Migrant children and adolescents face diverse compounding challenges. Though migration experiences are varied, migration and resettlement-related challenges can span years to decades and include traumatic stress, instability, uncertainty, and socioeconomic precariousness. For migrant children and adolescents, puberty unfolds within a developmental ecology characterized by multiple, intersecting stressors that may influence the biological trajectory of pubertal development and the psychosocial experience of this transition. In this commentary, we briefly show why researchers studying puberty should be considering migrant children and adolescents who experience precarity and severity in traumatic stressors, and we provide salient recommendations to improve the measurement and study of puberty in migrant adolescent populations.
Citizenship status confers rights and access to healthcare, yet little is known about how it impacts contraception use and type of method use. This study examined the role of citizenship status on contraceptive use among reproductive-aged (18–44 years), cis-gender Latinx and Asian and Pacific Islander (API) women. This study used the 2017–2020 waves of the California Health Interview Survey (CHIS). Inclusion criteria included cisgender, heterosexual Latinx and API women of reproductive age (18–44 years) who were at risk of becoming pregnant (N = 3,027). Participants were classified into the following categories based on their citizenship status: non-citizens without a green card, legal permanent residents (LPRs), naturalized citizens, and U.S.-born citizens. We conducted bivariate analyses using Pearson’s chi-square tests and multivariable analyses using adjusted binomial logistic regressions to assess associations between citizenship status and use of any modern and reversible method of contraception and type of method used. Models were stratified by race/ethnicity. All analyses were weighted. Three-quarters (75.8
The H-2 A Temporary Agricultural Workers Program, which supplies seasonal labor essential to U.S. food security, has grown over 230
Immigration enforcement increasingly intersects with healthcare delivery, creating clinical situations that may affect immigrant patients’ access to care, trust in healthcare institutions, and interactions with physicians. Despite these challenges, formal training on immigrant patient rights and physician responsibilities during immigration enforcement encounters remains limited. We evaluated the impact of a case-based educational intervention on resident physician preparedness for these encounters. We conducted a pre–post educational intervention study at an urban academic teaching hospital serving a diverse immigrant population. Resident physicians participated in a 60-minute curriculum addressing immigrant patient rights, physician confidentiality obligations, emergency care requirements, distinctions between administrative and judicial warrants, and practical responses to immigration enforcement encounters. Anonymous electronic surveys administered immediately before and after the intervention assessed knowledge and confidence. Among 190 eligible residents, 58 residents completed the pre-intervention survey and 49 completed the post-intervention survey. Following the intervention, residents demonstrated significant improvements in knowledge of legal protections relevant to immigrant patient care and increased confidence in educating patients about their rights, protecting patient confidentiality, and interacting with immigration enforcement agents. Qualitative responses emphasized the curriculum’s immediate clinical applicability while identifying the need for institution-specific policies, communication scripts, and leadership guidance. Educational interventions addressing immigration enforcement encounters may improve physician preparedness for caring for immigrant patients while complementing institutional efforts to promote equitable, patient-centered care.
Multilingualism has emerged as a complex sociocognitive and behavioral trait with potential implications for cognitive resilience, functional capacity, and healthy aging. Recent large-scale European studies suggest that multilingual exposure is associated with more favorable biobehavioral aging profiles when cognitive, functional, and cardiometabolic domains are jointly considered. However, the interpretation and generalization of these findings require careful contextualization. In many regions of the Global South, particularly in Africa and Latin America, multilingual experiences are frequently shaped by different historical, sociocultural, and structural contexts than those commonly described in European cohorts. In many African and Latin American settings, multilingualism is deeply embedded in everyday life and may emerge from linguistic diversity, migration, colonial histories, minority language use, and local sociocultural practices. In these contexts, language use may reflect social stratification, structural inequality, or survival strategies rather than cognitive enrichment. Emerging concepts such as "stressful multilingualism" highlight that, under conditions of marginalization, multilingual exposure may coexist with psychosocial stress and adverse aging pathways. Additionally, ancestry, population admixture, and sociocultural dynamics intersect with language practices and independently influence aging trajectories, raising concerns about residual confounding in current models. While national-level indicators enable broad comparisons, they obscure substantial within-country heterogeneity. We argue that multilingualism should not be treated as a universally protective or modifiable factor without accounting for social context. Future research should prioritize underrepresented regions, incorporate individual-level measures of language experience, and integrate structural determinants such as inequality, discrimination, and cultural identity. Such approaches are essential to clarify the mechanisms linking multilingualism to aging and to ensure globally relevant and equitable interpretations.
