LATIN AMERICAN IMMIGRANTS

YARA BEZGINA, CHAZ RALPHS, CYNTHIA RODRIGUEZ, JAMES STEWART, STEVE YOUNG

ENRIQUES JOURNEY

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ENRIQUES JOURNEY

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ENRIQUES JOURNEY

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https://www.youtube.com/watch?v=-7UZk6Hg-Xo

BACKGROUND

BACKGROUND
Latino Immigration
~700,000 immigrants enter the US illegally each year ~1 million immigrants arrived legally since 2000 ~1.7 million children live illegaly
mostly from Mexico and Central America

~36 million US residents were born in another country in 2006

Nearly 1/3 live in US illegally First wave in1960s and continues today

Divorce and Family Disintegration Rates

Increased rates in Latin America over recent decades Single mothers unable to feed and raise children Trend of single Latin American mother leaving children with family (Nazario, 2006)

THE AMERICAN DREAM

Is a vehicle of hope for immigrants
Economic and educational opportunities in the US Send money back home Gain financial independence Higher education opportunities Better future for their family Escape crime and poverty American citizenship Reunite with one or more family members

PUBLIC OPINION
Varies greatly 82% of Latinos say discrimination affects them
Common Reasons: differences in language and appearance

Many immigrants experience:

Ethnic slurs Racial profiling Perpetuated stereotypes in the media Blame for economic issues
(Lopez, 2009)

PUBLIC OPINION
Anti-immigrant sentiment is largely derived from viewing migrants as threats
Subvert national culture and values

Threaten economic wellbeing of native Americans

Use resources and take jobs

Nativism
Intense opposition to an internal minority during economic downturns, Example: treatment post-9/11
(Lopez, 2009)

OPPRESSION IN THE US
Drawback of living in the Unites States:
Live in the shadows Face deportation Racism

Socioeconomic Status (SES)

Poorer with lower incomes Qualify for more state and local services 3x more likely to receive government welfare
(Nazario, 2006)

PERSONAL INSIGHT INTO OPPRESSION OF IMMIGRANTS

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BELIEFS
Religious Beliefs
Central to life of the family and community Predominantly Roman Catholic

Health Beliefs and Practices

Physical or mental illness may be attributed to an imbalance between person and environment Influences include: emotional, spiritual and social state, and physical factors Most Hispanics primarily use cosmopolitan sources of health care (e.g., primary care physicians) to a far greater extent than traditional or folk sources
(Hunt, Arar, & Akana, 2000; Skaer, Robison, Sclar, & Harding, 1996)

VALUES
Familism valuing of family considerations over individual or community needs Nuclear family the most basic and common social unit, but many include extended families Respect and Honor

(Juarez, Ferrell, & Borneman, 1998; Lieberman et al, 1997)

ROLES
An individual may participates in multiple roles: worker, parent, child, sibling, caretaker for elder, breadwinner, protector of the family, gang member Elders: have prestigious status; sought for advice Fathers or eldest male: holds the greatest power Females: homemaker and childrearing

Children: older children help raise youger siblings

(de Paula, Lagana, & Gonzalez-Ramirez, 1996)

IMMIGRANT FAMILY DYNAMICS

The Heartache of an Immigrant Family Benefits:
Example: mothers send money so children can eat and attend school

Consequences:

Disruption of family Children may deeply resent mothers for leaving Search for love elsewhere
Children may have difficulties in school with

Boys: gang members Females: pregnancy and starting own family

Depression Acting up Trusting authority figures In Los Angeles, about 16% graduate from a newcommer school

(Nazario, 2006)

CUSTOMARY PRACTICES
"Culture . . . is a system of symbols that is shared, learned and passed on through generations of a social group. Culture mediates between human beings and chaos; it influences what people perceive and guides people's interactions with each other. It is a process rather than a static entity and it changes over time" (Lipson, 1996). Most Common Constants Regarding Culture:
Familism Language Faith

Dying and Death Practices - the family is often significantly involved in caring for a family member who is dying
(de Paula, Lagana, & Gonzalez-Ramirez, 1996)

CUSTOMARY PRACTICES
Communication
Verbal and Non-Verbal
Usually characterized by respeto (respect) Use formality to show respect, especially when addressing elderly Direct eye contact is less common

Celebration and Holidays

Commonly celebrate popular holidays (e.g. Christmas) El Dia de Independencia Quinceera Dia de Los Muertos Dia de Los Santos Lady de Guadalupe
(de Paula, Lagana, & GonzalezRamirez, 1996; Rodriguez, 1995)

