Within the United States (U.S.), the COVID-19 pandemic highlighted critical inequalities affecting undocumented communities and resulting in particularly heightened stress for members of these communities. In addition to the stress associated to COVID-19, immigrants in the U.S. were more than ever subjected to a hostile anti-immigrant climate under Trump's administration. Given this compounded stress, the impact of the pandemic on mental health is likely to be disproportionately experienced by undocumented immigrants. In response, a group of psychologists partnered with a leading immigrant rights advocacy organization and formed a reciprocal collaboration to support undocumented communities. A major focus of the collaboration is to foster learning, supporting members of the immigrant community to contribute to their own well-being and others in the community. Accordingly, the collaborative developed and delivered a web-based mental health education session to the immigrant community and to practitioners serving this population. The session presented the use of healing circles as a strength-based approach to building resilience and also sought feedback regarding specific features of healing circles that can enhance their effectiveness in managing distress. Survey data and qualitative findings from this study show that those who participated in the web-based program perceived the session as validating and informative. Findings also underscored the need for creating safe spaces for community members to be vulnerable about their lived experiences while promoting ownership of their narratives. We discuss practical implications pertaining to the development and facilitation of social support groups for immigrants led by non-specialist community members trained for this role.
Despite extensive evidence showing that Latinx caregivers' language preference and level of acculturation influence parenting practices and treatment acceptability, there is a paucity of studies examining how these individuals acquire skills taught in behavioral parenting interventions such as parent-child interaction therapy (PCIT). Previous studies have shown that Latinx families, especially those who speak Spanish, require additional sessions to complete PCIT compared with non-Latinx White families, a disparity that could lead to high attrition rates and poor treatment outcomes. This study examined whether parenting skills (i.e., do and don't skills) changed as a function of caregiver language preference and level of acculturation among Latinx families receiving a home-based adaptation of PCIT for infants. Twenty-six Latinx caregiver-child dyads received the intervention and were assessed at posttreatment and at 3- and 6-month follow-ups. Caregivers were on average 30.85 years old (SD = 5.14), mostly married (69.2%) and Spanish-speaking (57.7%). Half of these families lived below the poverty line. Moderation analyses showed that more acculturated Spanish-speaking caregivers showed fewer reductions in their use of don't skills than their English-speaking counterparts at posttreatment and at 3- and 6-month follow-ups. No moderation effects were found for the use of do skills. Results highlight critical cultural factors that affect parenting skill change among Spanish-speaking Latinx families. These findings could inform data-driven cultural adaptations of PCIT that improve treatment engagement and reduce attrition among Latinx families, especially given existing inequities in mental health care for this population.
COVID-19 has disproportionately affected the Latinx community, leading to heightened economic instability and increased mortality/morbidity. Frontline community health workers (promotoras) have played an integral role in serving low-income Latinx immigrant communities, disseminating health information to this vulnerable community while also facing heightened risks to their own health and wellbeing. This study explores the impact of the pandemic on Latinx communities and the promotoras that serve them, examining how the stresses and inequities the pandemic wrought might be mitigated. Promotoras (N = 15, all female) were recruited from a local health agency in Santa Ana, CA and completed a semi-structured interview about their experiences during COVID-19. Qualitative analyses demonstrated that the pandemic substantially affected the daily lives both of community members, via economic challenges, limited access to reliable pandemic-related information, and psychological and social stress, and of promotoras, via changes to the nature of their work and psychological and social stress. Promotoras perceived that these harms might be mitigated by providing for economic and material needs in the community, and that promotoras can be fortified to continue serving the community through self-care and psychosocial healing practices. According to promotoras, the Latinx community needs economic and material resources to overcome COVID-19 related stressors. Additionally, promotoras may benefit from programming to preserve mental and physical health in the wake of new stressors. Lending greater support to promotoras within the agencies in which they are nested may enable them to be more successful in fulfilling their mission and sustaining their own health.
