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Tanner AE, Hall MA, Aguilar-Palma SK, Mann-Jackson L, Alonzo J, Bertoni AG, McCoy TP, Garcia M, Sucaldito AD, Turner MJ, Robles Arvizu J, Russell LP, Rhodes SD. Understanding uptake of COVID-19 testing, vaccination, and boosters among Spanish-speaking Latines in the United States: Qualitative insights from Spanish speakers and key informants. PLoS One 2024; 19:e0296812. [PMID: 38452119 PMCID: PMC10919869 DOI: 10.1371/journal.pone.0296812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/19/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Latine communities in the United States have been disproportionately affected by COVID-19. It is critical to gain a better understanding of the sociocultural determinants that challenge and facilitate COVID-19 testing, vaccination, and booster uptake within these vulnerable communities to inform culturally congruent strategies and interventions. METHODS In summer 2022, our community-based participatory research partnership conducted 30 key informant interviews and 7 focus groups with 64 Spanish-speaking Latine participants in North Carolina. Interviewees consisted of representatives from health and service organizations, most of whom were engaged with direct service to Spanish speakers. Interviews were conducted in either English or Spanish, depending on the preference of the participant; all focus groups were conducted in Spanish. Interviews and focus groups were conducted in person or by videoconference. RESULTS Twenty themes emerged that we organize into four domains: general perceptions about COVID-19; barriers to COVID-19 testing, vaccination, and booster uptake; facilitators to COVID-19 testing, vaccination, and booster uptake; and recommendations to promote testing, vaccination, and booster uptake. DISCUSSION Results underscore important sociocultural determinants of ongoing COVID-19 testing, vaccination, and booster uptake to consider in developing interventions for Spanish-speaking Latines in the United States. Based on this formative work, our partnership developed Nuestra Comunidad Saludable (Our Healthy Community). We are implementing the intervention to test whether trained peer navigators can increase COVID-19 testing, vaccination, and booster uptake among Spanish-speaking Latines through blending in-person interactions and mHealth (mobile health) strategies using social media.
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Affiliation(s)
- Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, United States of America
| | - Mark A. Hall
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
- Wake Forest University School of Law, Winston-Salem, NC, United States of America
| | | | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
- Wake Forest Clinical and Translational Sciences Institute Program in Community-Engaged Research, Winston-Salem, NC, United States of America
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Alain G. Bertoni
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Thomas P. McCoy
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC, United States of America
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Ana D. Sucaldito
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
- Wake Forest Clinical and Translational Sciences Institute Program in Community-Engaged Research, Winston-Salem, NC, United States of America
| | - Mari Jo Turner
- Hispanic League, Inc, Winston-Salem, NC, United States of America
| | - Jose Robles Arvizu
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Laurie P. Russell
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Scott D. Rhodes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
- Wake Forest Clinical and Translational Sciences Institute Program in Community-Engaged Research, Winston-Salem, NC, United States of America
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Argibay S, Auchincloss AH, Chaparro MP, Kravitz C, Eastus A, Langellier BA. Impact of county and state immigration policies on immigrant household enrollment in the supplemental nutrition assistance program. J Migr Health 2024; 9:100224. [PMID: 38596617 PMCID: PMC11002295 DOI: 10.1016/j.jmh.2024.100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/18/2024] [Accepted: 02/28/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Low-income immigrants who are eligible to participate in the Supplemental Nutrition Assistance Program (SNAP) participate at lower rates compared to non-immigrants. Immigrant households may be more likely to participate in SNAP if they live in areas with policies that integrate them into society and protect them from deportation. Methods Data on low-income immigrant households came from the 2019 American Community Survey (N = 87,678). The outcome was whether any household member received SNAP in the previous 12 months. Immigrant policy exposures came from two sources: the State Immigration Policy Resource, which includes 18 immigrant criminalizing and integrating policies, and a database that identified 'sanctuary policies' (SP), which we summarized at the county level. Multivariable logistic regression adjusted for person/household-level and area-level confounders. Results Living in a jurisdiction with a SP was associated with 21% higher odds of enrolling in SNAP compared to living in a jurisdiction without a SP (adjusted odds ratio [aOR] 1.21, 95% CI=1.11,1.31). Relative to the least immigrant friendly states, living in the most immigrant-friendly states was associated with 16% higher odds of SNAP enrollment (aOR=1.16, 95%CI=1.06-1.28). When SP and state-level immigrant friendly policy environment were cross-classified, SNAP participation was 23% and 26% higher for those living in jurisdictions with one- and both- exposures, respectively, relative to those with neither (aOR 1.23; CI 1.12,1.36; aOR 1.26; CI 1.15,1.37). Conclusions Many at high risk of food insecurity - including immigrants and citizens in households with immigrants - are eligible for SNAP but under-enroll. Policies that welcome and safeguard immigrants could reduce under enrollment.