Culturally and linguistically diverse (CALD) populations experience disproportionate burdens of chronic disease compared to the general population; previous research demonstrated group-based interventions improve health outcomes across various chronic conditions. This umbrella review aims to summarise the available evidence concerning group-based interventions for CALD populations with chronic conditions. We conducted this umbrella review in accordance with the Cochrane Handbook for Systematic Reviews of Interventions, reported per PRISMA, and quality-assessed using AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, version 2). We searched 11 databases (MEDLINE, Embase, Emcare, CINAHL, PsycINFO, SCOPUS, Web of Science, Cochrane, Epistemonikos, LILACS, and SciELO citation index of Web of Science) from inception to June 3, 2025, without language restrictions. All screening, data extraction, and quality assessment were carried out in duplicate. We descriptively synthesised the findings and determined the effectiveness and effect sizes of interventions as concluded by the review authors. We identified 22 systematic reviews, 271 primary studies, and over 32,320 people. Reviews originated from high-income countries; published in the last 10 years (82
Increasing international migration has transformed the maternity population of Cyprus, yet little is known about whether maternal health profiles and pregnancy complications differ across nationality groups. Understanding such differences is important for identifying potential maternal health inequalities and informing equitable maternity care in increasingly diverse maternity populations. This retrospective study analysed routinely collected maternity records from Paphos General Hospital, Cyprus. Of 2,233 deliveries between 2015 and 2020, medical records could be retrieved and contained sufficient information for abstraction for 1,112 births (49.8
Arabic-speaking refugees in the United States face an elevated burden of chronic disease yet encounter significant barriers to care, and little research has examined their experiences in the U.S. primary care system. This study characterizes the patient experiences of Syrian and Iraqi refugees in San Diego to identify factors that enhance or hinder healthcare integration and satisfaction. Semi-structured interviews lasting 30 to 90 min were conducted in Arabic with 109 Syrian and Iraqi refugees residing in San Diego with a confirmed diagnosis of hypertension. Interviews were transcribed, translated, and analyzed using inductive thematic analysis. The Warwick Patient Experience Framework (WaPEF) guided the development of the interview guide and the organization of themes. Seven themes were identified across four WaPEF categories. Regarding service responsiveness, participants preferred providers who were perceived as sharing their language or cultural background, which facilitated trust and comfort. Within lived experience, comparisons with healthcare in participants’ home countries shaped expectations of U.S. care. Within the continuity of care and relationships, long wait times and limited appointment availability were major barriers that sometimes led to emergency department use, while proactive follow-up and trust facilitated consistent care. Within communication, language barriers and inconsistent interpreter services hindered care, while compassionate treatment strengthened the patient-provider bond. Language- and culture-concordant care, compassionate communication, and trusting patient-provider relationships facilitated positive healthcare experiences, while long wait times and inconsistent interpreter services remained key barriers. These findings identify opportunities to strengthen patient-centered care for Iraqi and Syrian refugee populations.
This phenomenological study examines the lived experiences of Afghan refugees and asylum seekers navigating health and social support in Türkiye. Data were collected through in-depth, semi-structured interviews with 25 Dari-speaking Afghan refugees residing in Kayseri, Türkiye, between December 2023 and June 2024. Interviews were conducted in Dari or English, based on participant preference, and audio-recorded with participants' consent. The interviews were conducted using an interview guide designed to facilitate conversation about lived experiences in Türkiye with a focus on health. Reflexive thematic analysis revealed four overlapping themes: (1) widespread psychological distress, (2) discrimination and social exclusion in everyday interactions, (3) economic hardship as a mental health burden, and (4) restrictive migration policies as chronic stressors. Findings underscore how restrictive migration policies shape health outcomes, positioning them as critical social determinants of health for Afghan refugees and asylum seekers.