Objectives Prior research indicates that Latinas are at risk for experiencing high levels of anxiety during pregnancy. Pregnancy anxiety is a specific affective experience involving fears and worries about one's current pregnancy and it has been linked to heightened risk for preterm birth and developmental effects. Despite this concerning pattern, research has rarely examined Latina beliefs about the transition to motherhood and little is known about specific sources of pregnancy anxiety in Latinas, including whether fears are rooted in cultural concerns. The present study investigates the experiences of pregnancy anxiety among Latinas and explores their broader cultural beliefs surrounding pregnancy. Methods Fourteen pregnant Latinas articulated their experience of pregnancy anxiety, how they coped with their anxiety, and the beliefs they held surrounding pregnancy in 11 individual interviews and one focus group of three participants, all conducted in Spanish. Results Thematic analysis revealed that overall, Latinas felt that anxiety during pregnancy was normal, and that they worried about labor and delivery, losing their baby, their baby being born with a birth defect, and felt affected by the broader sociopolitical climate. Latinas felt lucky to be pregnant, believed that pregnancy was a blessing from God, and stressed the importance of maintaining a healthy pregnancy. Themes about family involvement and culturally-driven privileged status also emerged. Conclusions The present study highlights specific themes that may be important to consider in the context of Latina perinatal health. Such findings set the stage for future investigations examining the experience of anxiety specific to pregnancy in Latinas.
The purpose of this study was to examine the relations among discrimination, depression, and health among a sample of diverse Latinx immigrants. A secondary aim was to examine whether direct and indirect effects among these variables were moderated by social support. A sample of 204 Latinx immigrants completed questionnaires in community centers, health clinics, and retail establishments. Depression was found to mediate the effect of discrimination on physical health. Social support was found to moderate this indirect effect, wherein higher levels of social support weakened the effect. Results from this study indicate that through depression, health can be impacted by minority stressors, and these relationships can be buffered by links to cultural strengths including social support.
According to intersectionality theory, oppression predisposes individuals from disadvantaged groups to experience disparities in health. Such disparities are evident in the sexual health among college-aged Latina women living in the U.S., who tend to report significantly higher rates of sexually transmitted infections and unintended pregnancies than their White peers. Guided by intersectionality theory, the present study examined sexual risk behaviors (i.e., inconsistent condom use, number of sexual partners) in relation to ethnic identity development and reported experiences of discrimination and sexism among 450 Latina college students (ages 18-26 years old). Notably, results indicated that Latinas who reported relatively lower levels of ethnic identity commitment had, on average, approximately five more sexual partners when they had reported greater lifetime experiences of sexism. Findings highlight how sexist experiences contributed to an increased number of partners among Latinas reporting relatively lower levels of ethnic identity commitment, demonstrating that strong ethnic identity commitment was protective against risk in accordance with past research. Results indicate a continued need for sexual health interventions with Latina college students.
Objectives This study examined 1) associations between parent-adolescent acculturation gaps in Americanism and Hispanicism and adolescents' lifestyle behaviors (fruit and vegetable intake and physical activity), and 2) the moderating roles of adolescent- and parent-reported family communication on these associations. Methods Hispanic adolescents who have overweight or obesity (n=280; 52% female, 13.0±0.8 years old) and their parents (88% female, 44.9±6.5 years old) completed baseline measures on acculturation, family communication, weekly physical activity, and daily fruit and vegetable intake as part of their participation in a family-based health promotion efficacy trial. Acculturation gaps were calculated by taking the product of adolescent and parent scores for each subscale (Americanism and Hispanicism). We conducted multiple linear regression analyses with three-way interaction terms (e.g., parent Americanism x adolescent Americanism x family communication) to assess for moderation. Results Family communication significantly moderated the association between parent-adolescent acculturation gaps in Americanism and adolescent fruit and vegetable intake. For families with low adolescent-reported family communication, parent-adolescent discrepancies in Americanism were associated with lower adolescent fruit and vegetable intake whereas there were no significant associations for families with high family communication. There were no effects on weekly minutes of physical activity. Acculturation gaps in Hispanicism were not significantly associated with either outcome. Conclusions Findings highlight the importance of parent-adolescent acculturation gaps and family communication on fruit and vegetable intake for Hispanic adolescents. Targeting parent-adolescent acculturation gaps for families with low levels of communication may be important to improve dietary behaviors in Hispanic adolescents, who are already disproportionately affected by obesity.
Latinx sexual minority men (LSMM) have higher rates of HIV incidence than most other ethnic and racial groups. Given that transmission risk is higher among primary partners, it is critical to identify factors that would facilitate partner recruitment into couples-based sexual health research studies. The present study utilizes a sample of index participants (n= 625), which includes 530 LSMM who did not recruit their partner and 95 LSMM who successfully did so (N = 625). Participants completed measures of communication styles and cultural values of masculinity. Findings suggest that caballerismo (chivalry/nurturing) and constructive communication were significantly and positively associated with the odds of recruiting one's partner in an interaction model. Consideration of cultural factors and communication style may enhance the efficiency of recruitment of LSMM and facilitate partner engagement.