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Affiliation(s)
- Sofia Argibay
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel, University. Nesbitt Hall, 3215 Market St., Philadelphia, PA 19104, United States
| | - Amy H. Auchincloss
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel, University. Nesbitt Hall, 3215 Market St., Philadelphia, PA 19104, United States
| | - M. Pia Chaparro
- Department of Health Systems and Population Health, School of, Public Health, University of Washington, 305 J Raitt Hall, Box 353410, Seattle, WA 98195, United States
| | - Caroline Kravitz
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel, University. Nesbitt Hall, 3215 Market St., Philadelphia, PA 19104, United States
| | - Alexandra Eastus
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel, University. Nesbitt Hall, 3215 Market St., Philadelphia, PA 19104, United States
| | - Brent A. Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel, University. Nesbitt Hall, 3215 Market St., Philadelphia, PA 19104, United States
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YOUNG MARIADETRINIDAD, TAFOLLA SHARON, PEREZ‐LUA FABIOLAM. Caught Between a Well-Intentioned State and a Hostile Federal System: Local Implementation of Inclusive Immigrant Policies. Milbank Q 2023; 101:1348-1374. [PMID: 37707458 PMCID: PMC10726814 DOI: 10.1111/1468-0009.12671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 08/11/2023] [Accepted: 08/21/2023] [Indexed: 09/15/2023] Open
Abstract
Policy Points Inclusive state immigrant policies that expand rights and resources for immigrants may improve population health, but little is known about their local-level implementation. Local actors that have anti-immigrant attitudes can hinder the implementation of state policies, whereas the persistent influence of anti-immigrant federal policies reinforces barriers to accessing health and other resources granted by state policies. Local actors that serve immigrants and support state policy implementation lack the resources to counter anti-immigrant climates and federal policy threats. CONTEXT In the United States, inclusive state-level policies can advance immigrant health and health care access by extending noncitizens' access to public benefits, workplace rights, and protections from immigration enforcement. Although state policies carry promise as structural population health interventions, there has been little examination of their implementation at the local level. Local jurisdictions play multiple roles in state policy implementation and possess distinct immigration climates. Examining the local implementation of state immigrant policy can address challenges and opportunities to ensure the health benefits of inclusive policies are realized equitably across states' regions. METHODS To examine the local implementation of state immigrant policies, we selected a purposive sample of California counties with large immigrant populations and distinct social and political dynamics and conducted and analyzed in-depth interviews with 20 community-based organizations that provided health, safety net, and other services. FINDINGS We found that there were tensions between the inclusionary goals of state immigrant policies and local anti-immigrant climates and federal policy changes. First, there were tensions between state policy goals and resistance from local law enforcement agencies and policymakers (e.g., Board of Supervisors). Second, because of the ongoing threats from federal immigration policies, there was a mismatch between the services and resources provided by state policies and local community needs. Finally, organizations that served immigrants were responsible for contributing to policy implementation but lacked resources to meet community needs while countering local resistance and federal policy threats. CONCLUSIONS This study contributes knowledge regarding the challenges that emerge after state immigrant policies are enacted. The tensions among state immigrant policies, local immigration climates, and federal policy changes indicate that state immigrant policies are not implemented equally across state communities, resulting in challenges and limited benefits from policies for many immigrant communities.