U.S. immigration policies function as structural determinants of health, yet their impacts across multiple domains remain poorly integrated. Following PRISMA guidelines, this systematic review of 45 empirical studies (2010–2025) across PubMed, PsycINFO, and Web of Science considers the impact that U.S. immigration and enforcement policies have on the psychological and somatic health of immigrants, refugees, and asylum seekers. Findings are organized into four thematic clusters: Detention and Trauma, Caregiving Disruptions and Family Separation, Migration and Resettlement Stress, and Policy and Geographic Risks. Results illustrate how pre-migration, transit, and post-migration stressors intersect with restrictive policies and detention environments, contributing to elevated rates of PTSD, depression, anxiety, and somatic distress. This review demonstrates how enforcement-driven family separation, and the consistent threat of it, functions conceptually as a structural pathogen that is linked to intergenerational health burdens regardless of legal status. These findings underscore the need to recognize immigration policy as a critical social determinant of health and highlight the importance of policy-level interventions to mitigate systemic harm and preserve family health and unity.
Spanish-speaking individuals represent one of the fastest growing populations in the United States. Spanish-speaking patients with limited English proficiency (LEP) face a range of structural, cultural, and financial barriers within U.S. healthcare systems. Language barriers are closely linked to challenges in healthcare access and quality, contributing to persistent disparities in health outcomes. Medical interpreters serve as a critical link between Spanish-speaking patients and healthcare providers. This study uses a social determinant of health (SDoH) framework to examine medical interpreters' experiences, with a focus on identifying opportunities to improve care quality for Spanish-speaking patients. Twelve medical interpreters in the southwestern U.S. from a range of healthcare contexts were interviewed for this study. Virtual interviews were recorded and transcribed for qualitative analysis. A reflexive thematic analysis approach was used to analyze data in multiple rounds of collaborative coding to produce themes from participant narratives. Four interrelated themes emerged that were linked to patient experience, organizational practices, and health outcomes: (1) lack of prioritization of interpretation services; (2) rushed clinical interactions; (3) failure to center patient understanding; and (4) manifestation of bias at the system level. Findings highlight the need for healthcare system changes to improve care quality for Spanish-speaking patients. Improving the availability and integration of interpretation services, along with expanding time for interpreted encounters and strengthening collaboration between interpreters and providers, may enhance patient understanding and engagement. Policy and training efforts that support culturally responsive care and reimbursement for language services are also needed to address persistent disparities.
Healthcare settings, dedicated to patient care and healing, have traditionally been somewhat insulated from broader political and cultural controversies. However, on January 21, 2025, the Department of Homeland Security rescinded the "sensitive location" designation for hospitals and other healthcare facilities, permitting Immigration and Customs Enforcement to conduct more enforcement actions in these settings. The previous sensitive location designation effectively meant that immigration enforcement actions, such as arrests or surveillance, were to be avoided absent exigent circumstances (i.e., emergent situations in which inaction would compromise safety or law enforcement goals). As a result, healthcare professionals are likely to encounter increased immigration enforcement activity in the workplace, raising important concerns about patient privacy, public health, and the professional responsibilities of clinicians and health systems. In this viewpoint, we offer practical guidance for healthcare professionals and institutions on mitigating risks to patient privacy and safety amid heightened immigration enforcement in healthcare settings, and we explain the narrow circumstances under which immigration officials may lawfully request or obtain identifying patient information. Our aim is to offer suggestions to help foster a patient care environment that maximizes patient trust and safety. We also hope to assist in clarifying healthcare systems' legal obligations.