Youth-onset type 2 diabetes (T2D) is on the rise and may be associated with more adverse health outcomes than adult onset. Latinx adolescents are disproportionately at risk for T2D yet are underrepresented in prevention efforts. Extant interventions to prevent T2D in Latinx adolescents show limited effectiveness. Comprehensive understanding of Latinx adolescent/family needs is lacking, but necessary for cultural tailoring of T2D prevention. Researchers conducted focus groups with 32 Latinx adolescents (age 10-18 years) from Northern Colorado and 31 Spanish-speaking parents/caregivers, with 2.5-hr semistructured youth-specific and parent-specific discussions, respectively. No participants included in this study had T2D. Qualitative data were analyzed for emergent themes about barriers/facilitators of healthy living and T2D prevention preferences. Thematic content analysis yielded eight themes within three categories: barriers to healthy living, facilitators of healthy living, and program preferences. Barriers to healthy living included individual motivational factors/food preferences; financial cost and time demands of healthy eating/exercise; negative emotions; and external/relational factors such as parent feeding pressure and peer pressure/bullying. Facilitators of healthy living included individual motivational factors/enjoyment of healthy living and supportive family structure. Program preferences were for family-based programming with adolescent breakout sessions and for facilitation by culturally competent facilitators. T2D is recognized as a serious health concern among Latinx families. There is a need for culturally tailored prevention programming that, in order to be acceptable, should address cultural and socioeconomic considerations, provide coping skills for adolescent-specific psychosocial stressors, and utilize a family-based programming framework with adolescent breakout sessions and culturally competent facilitators.
Research has consistently shown that individual, interpersonal, community and structural factors influence the degree to which individuals' access and utilize health care services, and these factors may play a role in explaining racial and ethnic differences in health care outcomes. Differences in HIV prevalence and treatment between Latinx adults and white adults in the U.S. must be considered in the context of these factors. However, much of the existing research connecting these factors and HIV/AIDS outcomes in Latinxs remains disparate, limited in scope, and has yet not been applied to the use of biomedical HIV preventions. The following systematic literature review examined research related to PrEP in Latinx sexual minority men (SMM) to build a structural-ecological framework of the existing research, while identifying gaps in the literature and areas for future research. We searched two electronic databases using a systematic review protocol, screened 71 unique records, and identified 23 articles analyzing data from Latinx SMM and intended and/or actual PrEP-use in the United States. Based on the present review, disparities in PrEP uptake by Latinx SMM could be explained, in part, by examining how all levels of the structural-ecological framework uniquely contributes to how Latinx SMM engage with HIV prevention measures and come to understand PrEP. It is clear from the existing literature base that some of the most prominent barriers deterring Latinx SMM from seeking PrEP services are the lack of information surrounding PrEP and HIV/gay stigmas. However, higher order structural-level risks can facilitate or reduce access to PrEP. We propose a structural-ecological model to help visualize multi-level domains of unique stressors that limit the implementation of PrEP among Latinxs. At this stage, the available literature provides little guidance beyond suggesting that culturally adapted interventions can be effective in this population. The model developed here provides that needed specificity regarding targeted interventions that will fit the needs of this population.
