Irritable bowel syndrome (IBS) is a diagnosis of the gut-brain interaction (DGBI) characterized by abdominal pain/discomfort and alterations in bowel habits. Its etiology is typically attributed to disruptions in the gut-brain axis. While extensive research has established significant associations with facets of mental health (e.g., trauma, anxiety), less is known about IBS in a cross-cultural context and the social determinants of health that may affect its presentation. The purpose of this study was to investigate the role of discrimination with the likelihood of obtaining an IBS diagnosis among a diverse sample. A logistic regression was conducted among 980 Black, Asian, Latinx, and Arab/Middle Eastern North African groups. Results revealed that racial discrimination [OR = 1.04, 95% CI = 1.01, 1.07, p = .012] emerged as a significant predictor of IBS diagnosis. Sex did not emerge as a significant predictor. Implications for health care are discussed. Providers should approach IBS through a biopsychosocial lens while considering discrimination as a social determinant of health that may be related to provider-patient interactions or the physiological toll of discrimination.
Migrant women contribute significantly to the international and New Zealand (NZ) workforce, including in gendered occupations such as healthcare/social assistance, retail/hospitality and education. Such occupations may be characterized by caring and service-related interactions, precarity, low pay and societal devaluation of the work. Work-related injuries (WRIs) can have a profound impact on workers’ health and wellbeing. Previous studies have primarily focused on the experiences of migrant men (in male-dominated occupations) with little attention to migrant women’s WRI experiences. To address this knowledge gap, in-depth interviews were undertaken with ten migrant women previously recruited into the Prospective Outcomes of Injury Study who registered a WRI with the Accident Compensation Corporation (NZ’s ‘no fault’ injury compensation scheme). Data were analyzed using Interpretative Phenomenological Analysis, with two themes generated: 1) ‘Locating the WRI’, the foregrounding of WRIs, including managing workplace psychosocial hazards and professional identities and, 2) Coping with ‘the long tail’ (of WRI) including navigating injury supports/services and changing work opportunities following injury. Interviewees reported workplace psychosocial hazards contributed to injury incidence, lack of injury acknowledgment and negative return to work experiences post-injury. Sustaining a WRI whilst registering professional qualifications in NZ resulted in [unwarranted] changes to career pathways, highlighting a potential inequity for migrant women. Injury services should act to mitigate the impact of such outcomes, thus supporting ongoing employment and career pathways of migrant women. Research is needed to investigate the extent and impact of identified WRI inequities for migrant women in other countries, including those with different injury support services.
Promotores, also known as community health workers, deliver culturally- and linguistically-informed public health interventions and can be part of the response to the US’ addiction crisis. However, no promotor programs have addressed addiction in the Latine community, and no Spanish-language curriculum exists. Addiction medicine physicians partnered with community-based organizations to co-design and implement the Program for Education in Drugs and Alcohol for Latine (PEDAL) in Spanish. PEDAL trained promotores to recognize and communicate about substance use, connect individuals to services, and educate the community about addiction. We performed a mixed-methods evaluation to understand PEDAL’s impact on curriculum objectives, substance use-related attitudes and stigma, and promotores’ overall experience via focus groups. We found increased promotor confidence in curricular objectives, but no change in attitudes and stigma immediately following completion. Focus groups showed improved attitudes and reduced stigma three months later. PEDAL may build community capacity to address the addiction crisis, especially among Latine and other communities that may not be reached by current interventions.
Immigrant and refugee youth are at higher risk of developing a psychotic disorder compared to non-newcomers and often have less access to medical care. A potential barrier may be the differing explanatory models of psychosis and attitudes towards mental health care between newcomers and healthcare providers, which can lead to missed early intervention. Furthermore, the explanatory models of psychosis may also differ between youth and their families as a result of acculturation differences, which may lead to intergenerational conflicts and disagreements about care decisions. The aim of the study is to characterize the explanatory models regarding early psychosis and attitudes toward treatment among migrant youth and their caregivers. The Arksey and O’Malley framework for scoping reviews was followed. A search strategy was developed with concepts of “migrants”, “youth”, “explanatory model”, and “psychosis”. Medline, Embase, PsycINFO, EBSCO Child Development Adolescent Studies, Cochrane, and Google Scholar were searched for relevant articles. Of the 1115 studies identified, 10 studies met criteria. The results suggest that people with migration history often held differing explanatory models of psychosis as compared to non-migrants, and that these models were influenced by specific cultural factors. Most studies focused on caregiver perspectives while youth perspectives were underexplored. Rather than a simple relationship in which greater divergence from the biomedical model led to increased disengagement, studies found that explanatory models could evolve over time and that youth and families could hold multiple, sometimes conflicting, illness explanations simultaneously. The integration of multiple explanatory models was crucial in treatment engagement and functional outcomes for many patients. Treating migrant youth with early psychosis remains a significant clinical challenge, yet significant gaps remain in understanding how youth and families understand psychosis. This paper shares findings that add new nuance to the existing literature as the impact of multiple explanatory models and the interaction of familial attitudes have not been reviewed in the treatment of psychosis. Further research should aim to incorporate youth perspectives and how these differ from and/or interact with the perspectives of caregivers. Such work can support more culturally-sensitive care and inform targeted interventions for this marginalized population.
Social determinants of health (SDOH) are increasingly recognized as major contributors to health outcomes. Beyond general social challenges, immigrants face additional barriers related to language, immigration status, legal concerns, discrimination, and exclusionary policies. Despite growing interest in SDOH screening, little is known about how existing screening instruments address immigrant-specific factors. Searches of Web of Science, PubMed, CINAHL, and PsychINFO identified peer-reviewed articles published between 2015 and 2025. Eligible studies included original research articles focused on immigrant populations and the use of an SDOH screening tool. Two reviewers independently screened titles, abstracts, and full texts. Data were extracted on screening tool characteristics, SDOH domains assessed, immigrant-specific indicators, language availability, study setting, and tool validation status. The final search yielded 1,155 articles. Eight studies met full inclusion criteria, describing nine screening tools or variants, including adaptations of the Health Leads Social Needs Screening Toolkit, the Centers for Medicare and Medicaid Services Accountable Health Communities screening tool, and the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences. Most studies occurred in urban primary care settings and primarily served Hispanic/Latinx immigrant populations. Core SDOH domains were well-represented across all tools. While all studies included at least one immigrant-specific measure, these were generally limited to language preference, nativity, legal concerns, and migrant worker status. No adapted or newly developed tool demonstrated formal psychometric validation. Current SDOH screening tools may fail to capture the broader structural factors that shape immigrant health, including immigration-related policies, legal precarity, discrimination, and fear. Significant gaps remain in culturally responsive, psychometrically validated instruments developed with and for immigrant communities.
