.20% (27 565/37 674), respectively. The maladaptation rates of the native Tibetan population for the respiratory, nervous, circulatory, and digestive systems of the human body were all lower than those of the immigrant Han population (P<0.001). There were no significant differences in the maladaptation rates of employees from different regions of Tibet (66.21% for Ngari Prefecture, 65.02% for Qamdo City, 66.67% for Lhasa City, 62.29% for Shigatse City, 65.03% for Shannan City, 64.42% for Nyingchi City, and 61.65% for Naqu City). The type of high-altitude residents (i.e., being native Tibetan or immigrant Han) was the main influencing factor for high-altitude maladaptation of the respiratory, nervous, circulatory, and digestive systems (P<0.001). According to the findings of the correlation analysis, age, type of high-altitude residents, and the duration of residence at a high altitude were associated with high-altitude maladaptation of the respiratory system, while type of high-altitude residents was the only factor associated with maladaptation of the nervous system, circulatory system, and digestive systems. Age and duration of living at at high altitude had significant effect on self-perceived dyspnea, a type of maladaptation of the respiratory system (P<0.001). Duration of high-altitude residence had significant effect on cyanotic lips or redness in the cheeks, a type of maladaptation of the circulatory system, and self-perceived loss of appetite, a type of maladaptation of the digestive system (P<0.05). More attention should be given to the HADT among employees of public institutions and enterprises who are living in Tibet Autonomous Region and immigrant Han people, in particular, should pay special attention to the protection of their respiratory, nervous, circulatory, and digestive systems.

Immigrants, health, and the impact of COVID-19: A narrative review.

While the COVID-19 pandemic has gravely challenged health systems globally, countries that host a large number of refugees are finding themselves even more burdened as providing preventive and curative services to refugees, and, migrants has proved to be a challenging task. The aim of this narrative review is to discuss the impact COVID-19 pandemic on immigrants, and seek to understand how COVID-19 affects provision of health services, access to health care and the socioeconomic situation. Like any other health challenge, COVID-19 has also left migrants susceptible to adverse outcomes, both directly and indirectly. Several factors limit their ability to avoid infections, access healthcare, and cope with socio-psychological impacts. In addition, undocumented immigrants or people living on short-term visit visas do not have full access to healthcare services in most countries. It is evident that COVID-19 has also influenced these workers leaving them jobless or receiving low wages or no pay, hence, this has hugely impacted the remittance and economic situation in their country. Extending access to healthcare to the entire immigrant population, irrespective of their legal status, is the cornerstone of an effective response to counter the COVID-19 pandemic.

Longitudinal study on blood and biochemical indexes of Tibetan and Han in high altitude area.

This study aims to review the blood routine and biochemical indicators of the plateau population for three consecutive years, and analyze the impact of the plateau on these blood indicators of the Tibetan population and the Han immigrant population. These parameters were extracted from the Laboratory Department of Ali District People's Hospital in Tibet from January 2019 to December 2021, including blood routine, liver and kidney function, blood lipids, myocardial enzyme spectrum, and rheumatic factor indicators. Changes in these parameters were analyzed over 3 consecutive years according to inclusion and exclusion criteria. A total of 114 Tibetans and 93 Hans participated in the study. These parameters were significantly different between Tibetan and Han populations. Red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), mean hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cells (WBC), lymphocytes (LYMPH) and monocytes (MONO) were significantly higher in Hans than Tibetans (p < 0.05). Biochemically, total bilirubin (TBIL), direct bilirubin (DBIL), albumin (ALB), urea nitrogen (Urea), creatinine (Cr), uric acid (UA), glucose (GLU), triglycerides (TG) and creatine kinase isoenzyme (CKMB) were significantly higher in Hans than Tibetans; aspartate aminotransferase (AST), glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), antistreptolysin (ASO), and C-reactive protein (CRP) were significantly higher in Tibetans than Hans (p < 0.05). There were no obvious continuous upward or downward trend of the parameters for 3 consecutive years. In high-altitude areas, Han immigrants have long-term stress changes compared with Tibetans. The main differences are reflected in the blood system, liver and kidney functions, etc., which provide basic data for further research on the health status of plateau populations.

Can We Rely on Projections of the Immigrant Population? The Case of Norway

Demographic forecasters must be realistic about how well they can predict future populations, and it is important that they include estimates of uncertainty in their forecasts. Here we focus on the future development of the immigrant population of Norway and their Norwegian-born children (“second generation”), grouped by three categories of country background: 1. West European countries plus the United States, Canada, Australia, and New Zealand; 2. Central and East European countries that are members of the European Union; 3. other countries. We show how to use a probabilistic forecast to assess the reliability of projections of the immigrant population and their children. We employ the method of random shares using data for immigrants and their children for 2000–2021. We model their age- and sex-specific shares relative to the whole population. Relational models are used for the age patterns in these shares, and time series models to extrapolate the parameters of the age patterns. We compute a probabilistic forecast for six population sub-groups with immigration background, and one for non-immigrants. The probabilistic forecast is calibrated against Statistics Norway’s official population projection. We find that a few population trends are quite certain: strong increases to 2060 in the size of the immigrant population (more specifically those who belong to country group 3) and of Norwegian-born children of immigrants. However, prediction intervals around the forecasts of immigrants and their children by one-year age groups are so wide that these forecasts are not reliable.