Although new HIV infections have remained stable or decreased for most U.S. groups at risk for HIV, incidence among Latinx increased by 6% and among Latinx individuals, immigrants are disproportionately infected. One driver of these infections is low rates of HIV testing. While research shows the chilling effect that restrictive immigration laws can have on immigrants' health care utilization, few studies have examined the influence of perceived immigration context and healthcare utilization immigration law concerns on following a public health recommendation such as HIV testing. The purpose of the study is to test an exploratory model of immigration-related variables and their impact on U.S. Latinx immigrants' yearly HIV testing. U.S.-Latinx immigrants (N=169) completed a cross-sectional survey assessing perceived enforcement of immigration laws, perceptions of law enforcement attitudes towards Latinx and immigrants, fear of deportation, concerns with the consequences of immigration laws for health care utilization, and yearly HIV testing. Path analysis findings indicated that perceived enforcement of immigration laws was related to perceived negative attitudes from law enforcement towards Latinx and immigrants which was associated with fear of deportation. Fear of deportation was associated with concerns with the implications of immigration laws for accessing publicly funded healthcare services and these concerns were negatively related to yearly HIV testing and mediated the association between fear of deportation and yearly HIV testing. Findings point to the need of developing and implementing individual- and policy-level interventions to increase HIV testing among Latinx immigrants in a restrictive immigration law environment. Resumen Aunque nuevas infecciones de VIH se han mantenido estable o han disminuido para la mayoría de los grupos en los Estados Unidos (E.U.) en alto riesgo de contraer VIH, la incidencia de VIH entre Latinx ha aumentado 6% y entre individuos Latinx, los inmigrantes están desproporcionalmente afectados por la epidemia. Uno de los factores que contribuye a la alta tasa de VIH es la baja tasa de pruebas de VIH entre inmigrantes. Aunque la investigación confirma los efectos escalofriantes que las leyes restrictivas de inmigración pueden tener en la utilización de servicios de salud entre los inmigrantes, pocos estudios han examinado la influencia de la percepción del contexto de inmigración y las preocupaciones sobre las implicaciones de las leyes de inmigración si se utilizan servicios de salud públicos en seguir la recomendación de salud pública de hacerse la prueba de VIH regularmente. El propósito del estudio es someter a la prueba un modelo exploratorio de la influencia de variables relacionadas a la inmigración y su impacto en las pruebas anuales de HIV en los inmigrantes Latinx que viven en los E.U. (N=169). Los participantes contestaron un cuestionario transversal que midió la percepción del enforzamiento de las leyes de inmigración, la percepción de las actitudes de los agentes que enforzan las leyes de inmigración hacia Latinx y inmigrantes, el miedo a la deportación, las preocupaciones especificas sobre las consecuencias de las leyes de inmigración para la utilización de servicios de salud, la percepción de la sociedad sobre el estigma de VIH, y si los inmigrantes se hacen la prueba de VIH anualmente. Los resultados de los análisis de trayectoria indicaron que el enforzamiento de las leyes de inmigración esta relacionada con la percepción de que los agentes policiacos que enforzan las leyes tienen actitudes negativas hacia Latinx y inmigrantes lo cual esta asociado con el miedo a la deportación. El miedo a la deportación esta asociado a las preocupaciones sobre las implicaciones de las leyes de inmigración para la utilización de los servicios de salud patrocinados por el gobierno federal y estas preocupaciones fueron negativamente relacionadas con las pruebas anuales de VIH y mediaron la asociación entre el miedo a la deportación y las pruebas anuales de VIH. Los resultados señalan la importancia de desarrollar e implementar intervenciones al nivel individual y al nivel de política para aumentar las pruebas de VIH entre los inmigrantes Latinx en un ambiente de leyes restrictivas de inmigración.
The main objective of the current study is to analyze how the unique perspectives from both parents and children in regards to parental knowledge of the child's whereabouts, activities, and friendships are related to the adolescent's recent substance use four months later. Differences between parents and children, as well as between male and female adolescents are examined. Data come from a Latinx sample (mostly Mexican-origin) of 523 parent-adolescent dyads from Arizona (US) using a multi-informant approach (parent and adolescent reports). The results indicate that parents, especially mothers, report higher levels of parental knowledge than adolescents do. The structural equation modeling (SEM) results for the total sample indicate that both parents' and adolescents' unique perception of the level of parental knowledge is negatively related to the adolescents' recent alcohol and cannabis use four months later. Further, multi-group SEM results split by gender indicate that parents' unique perception of higher levels of parental knowledge is only marginally related to lower alcohol use for both males and females, whereas adolescents' unique perception is negatively related to alcohol and cannabis use (significantly) and tobacco use (marginally) for both males and females. No significant gender differences were found in the effects of parental knowledge on substance use. Findings suggest that parents' and adolescents' perceptions seem to be quite distinctive and independent from each other. Implications of these results regarding intervention programs for preventing substance use are discussed.
