Y A R A B E Z G I N A , C H A Z R A L P H S , C Y N T H I A R O D R I G U E Z , J A M E S S T E W A R T , S T E V E Y O U N G

LATIN AMERICAN IMMIGRANTS

ENRIQUE’S JOURNEY

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ENRIQUE’S JOURNEY

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ENRIQUE’S JOURNEY

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

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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

• 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 • Boys: gang members• Females: pregnancy and starting own family

• Children may have difficulties in school with• 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• Quinceñera• Dia de Los Muertos• Dia de Los Santos • Lady de Guadalupe

(de Paula, Lagana, & Gonzalez-Ramirez, 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 ANDHIGHER 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 post-secondary 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 don’t speak English and the children don’t learn Spanish; and this creates problems. The kids often don’t feel American completely and not part of the Spanish culture as they don’t 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

• Examples of alienation:• Under the counter jobs• Few/limited opportunities • Discouraged to put down roots• Lack connection to their “old world”• 1 ½/1.5 generation – children who straddle both worlds but are not

truly part of either

Berry, Phinney, Sam, and Vedder, 2006, Jacoby, n.d.,

Zhou, 1997)

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: Josue’s 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 Practices1. Stops based on ethnicity and class2. Use of intimidation3. Restricting freedom of movement of only Mexicans4. Reinforce stereotypes5. 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 IMMIGRANTSTO 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• A large number are the uninsured, including illegal immigrants

• Effects of the Affordable Care Act (ACA)• Cutting financial aid to hospitals for emergency care by halt• Premise that fewer people will lack health insurance

(Berstein, 2012)

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 can’t go to college because I don’t have papers”:

Incorporation patterns of Latino undocumented youth. Latino Studies, 4(3), 212-231. doi:10.1057/palgrave.lst.8600200

Bernstein, N. (2012, July 26). Hospitals fear cuts in aid for care to illegal immigrants. The New York Times. Retrieved from http://www.nytimes.com/2012/07/27/nyregion/affordable-care-act-reduces-a-fund-for-the-uninsured.html?pagewanted=all&_r=0

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, 7–12.

Central Intelligence Agency (1998). World factbook [Online], Available: http://www.odci.gov/cia/publications/factbook/

Cuellar, A. (2011, December 27). As work conditions shifts inhumanity of immigrant labor becomes human rights concern. San Francisco Public Press. Retrieved from http://sfpublicpress.org/news/2011-12/as-work-conditions-shift-inhumanity-of-immigrant-labor-becomes-human-rights-concern

REFERENCESDe 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.26.5.1258Hunt, 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.

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%20-Immigration%20Alienation(1).pdfJuarez, 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). Womenís health care: Cross-cultural 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.Meyerson, H. (2011, June 24). Protecting undocumented workers. The Los Angeles Times. Retrieved

from http://articles.latimes.com/2011/jun/24/opinion/la-oe-meyerson-undocumented-abuses-20110624

REFERENCESNazario, S. (2006). Enrique’s journey. New York: Random House Trade Paperbacks.Rangel, E. (1999, May 26). Working toward the middle. The Dallas Morning News, pp. D1, D10.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.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.htmlRomero, 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: 10.1163/156916306777835376Skaer, 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), 29-34Tavernise, S. (2013, May 18). The health toll of immigration. The New York Times. Retrieved from http://www.nytimes.com/2013/05/19/health/the-health-toll-of-immigration.html?pagewanted=allZhou, 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/295254Zuelhke, E. (2009, November). Immigrants work riskier and more dangerous jobs in the United States. Population Reference Bureau. Retrieved from http://www.prb.org/Publications/Articles/2009/usimmigrantsriskyjobs.aspx