OCCUPATIONAL INJUSTICES AND HEALTH AND WELLBEING DISPARITIES

Inverse correlation between occupational injustice and health and wellbeing. Occupational injustices have negative impact on health and well being

Common challenges faced by immigrants:

Alienation/Adjustment Finding work/low pay Financial obligations/SES vs. occupational balance Barriers to accessing healthcare services Lack of culturally sensitive service delivery Health education
(Braveman & Bass-Haugen, 2009; Hammell, 2008; Nazario, 2007)

OCCUPATIONAL ALIENATION AND HIGHER EDUCATION

Documented and undocumented immigrants grow up the same through high school Legal status does not determine:
Academic success Desires for higher education Dreams and aspirations

Educational progress stops for undocumented at high school

Unable to apply for scholarships or loans Not legal for dream job Forced to work undesirable jobs
(Abrego, 2006)

THE DREAM ACT

Development, Relief, and Education for Alien Minors
Requirements:
Be under the age of 35 on date of legislation's enactment Have arrived in the United States before age 16 Have obtained a US high school diploma or equivalent Have maintained a "good moral character" throughout residence

Granted a conditional permanent resident status

Serves as intermediate step toward legal permanent status

Granted 6-year window to complete 2 years of postsecondary education or 2 years of military service
Following trial period, eligible to apply for citizenship
(Conger, 2013)

OCCUPATIONAL ALIENATION AND CULTURAL LIMBO

Another problem I feel is that we have too many Mexican immigrants where mom and dad dont speak English and the children dont learn Spanish; and this creates problems. The kids often dont feel American completely and not part of the Spanish culture as they dont speak the language.
(J., personal communication, February 19, 2014)

OCCUPATIONAL ALIENATION AND CULTURAL LIMBO

Psychological and sociocultural acculturation and adaptation
Integration profile best Ethic profiles moderately good psychological but poorer sociocultural adaptation. Diffused profiles had the worst Under the counter jobs Few/limited opportunities Discouraged to put down roots Lack connection to their old world 1 /1.5 generation children who straddle both worlds but are not truly part of either
Berry, Phinney, Sam, and Vedder, 2006, Jacoby, n.d., Zhou, 1997)

Examples of alienation:

OCCUPATIONAL DEPRIVATION/IMBALANCE
Work multiple jobs
Long hours at work Less time/energy for meaningful occupations

Work risker jobs

Underreported workplace injury Highest fatality rate

Protecting undocumented workers

Example: Josues Story The PowerAct
Legislation that would provide U visas or temporary legal status to immigrant victims who come forward to report violent crimes, and would expand the protection to those who come forward to report workplace violations
(Meyerson, 2011; Nazario, 2007; Zuehlke, 2005)

OCCUPATIONAL RIGHTS AND RACIAL PROFILING IN LAW ENFORCEMENT

1975 Supreme Court decision
Having Mexican appearance is just cause for questioning immigration status Mexican appearance is described as speaking Spanish, looking Mexican, shopping in Mexican shops, etc.

Immigration Law Enforcement Practices

1. 2. 3. 4. 5. Stops based on ethnicity and class Use of intimidation Restricting freedom of movement of only Mexicans Reinforce stereotypes Unfair and partial treatment
(Romero, 2006)

RED CARD

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HEALTH DISPARITIES
Health deteriorates over time due to acculturation to US
Worse rates of heart disease, HTN, and diabetes

American-born children have more money, but live shorter lives than parents Reasons for the decrease in health are:
Unhealthy habits (fast food, smoking, drinking) Unhealthy environment Lack of access to health care Living in rural areas with little resources
(Tavernise, 2013; Derose, Escarce, & Lurie, 2007)

COMPARING LATINO IMMIGRANTS TO US-BORN CITIZENS

Less health insurance and routine care
Undocumented least likely

More problems obtaining health care

Naturalized and undocumented Mexicans US-born Latinos (not Mexican)

More negative experiences

Undocumented most likely Thought they would get better care if different race

More difficulties understanding physician

Undocumented most likely

Less health care usage

(Ortega, et al., 2007)

HEATH DISPARITIES (CONT.)

