It is increasingly argued that social and economic inequities poorly affect overall health. One of the means through which these inequities are translated to the body is via negative emotions, which carry known psychological and physiological responses. This paper examines migration-related psychosocial stressors impacting first-generation Mexican immigrants in southern Arizona, and reports on the primary emotional experiences immigrants associate with these stressors. Data were drawn from a qualitative, ethnographic study conducted over the course of 14 months during 2013–2014 with first-generation Mexican immigrants (N = 40) residing in Tucson Arizona and service providers working directly in the immigrant community (N = 32). Results indicate that the primary structural vulnerabilities that cause emotional hardship among immigrants are pre-migration stressors and adversity, dangerous border crossings, detention and deportation, undocumented citizenship status, family separation, and extreme poverty. Many of these factors have intensified over the past decade due to increased border security and state level anti-immigrant legislation in Arizona. Immigrants connected these hardships to the emotions of trauma (50%), fear (65%), depression (75%), loneliness (75%), sadness (80%), and stress (85%), and most respondents reported suffering from three or more of these emotions. Given the heavy emotional toll of migration and the direct impact that regional legislation and border security had on well-being, this paper argues that emotion be considered an important mechanism for health declines in the immigrant community. In order to stem the frequency and intensity of emotional stress in the Mexican immigrant community in Tucson, it is imperative to support organizations and policies that promote community building and support networks and also expand access to and availability of mental health services for immigrants regardless of documentation status.

This article explores the intersection of two growing health concerns: the rising incidence of loneliness and the negative health impacts of migration and displacement. To better evaluate loneliness across diverse populations, we emphasize the cultural shaping of expectations for social lives and the ways in which structural vulnerability and violence can undermine these expectations. We draw on ethnographic research with two groups of migrants: Mexican immigrants living in southern Arizona and Turkana pastoralists of Kenya who experience displacement and unpredictable mobility as a result of low intensity violence. For Mexican immigrants, feelings of loneliness intertwine with the emotions of fear, trauma, and sadness, all closely associated with social isolation. The Turkana describe loneliness associated with the loss of their animals, or the shifting social landscapes they must traverse to keep their families safe. The culturally salient experiences described by these two communities highlight the complexity of defining loneliness. Given the pace of global migration and the number of refugees and displaced persons, closer scrutiny of how cultural expectations and structural violence interact to produce feelings of loneliness seems overdue.

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Mexican-origin men are at increased risk of developing non-alcoholic fatty liver disease (NAFLD). The purpose of this qualitative research was to assess Mexican-origin men’s knowledge and cultural attitudes toward NAFLD and their interest in risk reduction. Semi-structured interviews were conducted with 11 Spanish-speaking Mexican-origin men who were considered high-risk of having NAFLD according to transient elastography (FibroScan®) continuous attenuation parameter (CAP) scores (≥280). Audio recordings of these interviews were transcribed and interpreted in their respective language to facilitate data analysis using NVivo 12. A thematic codebook was developed, from which the research team identified emerging themes. Findings demonstrated limited knowledge about NAFLD and in general chronic liver disease among Mexican-origin men. Cultural attitudes appeared to both enhance and mitigate their perceived risk for NAFLD. Interviews also revealed high interest levels for reducing NAFLD risk, with family and loved ones acting as the main motivators for engagement in healthier behaviors. Inclination toward family-based interventions was reported as a subject of interest for this high-risk population. This qualitative study suggests that the development of a NAFLD-specific intervention approach for Mexican-origin men may be feasible and should consider a familial and cultural context centered in improving lifestyle health behaviors.

Introduction The mechanisms for the observed disparities in diabetes-related amputation are poorly understood and could be related to access for diabetic foot ulceration (DFU) care. This qualitative study aimed to understand patients’ personal experiences navigating the healthcare system and the barriers they faced. Methods Fifteen semi-structured interviews were conducted over the phone between June 2020 to February 2021. Participants with DFUs were recruited from a tertiary referral center in Southern Arizona. The interviews were audio-recorded and analyzed according to the NIMHD Research Framework, focusing on the health care system domain. Results Among the 15 participants included in the study, the mean age was 52.4 years (66.7% male), 66.7% was from minority racial groups, and 73.3% was Medicaid or Indian Health Service beneficiaries. Participants frequently reported barriers at various levels of the healthcare system. On the individual level, themes that arose included health literacy and inadequate insurance coverage resulting in financial strain. On the interpersonal level, participants complained of fragmented relationships with providers and experienced challenges in making follow-up appointments. On the community level, participants reported struggles with medical equipment. On the societal level, participants also noted insufficient preventative foot care and education before DFU onset, and many respondents experienced initial misdiagnoses and delays in receiving care. Conclusions Patients with DFUs face significant barriers in accessing medical care at many levels in the healthcare system and beyond. These data highlight opportunities to address the effects of diabetic foot complications and the inequitable burden of inadequately managed diabetic foot care.

Barriers to health care access faced by Mexican immigrants in the United States have been well-documented, including lack of insurance, fear of deportation, and language barriers. However, little is known about this population’s care-seeking experiences before migration. In this article, I use a life-course approach to explore binational isolation from health care and the ways in which early-life experiences pattern Mexicans’ care-seeking practices in the United States. This ethnographic research project took place in Tucson, Arizona, between 2013 and 2014 and used semistructured interviews with service providers and first-generation Mexican immigrants. The majority of participants faced significant barriers to medical care in Mexico, which resulted in low rates of care utilization and heavy reliance on lay modalities. Immigrants faced an even broader array of barriers to care in the United States, and their lack of prior health care access further discouraged care utilization and compromised their medical care experiences after migration.

Introduction: Mexican-origin women suffer disproportionate rates of nonalcoholic fatty liver disease (NAFLD) and research on how to tailor NAFLD treatment interventions for this population is lacking.Objectives: The purpose of this study was to assess awareness, knowledge, perceptions, and information sources related to NAFLD in a community-based sample of Mexican-origin women.Methods: This study employed a convergent parallel mixed-methods approach and consisted of a brief questionnaire (n = 194) and interviews (n = 26) among Mexican-origin women recruited from community-based settings including health fairs, churches, and community events. Participants were eligible if they identified as Mexican-origin, had a BMI ≥ 25 kg/m2, were 18–64 years of age, had the ability to speak, read, and write in English and/or Spanish, and provided informed consent. A purposeful sampling approach was used to recruit a subset of women (n = 26) with confirmed liver steatosis indicative of NAFLD (controlled attenuation parameter ≥280 dB/m) who completed the questionnaire. The twenty-six participants then completed one on one, in-depth semi-structured interviews to ascertain their knowledge and understanding of NAFLD.Results: Qualitative findings revealed low awareness of risk factors for liver disease, NAFLD specifically. Knowledge of liver disease tended to center around cirrhosis, a condition many participants reported was prevalent in their families. Quantitative and qualitative findings both found information sources for NAFLD and liver disease to be predominantly friends, family, and media. Interviews revealed a misperception related to NAFLD risk that liver disease was only caused by high alcohol intake.Conclusion: Low levels of NAFLD awareness and knowledge warrant the need for greater efforts to educate the general population, perhaps by integrating NAFLD education into existing type 2 diabetes educational campaigns and prevention interventions. Additionally, further elicitation research conducted in Mexican-origin adults is needed to elucidate key factors within behavioral-theory constructs that can be targeted in future interventions tailored to this unique population.

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