Addressing health inequities for children in immigrant families: Psychologists as leaders and links across systems.

Abstract

What can psychologists do to address social determinants of health and promote health equity among America's approximately 20 million children in immigrant families (CIF)? This article identifies gaps in current research and argues for a stronger role for psychologists. Psychologists can advocate for and enact changes in institutional systems that contribute to inequities in social determinants of health and promote resources and services necessary for CIF to flourish. We consider systemic exclusionary and discriminatory barriers faced by CIF, including a heightened anti-immigrant political climate, continued threat of immigration enforcement, restricted access to the social safety net, and the disproportionate health, economic, and educational burden of the COVID-19 pandemic. We highlight the potential role of psychologists in (a) leading prevention that addresses stressors such as poverty and trauma; (b) changing systems to mitigate risk factors for CIF; (c) expanding workforce development across multiple disciplines to better serve their needs; (d) identifying mechanisms, such as racial profiling, that contribute to health inequity, and viewing them as public health harms; and (e) guiding advocacy for resources at local, state, and federal levels, including by linking discriminatory policies or practices with health inequity. A key recommendation to increase psychologists' impact is for academic and professional institutions to strengthen relationships with policymakers to effectively convey these findings in spaces where decisions about policies and practices are made. We conclude that psychologists are well positioned to promote systemic change across multiple societal levels and disciplines to improve the well-being of CIF and offer them a better future.

“Le pueden pagar más al que tiene papeles y menos al que no tiene”: An exploratory study of critical consciousness processes among newcomer Latinx immigrant youth.

“…NLIY experience significant mental health disparities and systemic barriers to health care (Alegría et al, 2023; Chang, 2019). The impact of policy on mental health is particularly salient for this population, given the outsized role of federal immigration policy in their lived experiences arriving in the United States (Castañeda et al, 2015).…”

How psychologists can help achieve equity in health care—advancing innovative partnerships and models of care delivery: Introduction to the special issue.

“…The third theme, intersecting societal systems, explores how immigration (e.g., border politics), environmental (e.g., pollution and climate change), criminal justice (e.g., mass incarceration), and public health systems work through psychological processes to dehumanize communities and drive and maintain health inequities. Alegría et al (2023) Content may be shared at no cost, but any requests to reuse this content in part or whole must go through the American Psychological Association.…”

“…The third theme, intersecting societal systems , explores how immigration (e.g., border politics), environmental (e.g., pollution and climate change), criminal justice (e.g., mass incarceration), and public health systems work through psychological processes to dehumanize communities and drive and maintain health inequities. Alegría et al (2023) explore the role of psychologists in institutional systems as advocates of change to promote health equity for children in immigrant families, including leading prevention efforts that address stressors, changing systems to mitigate risk factors, expanding workforce development across multiple disciplines, identifying mechanisms that contribute to health inequity, and guiding advocacy for resources at local, state, and federal levels. Smith et al (2023) illustrate how to use adaptations of data-informed processes to establish community-engaged research for victimization prevention of trans women and trans femmes.…”

What role can (and should) clinical science play in promoting mental health care equity?

“…To be clear, I am not proposing the adoption of a particular political orientation to achieve what I see as a needed central role we should play as clinical scientists when I refer to advocacy and policy involvement. Rather, I am referring to this broader and prosocial definition of advocacy that is largely apolitical in nature and focuses on sustained and targeted actions to support public policy around mental health care in vulnerable groups, as I have discussed in prior work (Asnaani, Charlery White, & Phillip, 2020) and has been delineated in other key works in the field (e.g., Alegría et al, 2023; Marshall-Lee et al, 2020). What I mean here is in line with the growing call of many scholars in the field to recognize that our discipline has relied on secondary or external “trickle down” of our scientific findings to the places that will effect change and systematic adoption, and that this approach simply does not suffice in promoting equity in mental health care (McGuire & Miranda, 2008).…”