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Affiliation(s)
| | - SHARON TAFOLLA
- School of Social Sciences, Humanities and ArtsUniversity of California Merced
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Yang YT, Berg CJ. How Preemption Can Lead to Inequity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10476. [PMID: 36078191 PMCID: PMC9518357 DOI: 10.3390/ijerph191710476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
American cities and localities have historically been places of innovation and incubation when it comes to advancing equity and inclusion. Now, local governments in many states are leading the fight for stronger public health protections against COVID-19-through mask mandates, stay-at-home orders, and paid leave provisions, among other actions. However, state lawmakers have long used preemption-state laws that block, override, or limit local ordinances-to stifle local government action, often under pressure from corporate interests and political ideology. Through preemption, state lawmakers have obstructed local communities-often majority-minority communities-from responding to the expressed needs and values of their residents through policies. In this article, we first look at the context behind preemption and its disparate effects. After establishing a conceptual framework for measuring disparities, we discuss how the current COVID-19 pandemic is disproportionately harming the same communities that have been preempted from taking local action, limiting their ability to effectively combat the public health crisis. We argue that all stakeholders interested in health equity have a role to play in addressing the misuse of state preemption.
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Affiliation(s)
- Y. Tony Yang
- Center for Health Policy and Media Engagement, School of Nursing, George Washington University, 1919 Pennsylvania Ave. #500, Washington, DC 20006, USA
- Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA
- George Washington Cancer Center, George Washington University, 800 22nd Street NW, #7000C, Washington, DC 20052, USA
| | - Carla J. Berg
- George Washington Cancer Center, George Washington University, 800 22nd Street NW, #7000C, Washington, DC 20052, USA
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA
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Pomeranz JL, Silver D, Lieff SA, Pagán JA. State Paid Sick Leave and Paid Sick-Leave Preemption Laws Across 50 U.S. States, 2009-2020. Am J Prev Med 2022; 62:688-695. [PMID: 35459452 DOI: 10.1016/j.amepre.2021.11.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/04/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Paid sick leave is associated with lower mortality risks and increased use of health services. Yet, the U.S. lacks a national law, and not all employers offer paid leave, especially to low-wage workers. States have enacted paid sick-leave laws or preemption laws that prohibit local governments from enacting paid sick-leave requirements. METHODS In 2019 and 2021, state paid sick-leave laws and preemption laws in effect in 2009-2020 were retrieved from Lexis+, coded, and analyzed for coverage and other features. Data from the U.S. Bureau of Economic Analysis were used to estimate the jobs covered by state paid sick-leave laws in 2009-2019. RESULTS In 2009, no state had a paid sick-leave law, and 1 state had preemption. By 2020, a total of 12 states had paid sick-leave laws, with a form of preemption (n=9) or no preemption (n=3), and 18 additional states solely preempted local laws without requiring coverage, creating a regulatory vacuum in those states. Although all state paid sick-leave laws covered private employers and required care for children and spouses, some laws exempted small or public employers or did not cover additional family members. The percentage of U.S. jobs covered by state-required paid sick leave grew from 0% in 2009 to 27.6% in 2019. CONCLUSIONS Variation in state paid sick-leave laws, preemption, and lack of employer provision of paid sick leave to low-wage workers creates substantial inequities nationally. The federal government should enact a national paid sick-leave law.