This article presents a content analysis of empirical publications (i.e., quantitative, qualitative, and mixed methods) regarding the inclusion of AfroLatinxs, and race-related factors in general, in two Latinx-focused psychology journals, Journal of Latinx Psychology and Hispanic Journal of Behavioral Science, between 2009 and 2020. We organized the articles into domains that were grounded in a framework that categorized race as a demographic category, from a cultural deprivation lens, a cultural difference lens, or a raced-based paradigm. In general, the results showed a major gap related to the inclusion of AfroLatinx in research studies, as less than 2% of articles across both journals included AfroLatinxs. Furthermore, we found most studies in this area are limited to sociodemographic self-reported race, the inconsistent use of race and skin color measures and a panethnic label to conceptualize race with Latinx populations. We give future research recommendations to explain the complexity of the Latinx population regarding race, and we provide insight into AfroLatinxs experiences.
Latinxs immigrants in the United States experience sources of stress (i.e., stressors) that can limit their ability to engage in healthy behaviors. Stress has been linked to increased type 2 diabetes (T2D) risk in Latinxs living with prediabetes, a group disproportionately affected by T2D. The purpose of this qualitative study is to describe and contextualize the variety of stressors experienced by Latinxs immigrants diagnosed with prediabetes. Semi-structured, in-depth interviews were conducted from March to September 2018 with 20 Latinx immigrants living with prediabetes in North Carolina. We used qualitative content analysis including systematic coding and comparative matrices. The most prominent stressors were those related to health status and healthcare access, finances, interpersonal relationships with family, and loneliness. Participants also identified stressors related to documentation status and discrimination. The stressors Latinx immigrants with prediabetes experience vary, therefore studies and interventions need to specify which sources of stress they are addressing. Multilevel interventions that ameliorate the effects of stressors may facilitate preventive health behaviors among Latinxs with prediabetes.
Promotoras de salud are community health workers that mostly help the underserved members of Latinx communities. They seek to reduce health disparities through community engagement and work that is voluntary or mostly unpaid. While there is evidence that promotoras aid in prevention, follow-up care, and treatment adherence, little is known about promotoras themselves, specifically, the impact that fulfilling their roles has on their views of themselves and their service identities. Fourteen Spanish-speaking, Latina promotoras were interviewed individually about their experiences and their motivation for the role. Four themes emerged from the content analysis of the participant responses: "Uno Nace Siendo Promotora:" One is Born Being a Promotora, "Poner Esa Semillita:" To Plant a Seed by Sharing Knowledge, "Es un Regalo Ser Promotora:" It is a Gift to be a Promotora, and "Se Hace por Amor pero también Hay Necesidad:" A Labor of Love but there are Needs too. The findings show that assuming and enacting the promotora role had positive benefits, both personal and professional, despite the often-limited recognition they received. The findings have multiple implications for the development of health and prevention programs, particularly for those that involve promotoras de salud.
Latinx young adults 18-25 years old face unique challenges that disproportionately put them at high risk of experiencing health as well as economic and social burden due to the Coronavirus disease (COVID-19) pandemic. The present study examined how economic and psychosocial consequences as a result of the pandemic were associated with mental health issues among a community sample of Latinx young adults (N = 83) from Central Texas. Participants completed an online survey of COVID-related experiences and mental health needs. The survey asked about personal and family experiences of COVID-19 in two significant areas: (a) economic strain (e.g., economic hardship, food insecurity) and (b) psychosocial burden (e.g., losing relationships, substance use). Regression analyses examined the association of COVID-19 consequences on level of mental health symptoms and clinically significant outcomes. Relative to economic consequences, psychosocial consequences due to the COVID-19 pandemic were associated with higher levels of mental health symptoms. In contrast, in few cases, economic strain resultant from the pandemic was correlated with clinically significant outcomes among this sample. Collectively, findings suggest that the costs of the pandemic do not only pertain to mortality from illness but also to morbidity as it relates to deteriorating social circumstances and mental health. Findings from this study call for immediate attention to implement policies and programs to help mitigate the economic and social-emotional consequences of COVID-19 such as easy access to low-cost virtual mental health resources to Latinx young adults.