Scholars have not conventionally examined the COVID-19 pandemic and immigration enforcement together or as having similar dimensions. We use the framework of cascading crisis to assess the impact of the cascading pandemic-immigration enforcement crisis on Latine immigrants' health from the perspectives of community health workers (CHWs) deeply embedded in immigrant communities. This qualitative study was carried out in a large metropolitan region across two phases: December 2024-January 2025 (focused on the pandemic period, January 2020-May 2023) and April-May 2025 (focused after the official end of the public health emergency in May 2023). We conducted 41 semi-structured interviews with CHWs recruited from four local organizations and analyzed data using thematic analysis. We identified three themes highlighting how CHWs described immigration enforcement as an extension of the pandemic: immigrants' lockdown mentality and decreased access to services, elevated distrust of the government, and barriers with information-sharing. Although CHWs effectively forged trust-building strategies during the pandemic that carried forward beyond its official end, this trust is now being undermined. In response, CHWs have had to innovate to adapt to immigrants' new circumstances and reaffirm trust. A multi-faceted approach to addressing the pandemic-immigration enforcement cascading crisis will be necessary, including health care professional advocacy, health care delivery innovation, the passage of inclusionary state-local policies, and alternate models of community care.
INTRODUCTION:Approximately 40% of patients receive bystander cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrests in the U.S., with potentially lower rates among non-White individuals. Despite increasing efforts to promote bystander intervention in different racial communities, few educational programs target the Mandarin-speaking community. To address these gaps, we designed, implemented, and evaluated Mandarin CPR and AED workshops for Mandarin-speaking immigrants in the Greater New Haven area. METHODS:Participants were recruited through collaboration with a Chinese school and church. Participants filled out pre-workshop surveys that assessed demographics, knowledge on CPR and AED use, and perceptions of bystander interventions. Participants then completed a workshop which included a presentation, a live demonstration on a CPR manikin, and hands-on small-group practice. After the workshop, participants completed a post-workshop survey with the same knowledge and perception questions. Finally, they were assessed on CPR skills and AED use by trained instructors. RESULTS:Eighty-five participants were included in final analyses. Of these, 52% reported limited English proficiency, 80% had never learned CPR, and 72% did not know what an AED looked like. Post-workshop, participants demonstrated increased knowledge as well as increased willingness to and confidence in performing CPR (p < 0.001). All 85 participants passed the skills assessment. CONCLUSION:This study demonstrates that interactive, Mandarin CPR and AED workshops positively influenced participants' perceptions of bystander interventions and improved their knowledge and skills. We propose these language-congruent workshops as a feasible and effective intervention that can be implemented for diverse populations.
Although Turkey has become a central focus in migration research, the healthcare experiences of smaller, historically displaced groups—and the barriers they encounter—remain largely overlooked. One such group is the Ahıska Turks, whose forced migration history spans from the Caucasus to Central Asia and, more recently, to Turkey. Despite cultural and linguistic proximity to the host population, Ahıska Turk migrant women face persistent challenges in accessing healthcare due to linguistic, systemic, and gender-based barriers. The objective of this study was to explore Ahıska Turk migrant women’s experiences of accessing healthcare services in Turkey, with a particular focus on the barriers they encounter and the strategies they use to navigate the healthcare system. This qualitative phenomenological study was conducted with 20 Ahıska Turk migrant women residing in temporary accommodation centers in Elazığ, Turkey. Participants were selected using purposive sampling. Data were collected through semi-structured, in-depth interviews conducted between February and April 2025 and were analyzed thematically following Braun and Clarke’s framework. Three key themes emerged: (1) Reasons for Healthcare Utilization – participants prioritized children’s health over their own, delaying personal care; (2) Facilitators and persistent barriers – language difficulties, unfamiliarity with the health system, and ethnic misidentification were common obstacles; (3) Recommendations – participants suggested interpreter services, access to female providers, and clearer guidance through the system. Ahıska Turk women’s experiences indicate that formal access to healthcare services does not necessarily translate into equitable care. While many participants demonstrated resilience, they continued to encounter structural and interpersonal barriers that shaped their healthcare experiences. By focusing on women’s healthcare access experiences, perceived barriers, and everyday strategies for navigating health services, this study brings attention to the specific ways in which an under-researched migrant group engages with the healthcare system. The findings highlight the importance of culturally sensitive, linguistically inclusive, and gender-responsive healthcare practices to promote equity within increasingly diverse healthcare systems.