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Affiliation(s)
- Jennifer L Pomeranz
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York.
| | - Diana Silver
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
| | - Sarah A Lieff
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
| | - José A Pagán
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
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Mann‐Jackson L, Ravindran S, Perez A, Linton JM. Navigating immigration policy and promoting health equity: Practical strategies for clinicians. J Hosp Med 2022; 17:220-224. [PMID: 35504526 PMCID: PMC9305560 DOI: 10.1002/jhm.12792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Lilli Mann‐Jackson
- Department of Social Sciences and Health Policy, CTSI Program in Community-Engaged ResearchWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Senthuran Ravindran
- Departments of Medicine and PediatricsUniversity of South Carolina School of Medicine GreenvilleGreenvilleSouth CarolinaUSA
- Department of PediatricsPrisma Health UpstateGreenvilleSouth CarolinaUSA
| | - Alexander Perez
- Departments of Medicine and PediatricsUniversity of South Carolina School of Medicine GreenvilleGreenvilleSouth CarolinaUSA
- Department of PediatricsPrisma Health UpstateGreenvilleSouth CarolinaUSA
| | - Julie M. Linton
- Departments of Medicine and PediatricsUniversity of South Carolina School of Medicine GreenvilleGreenvilleSouth CarolinaUSA
- Department of PediatricsPrisma Health UpstateGreenvilleSouth CarolinaUSA
- Office of Student Affairs and AdmissionsUniversity of South Carolina School of Medicine GreenvilleGreenvilleSouth CarolinaUSA
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Mann-Jackson L, Simán FM, Hall MA, Alonzo J, Linton JM, Rhodes SD. State Preemption of Municipal Laws and Policies that Protect Immigrant Communities: Impact on Latine Health and Well-Being in North Carolina. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221087884. [PMID: 35343266 PMCID: PMC8961392 DOI: 10.1177/00469580221087884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Some U.S. municipalities have proclaimed themselves "sanctuary cities" and/or adopted laws and policies limiting local involvement in enforcement of federal immigration policies. Several states, however, have adopted laws that preempt municipal laws and policies designed to protect immigrants. We explored the consequences of House Bill (H.B.) 318, one such preemption law in North Carolina (NC), on the health and well-being of Latine immigrants. METHODS We conducted focus groups with Latine immigrants (n=49) and in-depth interviews with representatives from health, social service, and immigrant-serving organizations and local government (including law enforcement) (n=21) in NC municipalities that, before HB 318, adopted laws and policies supporting immigrants. Data were analyzed using constant comparison. RESULTS Twelve themes emerged, including the positive impacts of municipal sanctuary laws and policies are limited by preemption and other state and federal actions; laws and policies like HB 318 are confusing, have a chilling effect on health services use, and make life harder overall for Latine communities; intensified federal immigration enforcement has increased fear among Latine communities; Trump administration policies worsened anti-immigrant climates; and use of community identification cards and greater information dissemination and inter-organization coordination can lessen the consequences of preemption and other restrictive laws and policies. CONCLUSION State preemption of protective municipal laws and policies negatively and profoundly affects immigrant health and well-being. However, creative strategies have been implemented to respond to preemption. These findings provide critical data for decision-makers and community leaders regarding the detrimental impacts of preemption laws and mitigation of these impacts.
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Affiliation(s)
- Lilli Mann-Jackson
- Department of Social Sciences and
Health Policy, Wake Forest School of
Medicine, Winston-Salem, NC, USA
- CTSI Program in Community-Engaged
Research, Wake Forest School of
Medicine, Winston-Salem, NC, USA
| | | | - Mark A. Hall
- Department of Social Sciences and
Health Policy, Wake Forest School of
Medicine, Winston-Salem, NC, USA
- Wake Forest University School of
Law, Winston-Salem, NC, USA
| | - Jorge Alonzo
- Department of Social Sciences and
Health Policy, Wake Forest School of
Medicine, Winston-Salem, NC, USA
- CTSI Program in Community-Engaged
Research, Wake Forest School of
Medicine, Winston-Salem, NC, USA
| | - Julie M. Linton
- University of South Carolina (UofSC)
School of Medicine Greenville, Greenville, SC, USA
- Prisma Health Upstate, Greenville, SC, USA
| | - Scott D. Rhodes
- Department of Social Sciences and
Health Policy, Wake Forest School of
Medicine, Winston-Salem, NC, USA
- CTSI Program in Community-Engaged
Research, Wake Forest School of
Medicine, Winston-Salem, NC, USA
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