The Impact of Multiple Levels of Immigrant Policy on Rural Latino Mental Health and Health Care Access

多层次移民政策对农村拉丁裔心理健康和医疗保健获取的影响

• 批准号: 10567700
• 负责人: Maria-Elena De Trinidad Young
• 金额: $ 72.13万
• 依托单位: UNIVERSITY OF CALIFORNIA, MERCED
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-21 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10567700
• 关键词: Address; Affect; Arizona; Attitude; California; Categories; Charge; County; Cross-Sectional Studies; Data; Data Set; Enrollment; Environment; Exclusion; Goals; Health; Health Policy; Health Priorities; Health Services Accessibility; Health Status; Immigrant; Immigration; Individual; Institution; Intervention; Investigation; Knowledge; Latino; Latino Population; Law Enforcement; Measures; Mediating; Mediation; Medicaid; Mental Depression; Mental Health; Mental health promotion; Modeling; National Institute on Minority Health and Health Disparities; Outcome; Policies; Policy Making; Population; Population Study; Public Policy; Public Sector; Research; Resources; Respondent; Rights; Rural; Rural Community; Rural Health; Sampling; Services; Shapes; Social Environment; Social Perception; Social Work; Surveys; Testing; Urban Community; Urban Health; Variant; access disparities; community-level factor; experience; health care availability; health disparity populations; improved; innovation; population based; primary care provider; rural area; rural counties; rural setting; safety net; social culture; social determinants; social factors; social health determinants; structural determinants

Project Summary/Abstract There are persistent mental health and health care access disparities between rural and urban communities. Within rural communities, foreign- and US- born Latinos experience worse mental health and access to care than rural Whites or urban Latinos. While the social determinants of rural health have been recognized as a major underlying cause of health, there is limited investigation of and data on the structural and community factors specific to improving mental health and health care access of rural Latinos. The overarching goal of the proposed study is to investigate the association between mental health and health care access and immigrant policies among Latinos in rural regions by conducting a multilevel, cross-sectional study of the impact of policy contexts, social climates, and Latinos’ direct encounters with institutions that implement policy. The specific aims of this study are to: 1) investigate the impact of exclusionary county policy contexts and social climates on rural Latino mental health and health care access; 2) investigate the impact of rural Latinos’ encounters with exclusionary immigrant policy on their mental health and health care access; and 3) investigate the extent to which county policy contexts, social climates, and policy encounters jointly influence rural Latino mental health and health care access. To achieve these aims we will, first, collect county-level data on local policy contexts and social climates and will implement hierarchical regression models to test their associations with mental health and health care access, net of covariates. We will also conduct a population-based survey of foreign- and US-born Latinos in rural counties in California and Arizona. We will use survey data to construct a measure of respondents’ level of exclusionary encounters with policies and will implement hierarchical regression models to test their association with mental health and health care access. Finally, we will conduct analyses of the correlations between county policy contexts, social climates, and policy encounters and conduct tests of mediation and moderation to assess how their relationships contribute to mental health and health care access. The study’s multi-level approach will contribute to knowledge on the mechanisms that influence Latino and immigrant health. The study will produce new data to inform health policy and Latino-focused interventions in rural communities aimed at promoting mental health and increasing access to health care and safety net services.

项目概要/摘要 城乡之间持续存在心理健康和医疗保健获取方面的差距 社区。在农村社区中，外国和美国出生的拉丁裔人的心理状况较差 健康状况和获得护理的机会高于农村白人或城市拉丁裔。虽然社会决定因素 农村卫生已被认为是健康的一个重要根本原因，但农村卫生的有限性 针对改善心理的结构性和社区因素的调查和数据 农村拉丁美洲人的健康和保健服务。拟议研究的总体目标是 调查心理健康和医疗保健获取与移民之间的关系 通过对农村地区拉丁裔的政策进行多层次、横断面研究 政策环境、社会氛围以及拉丁裔与机构的直接接触的影响 落实政策。本研究的具体目的是：1）调查排斥性的影响 关于农村拉丁裔心理健康和医疗保健获取的县政策背景和社会氛围； 2) 调查农村拉美裔遭遇排斥性移民政策对他们的影响 心理健康和医疗保健服务； 3) 调查县政策的实施程度 背景、社会气候和政策遭遇共同影响农村拉丁裔的心理健康和 获得医疗保健服务。为了实现这些目标，我们首先将收集县级地方政策数据 背景和社会氛围，并将实施分层回归模型来测试他们的 与心理健康和医疗保健获取的关联（扣除协变量）。我们还将进行 对加利福尼亚州农村县的外国和美国出生的拉丁裔进行的一项基于人口的调查 亚利桑那。我们将使用调查数据来衡量受访者的排斥程度 遇到政策并将实施分层回归模型来测试其 与心理健康和医疗保健获取的关系。最后，我们将进行分析 县政策环境、社会氛围以及政策遭遇和行为之间的相关性 调解和调节测试，以评估他们的关系如何促进心理健康 和医疗保健服务。该研究的多层次方法将有助于了解 影响拉丁裔和移民健康的机制。该研究将产生新数据 为农村社区的卫生政策和以拉丁裔为重点的干预措施提供信息，旨在促进 心理健康和增加获得医疗保健和安全网服务的机会。