AfroLatinidad: Theory, Research, and Practice focus on ways for scholars and practitioners to center AfroLatinidad in theory, research, and practice. In recent years, there has been an increased acknowledgement of the racial diversity among Latinxs in the U.S. and Latin America, including the recognition of AfroLatinxs. However, there remains a significant gap in scholarship output as it relates to AfroLatinxs in the psychological research. This special issue is the first publication dedicated to AfroLatinxs in a leading national ethnic minority psychology journal and represents a significant advancement regarding representation, inclusion, and analysis of AfroLatinx populations in the psychological, educational, developmental, and social research. AfroLatinxs are likely to experience oppression within the non-Latinx and Latinx community due to their phenotypical characteristics (e.g., skin color, facial features, hair texture). It is therefore critical that researchers and practitioners utilize scholarly inquiry to understand the unique issues faced by members of this community. Rooted in intersectionality theory and building on additional frameworks that center race in the Latinx experience, the invited contributors examine how colorism, racism, and other forms of oppression impact the lives of AfroLatinxs. In this introduction, an overview of the events leading to this special issue is presented, followed by a description of the historical and contemporary racial landscape in the U.S. and Latin America in regard to AfroLatinxs, highlighting the ongoing sociopolitical challenges facing this population.
Social support protects against perceived stress and its harmful effects on psychological well-being. College students in general are at high risk for mental health disorders, and Latinx college students face unique stressors placing them at greater risk of psychological distress. Social support may be a key construct in improving outcomes for college students; however, few studies have empirically tested whether the protective effect of social support is equivalent across racial/ethnic groups. Using a series of regression models, we investigated whether social support moderates the relationship between perceived stress and endorsement of depression and anxiety symptoms in Latinx (n = 265) and non-Latinx White college students (n = 216) and whether this moderating effect varied by group membership. Participants completed a series of questionnaires measuring social support, perceived stress, and depression and anxiety symptoms. The moderating effects of social support varied by group membership and outcomes (i.e., depression and anxiety). Social support moderated the relationship between perceived stress and depression symptoms for both Latinx and non-Latinx White students. However, social support only buffered the effect of perceived stress on anxiety symptom endorsement for Latinx college students. These findings suggest that social support does not function uniformly across racial/ethnic groups or the endorsement of depression and anxiety symptoms. Social support may be particularly important for Latinx students by providing a buffer between perceived stress and symptoms of anxiety.
In the context of recent policies aimed at deterring immigration and criminalizing undocumented Latino immigrants, we examined factors predicting implicit and explicit attitudes toward this population. We hypothesized that more positive implicit and explicit attitudes toward undocumented Latino immigrants would be displayed by Latinxs (compared to non-Hispanic Whites) and by individuals having personal connections to undocumented immigrants or a high level of intercultural sensitivity. Latinx (n = 376) and non-Hispanic White (n = 214) college students (70% female, M age = 21) participated in this cross-sectional study and completed two Implicit Association Tests and measures of explicit attitudes, personal connections, and intercultural sensitivity. As predicted, Latinx participants held more positive implicit and explicit attitudes than non-Hispanic White participants. Intercultural sensitivity and personal connections to undocumented immigrants were associated with more positive explicit attitudes. Identifying factors that increase a sense of commonality and cultural sensitivity with undocumented Latino immigrants may be helpful in diminishing the profiling and criminalization of this community.
Migrant farmwork is often characterized by harsh working conditions that carry significant physical and mental health consequences. Using a learned helplessness framework, the current study examined the extent to which discrimination, immigration legal status difficulties, and adverse childhood experiences moderated the effects of harsh working conditions on depression and anxiety. The study also examined the extent to which harsh working conditions mediated the effects of discrimination, immigration legal status difficulties, and adverse childhood experiences on depression and anxiety. Participants were 241 migrant farmworkers recruited in the Midwest. Participants completed interviews consisting of the Migrant Farmworker Stress Index (MFWSI), Adverse Childhood Events scale (ACEs), Everyday Discrimination Scale, the Centers for Epidemiology Scale for Depression (CES-D), and the seven item Generalized Anxiety Disorder scale (GAD-7). Tests of indirect effects suggested, working conditions mediated the effects of ACEs, immigration legal status fears, and discrimination on CES-D and GAD-7 scores (p-values < .05). Higher ACEs and discrimination also appeared to be associated with larger effects of harsh working conditions on depression and anxiety (p-values < .05), while legal status fears did not significantly moderate the effect of harsh working conditions on either outcome (p-values > .05). Likely through different mechanisms, adverse childhood experiences, discrimination and immigration legal status are associated with higher risk of harsh working conditions and subsequently these conditions account for much of the relations between these three stressors with depression and anxiety. Additionally, discrimination and adverse childhood experiences appear to then enhance the effects of working conditions.
