Screening for Immigration-Related Health Concerns in a Federally Qualified Health Center Serving a Diverse Latinx Community: A Mixed Methods Study

Abstract

Background: Immigration-related concerns can impact health and are an important consideration while caring for a multinational Latinx immigrant community.Methods: Patients and caregivers waiting for a non-urgent clinic appointment were randomly screened with one of two social risk screening tools. One tool included a question about "any health or stability concerns related to immigration status." The other tool did not include an immigration health question. Immediately following, respondents were invited to participate in a semi-structured interview regarding their social risk screening experience.Results: 201 screens were completed, and 20 patients agreed to an interview. There were no significant sociodemographic differences between groups. Of those screened for immigration, 11% reported a concern. In both arms, interviewees felt that social risk screening was acceptable in a clinic setting.Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1

A Snapshot of Social Risk Factors and Associations with Health Outcomes in a Community Sample of Middle Eastern and North African (MENA) People in the U.S.

“…We also found that having more social risks was associated with worse self-reported health, chronic disease and mental health symptoms. Our findings align with other work in immigrant and marginalized communities demonstrating high prevalence of social risk factors and unmet needs, the relationship between social risks and health, and the influence of sociocultural, economic, and political contextual factors in immigrant communities [ 3 , 5 , 6 , 27 , 28 ].…”

“…More and more health care delivery settings and social service agencies are investing in social risk screening and linking to resources [ 2 ]. Multiple studies have identified social risk factors in various sub-populations to inform resource mobilization and tailored screening and referral models [ 3 – 6 ]. However, little work has been done to examine social risk factors in communities of Middle Eastern and North African (MENA) descent in the U.S., a population known to experience health inequities [ 7 ].…”

“…While racial/ethnic identity can be a proxy for disadvantage or discrimination within a racist U.S. socio-political environment, there are also more precise ways to measure experiences of discrimination and disadvantages [ 13 ]. One screening tool in the pediatric setting inquired about parental experiences with discrimination [ 20 ]; another study in the transgender population identified discrimination among one of several prevalent social risk factors [ 6 ]; and a recent study screened for immigration-related concerns in a Latinx undocumented population [ 3 ].…”

Health Related Social Needs Among Chinese American Primary Care Patients During the COVID-19 Pandemic: Implications for Cancer Screening and Primary Care

“…Health related social needs (HRSN), including transportation, food insecurity, housing stability and interpersonal violence which are more downstream factors that impact health care, also result directly in both poorer outcomes and weaker health system performance (17,(21)(22)(23). Thus, efforts to systematically collect information on HRSN in clinical settings and develop solutions to address HRSN are on the rise (12,13,16,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Few clinicbased HRSN studies to date, however, have focused on measuring HRSN in languages other than English or Spanish or in diverse immigrant populations, including Asian Americans (AA), where cultural factors and immigration experiences can pose additional barriers to accessing care and routine preventive services (33).…”

Combatting Fear Through Timely, Participatory Approaches to Immigrant Health Research: Response to Byhoff et al.

“…Patients not only approved of immigration-specific screening, but also that including it improved their healthcare experience. By naming an issue that was of high priority to them, immigration screening was received as, "recognition and acknowledgement of the patients' lived experience" [1].…”