Federal law requires that all people be treated regardless of immigration status Federal governement currently contributes $20 billion annually to reimburse hospitals in poor urban and rural areas Effects of the Affordable Care Act (ACA)

A large number are the uninsured, including illegal immigrants

Cutting financial aid to hospitals for emergency care by halt Premise that fewer people will lack health insurance
(Berstein, 2012)

???SOURCES OF VULNERABILITY???
Low SES
Less education Higher rates of poverty Lower rates of high-end jobs

Immigration status English

Lower immigration status decreases likelihood of health insurance

Decreased fluency equates to less physician visits and less preventative care

Stigma

Less satisfied experiences with health care May have fear of being deported
(Derose, Escarce, & Lurie, 2007)

BAFA BAFA SIMULATION

Volunteers?
Instructions: Debriefing on your culture (each culture is different) Act out social scenario Rules: No talking except for gibberish Must follow cultural expectations

DISCUSSION
What did it feel like to observe? participate? What new insights do you have?

How do you think this might translate into a health care setting?
What will you do differently after this experience?

REFERENCES
Abrego, L. J. (2006). I cant go to college because I dont have papers: Incorporation patterns of Latino undocumented youth. Latino Studies, 4(3), 212-231. doi:10.1057/palgrave.lst.8600200 Berry, J. W., Phinney, J. S., Sam, D. L., & Vedder, P. (2006). Immigrant youth: Acculturation, identity, and adaptation. Applied psychology, 55(3), 303-332. doi:10.1111/j.1464-0597.2006.00256.x Braveman, B., & Bass-Haugen, J. D. (2009). From the Desks of the Guest Editors Social justice and health disparities: An evolving discourse in occupational therapy research and intervention. American Journal of Occupational Therapy, 63, 712. Central Intelligence Agency (1998). World factbook [Online], Available: http://www.odci.gov/cia/publications/factbook/ De Paula, T., Lagana, K., & Gonzalez-Ramirez, L. (1996). Mexican Americans. In J. G. Lipson, S. L. Dibble, & P. A. Minarik (Eds.). Culture & nursing care (pp. 203-221). San Francisco: UCSF Nursing Press. Derose, K. P., Escarce, J. J., & Lurie, N. (2007). Immigrants and health care: Sources of vulnerability. Health Affairs, 26(5), 1258-1268. doi: 10.1377/hlthaff.26.5.1258 Hunt, L.M., Arar, N.H., & Akana, L.L. (2000). Herbs, prayer, and insulin: Use of medical and alternative treatments by a group of Mexican-American diabetes patients. Journal of Family Practice. 49(3), 216-223.

REFERENCES
Hammell, K. W. (2008). Reflections on well-being and occupational rights. Canadian Journal of Occupational Therapy, 75(1), 61-64. doi: 10.2182/cjot.07.007 Jacoby, T. (n.d.). Immigration alienation. Retrieved from http://immigrationworksusa.org/uploaded/Nexus%20Article%20Immigration%20Alienation(1).pdf Juarez, G., Ferrell, B., & Borneman, T. (1998). Perceptions of quality of life in Hispanic patients with cancer. Cancer Practice, 6(6), 318-324. Lieberman, L. S., Stoller, E. P., & Burg, M. A. (1997). Womens health care: Crosscultural encounters within the medical system. Journal of the Florida Medical Association, 84(6), 364-373. Lipson, J. G.. (1996). Culturally competent nursing care. In J. G. Lipson, S. L. Dibble, & P. A. Minarik (Eds.). Culture & nursing care (pp. 1-6). San Francisco: UCSF Nursing Press. Ortega, A. N., Fang, H., Perez, V. H., Rizzo, J. A., Carter-Pokras, O., Wallace, S. P., & Gelberg, L. (2007). Health care access, use of services, and experiences among undocumented Mexicans and other Latinos. Archive of International Medicine 167(21), 2354-2360.

REFERENCES
Nazario, S. (2006). Enriques journey. New York: Random House Trade Paperbacks Rangel, E. (1999, May 26). Working toward the middle. The Dallas Morning News, pp. D1, D10. Rodriguez, S. 1995. Hispanics in the United States: An insight into group characteristics. Department of Health and Human Services. Web Site: http://www/hhs.gov/about/heo/hgen.html Romero, M. (2006). Racial profiling and immigrant law enforcement: Rounding up of usual suspects in the Latino community. Critical Sociology, 32(2-3), 447-473. doi: 10.1163/156916306777835376 Skaer, T.L., Robison, L.M., Sclar, D.A., & Harding, G.H. (1996). Utilization of curanderos among foreign born Mexican-American women attending migrant health clinics. Journal of Cultural Diversity, 3(2), 29-34 Zhou, M. (1997). Growing up American: The challenge confronting immigrant children and children of immigrants. Annual review of sociology, 63-95. Retrieved from: http://www.jstor.org/stable/295254