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Substance use, HIV/AIDS, domestic violence and mental health (SAVAME) are syndemic health issues that disproportionately burden Latinos in the U.S. Yet, there are limited evidence-based interventions to address these interrelated syndemic issues and their shared socio-ecological determinants. This study sought to test the feasibility and acceptability of CRiSOL, a peer-based, resilience-focused intervention to reduce the impact of the SAVAME syndemic on Latino immigrants. Fifteen Latino immigrant community leaders were recruited and trained to serve as health promotion agents in their naturally existing social networks. The training was implemented with high fidelity, received with high satisfaction by the peer leaders, and associated with significant improvements in their knowledge, leadership skills, and social capital. During an 8-month outreach phase, nine leaders remained active in the program and documented 825 one-on-one interactions with community members, during which they provided advice/counseling (52.2% of interactions), health information/education (32.5%), referrals to health and social services (38.5%), food aid (39.9%), and service navigation/assistance (10.2%). While future research must be conducted to establish the effectiveness of CRiSOL, findings from this pilot evaluation indicate the feasibility, acceptability, and high level of reach of this intervention and suggest significant potential to reduce the SAVAME syndemic burden in Latino communities.

Objective Latino populations in the United States are disproportionately affected by substance use, HIV/AIDS, violence, and mental health issues (SAVAME). A growing body of evidence demonstrates the syndemic nature of SAVAME and the need for integrated strategies to reduce their impact. This study sought to understand the network of SAVAME services for Latino immigrants in Philadelphia to inform future interventions for SAVAME prevention and mitigation. Methodology Key informant interviews ( N  = 30) were conducted with providers working in Latino-serving organizations providing SAVAME services. Interviews were analyzed using thematic coding and grounded theory. Results Latino-serving providers perceived a large need for, and important limitations in the availability, accessibility, and adequacy of SAVAME services for Latino immigrants. Gaps were seen as especially acute for mental health and substance use services, partly because of insufficient funding for these services. Latino immigrants’ lack of health insurance, immigration status, limited English proficiency (LEP), stigma surrounding SAVAME issues, and limited knowledge of available services were identified as significant barriers preventing access to services. Providers noted that scarcity of well-trained, culturally competent, and ethnically concordant providers reduced the adequacy of SAVAME services for Latino immigrant clients. The small size, low levels of infrastructure, and limited capacity were reported as additional factors limiting the ability of many Latino-serving organizations to adopt a syndemic approach in the prevention and treatment of SAVAME services. Conclusions The results call for changes in the structure of funding streams and communitywide strategies to foster collaboration across SAVAME providers working with Latino immigrant clients.

The recent impetus of tougher immigration-related measures passed at the state level raises concerns about the impact of such measures on the migration experience, trajectory, and future plans of unauthorized immigrants. In a recent and unique survey of Mexican unauthorized immigrants interviewed upon their voluntary return or deportation to Mexico, almost a third reported experiencing difficulties in obtaining social or government services, finding legal assistance, or obtaining health care services. Additionally, half of these unauthorized immigrants reported fearing deportation. When we assess how the enactment of punitive measures against unauthorized immigrants, such as E-Verify mandates, has affected their migration experience, we find no evidence of a statistically significant association between these measures and the difficulties reported by unauthorized immigrants in accessing a variety of services. However, the enactment of these mandates infuses deportation fear, reduces interstate mobility among voluntary returnees during their last migration spell, and helps curb deportees' intent to return to the United States in the near future.