Acculturative stress, arising from cultural and psychological changes following intercultural contact, may increase vulnerability to maladaptive coping behaviors, including emotional eating. Evidence suggests that the association between acculturative stress and disordered eating differs by sex; however, Arab migrant populations remain underrepresented in this field. This study aimed to examine sex-stratified, migration-related predictors of emotional eating among Arab migrants living in Türkiye. This cross-sectional research was conducted between June 2022 and March 2024 and included 528 adults who migrated to Türkiye from Arab countries. Sociodemographic and migration-related characteristics were collected. Acculturative stress was assessed using the Acculturative Stress-Social, Attitudinal, Familial, and Environmental-Revised Short Form (SAFE-Short), and emotional eating was evaluated with Emotional Eating Scale (EES). Body mass index (BMI) was calculated from self-reported weight and height. Sex-stratified regression analyses were performed. BMI was positively associated with all EES subscales in both female and male participants. However, among male participants, the overall regression models for the Anger and Anxiety subdimensions were not statistically significant. Also, no sociodemographic or migration-related variables were associated with emotional eating among male participants. In females, higher age was associated with lower depression-related emotional eating, while single marital status was associated with higher anger-related emotional eating. Employment was associated with lower anger- and anxiety-related emotional eating. Migration due to personal safety concerns, living with individuals from different countries, and higher acculturative stress were associated with higher emotional eating scores in females. These findings may indicate that in social contexts where direct emotional expression is less acceptable for females, emotions are more likely to be regulated through eating-related behaviors.
Diverticulosis is a prevalent gastrointestinal condition of the colon, influenced by age, dietary, lifestyle, and hereditary factors. This study aimed to explore population-specific variations and disparities between two ethnic groups (Arabs and Jews) served by the same healthcare system. Clinical data of diverticulosis patients was extracted using the MDClone platform of Clalit Health Maintenance Organization. Demographic characteristics, comorbidities, hospital admissions and complications were analyzed. A total of 12,209 Arab and 136,885 Jewish patients (n = 149,094) were included in our analysis. Arab patients were diagnosed at a significantly younger age (59.4 ± 14.5 vs. 67.6 ± 13 years; p < 0.001). They also had a higher prevalence of smoking (30.3
To examine how health insurance and access to care shape the detection of chronic kidney disease (CKD) and to assess determinants of CKD severity among Afro-descendant adults in the Colombian Caribbean. This was a cross-sectional study using community-based screening data and applying multivariable regression and mediation analyses. Urban, rural, and suburban Afro-descendant communities in the Caribbean region of Colombia. Data were obtained from community-based CKD screening efforts (N = 1,327). Proteinuria, assessed using a urine dipstick, was used as an indicator of CKD in the full sample. Among participants with confirmed proteinuria and available creatinine data (n = 326), CKD severity was defined as moderate or worse kidney dysfunction (eGFR < 60 mL/min/1.73 m²). Guided by the Andersen Behavioral Model, we examined predisposing and enabling factors, including insurance type and access to care. Mediation analysis using generalized structural equation models estimated the indirect effects of insurance on access to care. Approximately one-quarter of the participants screened positive for proteinuria, indicating a substantial burden of undetected disease. Having a primary care doctor was associated with a higher probability of proteinuria, whereas difficulty in accessing care was associated with a lower probability, consistent with the detection process. Insurance was not directly associated with proteinuria but operated through access to care, with a significant indirect effect (β = −1.36, p < 0.001). Among individuals with kidney dysfunction, CKD severity was not associated with insurance or reported access barriers. Instead, severity was strongly associated with geographic context, with higher odds observed in rural (OR = 2.65; 95