Objectives. To examine racial/ethnic disparities in COVID-19 outcomes between Hispanics and Whites across 27 US jurisdictions whose health departments are members of the Big Cities Health Coalition (BCHC). Methods. Using surveillance data from the BCHC COVID-19 dashboard as of mid-June 2021, we computed crude incidence, age-adjusted hospitalization and mortality, and full vaccination coverage rates for Hispanics and Whites by city. We estimated relative and absolute disparities cumulatively and for 2020 and 2021 and explored associations between city-level social vulnerability and the magnitude of disparities. Results. In most of the cities with available COVID-19 incidence data, rates among Hispanics were 2.2 to 6.7 times higher than those among Whites. In all cities, Hispanics had higher age-adjusted hospitalization (1.5–8.6 times as high) and mortality (1.4–6.2 times as high) rates. Hispanics had lower vaccination coverage in all but 1 city. Disparities in incidence and hospitalizations narrowed in 2021, whereas disparities in mortality remained similar. Disparities in incidence, hospitalization, mortality, and vaccination rates were wider in cities with lower social vulnerability. Conclusions. A deeper exploration of racial/ethnic disparities in COVID-19 outcomes is essential to understand and prevent disparities among marginalized communities. (Am J Public Health. 2022;112(7): 1034–1044. https://doi.org/10.2105/AJPH.2022.306809 )

Despite having lower levels of education and limited access to health care services, Mexican immigrants report better health outcomes than U.S.–born individuals. Research suggests that the Mexican health advantage may be partially attributable to selective return migration among less healthy migrants—often referred to as \"salmon bias.\" Our study takes advantage of a rare opportunity to observe the health status of Mexican–origin males as they cross the Mexican border. To assess whether unhealthy migrants are disproportionately represented among those who return, we use data from two Californiabased studies: the California Health Interview Survey; and the Migrante Study, a survey that samples Mexican migrants entering and leaving the United States through Tijuana. We pool these data sources to look for evidence of healthrelated return migration. Results provide mixed support for salmon bias. Although migrants who report health limitations and frequent stress are more likely to return, we find little evidence that chronic conditions and self–reported health are associated with higher probabilities of return. Results also provide some indication that limited health care access increases the likelihood of return among the least healthy. This study provides new theoretical considerations of return migration and further elucidates the relationship between health and migration decisions.

Background Disparities in access to care persist for Latino youth born in the United States (US). The association of maternal characteristics, such as maternal citizenship status and insurance coverage, on youth health insurance coverage is unclear and is important to examine given the recent sociopolitical shifts occurring in the US. Methods We analyzed pooled cross-sectional data from the 2010–2018 National Health Interview Survey to examine the association of Latina maternal citizenship status on maternal insurance coverage status and youth uninsurance among US-born Latino youth. Our study sample consisted of 15,912 US-born Latino youth (ages < 18) with linked mothers. Our outcome measures were maternal insurance coverage type and youth uninsurance and primary predictor was maternal citizenship status. Generalized structural equation modeling was used to examine the relationships between maternal characteristics (maternal citizenship, maternal insurance coverage status) and youth uninsurance. Results Overall, 7% of US-born Latino youth were uninsured. Just 6% of youth with US-born mothers were uninsured compared to almost 10% of those with noncitizen mothers. Over 18% of youth with uninsured mothers were uninsured compared to 2.2% among youth with mothers who had private insurance coverage. Compared to both US-born and naturalized citizen Latina mothers, noncitizen Latina mothers had 4.75 times the odds of reporting being uninsured. Once adjusted for predisposing, enabling, and need factors, maternal uninsurance was strongly associated with youth uninsurance and maternal citizenship was weakly associated with youth uninsurance among US-born Latino youth. Conclusion Maternal citizenship was associated with both maternal uninsurance and youth uninsurance among US-born Latino youth. Federal- and state-level health policymaking should apply a two-generational approach to ensure that mothers of children are offered affordable health insurance coverage, regardless of their citizenship status, thus reducing uninsurance among US-born Latino youth.

Background: Limited research has explored sources of resilience for Latino immigrants or the potential of resilience-based interventions to promote Latino immigrant health and well-being. Purpose: To evaluate Latino immigrants' experiences with a resilience training and application of the training to participants' personal lives and their communities among Latino immigrants. Methods: We conducted a retrospective, qualitative study in Philadelphia, PA from 2017 to 2018. We completed semi-structured, key informant interviews with nine participants who had taken the resilience training, and one facilitator (N=10). Transcripts were analyzed via interpretive content analysis. Results: The training resonated deeply with participants because of their personal traumas and immigration-related adversity. Participants were primed by past experiences of violence, as well as by daily struggles they encounter as Latino immigrants in the United States amid worsening anti-immigrant rhetoric and policy. The training was found to be transformative by allowing participants to discover and tap into their own inherent resilience. Participants utilized the knowledge and skills acquired from the training to better manage daily situations, as well as worked to strengthen others within their networks. Conclusions: Resilience-based interventions can help to strengthen communities against adversity. Cultivating resilience in Latino immigrants can have positive effects on psychosocial health. Resilience-building approaches could be implemented as stand-alone or enhancing components of more complex health promotion interventions. More research is needed on resilience, as well as its utility in community-based interventions to promote the health and well-being of Latino immigrants.

Background: A smoke-free home rule has been associated with reduced cigarette consumption; however, it is unknown whether a home rule is associated with the use of alternative tobacco products (ATP) such as smokeless tobacco products, regular and water pipes, and cigars. This study examined the association between the smoke-free home rules and ever and current use of ATP. Method: Data from the 2010–2011 US Tobacco Use Supplements to the Current Population Survey were analysed using multivariable logistic regressions, including variables related to smoke-free home rules. Results: Overall, 83.9% respondents reported a smoke-free home rule inside their homes; 20.6% of respondents had tried at least one type of ATP, and 3.9% were current users in 2010–2011. Having a smoke-free home rule was associated with lower likelihood of current versus never use of any ATP (adjusted odds ratio (AOR) = 0.80, 95% confidence interval (CI): 0.77–0.83). Among ever users of any ATP, the existence of a smoke-free home rule was associated with lower odds of being a current user (AOR = 0.49, 95% CI: 0.43–0.56). Similar associations were observed for each type of ATP examined (p < 0.05). Conclusion: Smoke-free home rules are associated with lower current ATP use among the US population. Future research should examine whether promoting smoke-free home rules could help to reduce ATP use and related diseases.

US President Trump’s administration has vowed to boost immigration enforcement to get rid of “bad hombres,” or undocumented immigrants with criminal records. Using past data on the alleged detention motives for a representative sample of Mexican deportees, we evaluate how prior widespread and prioritized enforcement has fared in that regard. We find that while the early sweeping approach to enforcement raised deportees’ propensity of being detained for minor offenses, the trend reversed with prioritized enforcement. These findings inform policy tactics that, aside from proving effective in prioritizing serious criminal offenses, can also lead to significant savings to taxpayers.

Latino immigrants are disproportionately impacted by substance use, HIV/AIDS, domestic violence, and mental health (SAVAME). The burden of these syndemic conditions is influenced by limited access to health and social services to prevent and treat these conditions. The syndemic nature of these factors necessitates an integrated, coordinated approach to address them simultaneously. We analyzed characteristics of Latino-serving organizations in Philadelphia, PA, that provide SAVAME-related health and/or social services, and their interorganizational collaborations to meet the needs of Philadelphia’s Latino communities. We surveyed Latino-serving organizations (N=43) identified through existing resource directories and key informants. Network analyses identified patterns and density of collaborative ties (i.e., referrals, administrative, or planning/advocacy) across organizations and characterized these ties by type of service. Density (expressed as percent of all possible ties) revealed a higher referral rate (40%) than administrative (29%) or planning (26%) coordination. Network sociograms display clusters of providers by geography. Examination of bonding (within-group) ties revealed comparable perceptions of high value among both South/Center Philadelphia (57%) and in North Philadelphia providers (56%), but bridging (between-group) ties suggest lower levels of high-value perceptions (24%). No evident clustering by type of service based on syndemic factor was observed. Density of bridging across types of providers was highest for referrals (38%) followed by planning (23%) and administrative coordination (20%). Interventions to promote collaboration between providers should focus on facilitating administrative and planning collaborations that leverage existing capacity of the network. Given the syndemic nature of these conditions, greater collaboration between providers of complementing SAVAME services is imperative.