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      The legacy of immigration policies and employment exclusion: Assessing the relationship between employment exclusions and immigrant health

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          Abstract

          Restrictive federal and state immigration policies create conditions of employment exclusion that may negatively influence the health of immigrants. In particular, these policy effects are reflected in labor market and workplace experiences that determine the types of work and employment opportunities that immigrants are able to access and pursue. This study examines the relationship between both cumulative and individual measures of employment exclusion and self-rated health and psychological distress among Asian and Latino immigrants in California, and whether this relationship is modified by legal status. We used data from the Research on Immigrant Health and State Policy (RIGHTS) study (n = 2010). We used both multivariable logistic regression and linear regression models for our analyses. For cumulative models, labor market exclusion was associated with poor health (OR = 1.21, 95% CI: 1.01, 1.46). Workplace exclusion was also associated with poor self-rated health (OR = 1.45, 95% CI: 1.15, 1.82) and increased psychological distress (β = 0.69, 95% CI: 0.31, 1.07). For individual measures of employment exclusion, settling for a job – a labor market exclusion – and working in a dangerous job and experiencing wage theft – workplace exclusions – were associated with poor health and increased psychological distress. There was no evidence that the association between employment exclusions and health varied by legal status. These findings demonstrate that the combined effect of employment exclusions is detrimental to immigrant health. To improve population health, public health researchers should continue to interrogate the policy conditions at the federal, state, and local level that exclude immigrants from employment opportunities and workplace protections.

          Highlights

          • Restrictive immigration policies are reflected in labor market and workplace experiences.

          • Employment exclusions are associated with poor general and mental health among immigrants.

          • Cumulative rather than single experiences of employment exclusion systematically exert greater influence on immigrant health.

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          Most cited references49

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          Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies

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            Validity study of the K6 scale as a measure of moderate mental distress based on mental health treatment need and utilization.

            The widely-used Kessler K6 non-specific distress scale screens for severe mental illness defined as a K6 score ≥ 13, estimated to afflict about 6% of US adults. The K6, as currently used, fails to capture individuals struggling with more moderate mental distress that nonetheless warrants mental health intervention. The current study determined a cutoff criterion on the K6 scale indicative of moderate mental distress based on mental health treatment need and assessed the validity of this criterion by comparing participants with identified moderate and severe mental distress on relevant clinical, impairment, and risk behavior measures. Data were analyzed from 50,880 adult participants in the 2007 California Health Interview Survey. Receiver operating characteristic curve analysis identified K6 ≥ 5 as the optimal lower threshold cut-point indicative of moderate mental distress. Based on the K6, 8.6% of California adults had serious mental distress and another 27.9% had moderate mental distress. Correlates of moderate and serious mental distress were similar. Respondents with moderate mental distress had rates of mental health care utilization, impairment, substance use and other risks lower than respondents with serious mental distress and greater than respondents with none/low mental distress. The findings support expanded use and analysis of the K6 scale in quantifying and examining correlates of mental distress at a moderate, yet still clinically relevant, level. Copyright © 2012 John Wiley & Sons, Ltd.
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              Structural vulnerability and health: Latino migrant laborers in the United States.

              Latino immigrants in the United States constitute a paradigmatic case of a population group subject to structural violence. Their subordinated location in the global economy and their culturally depreciated status in the United States are exacerbated by legal persecution. Medical Anthropology, Volume 30, Numbers 4 and 5, include a series of ethnographic analyses of the processes that render undocumented Latino immigrants structurally vulnerable to ill health. We hope to extend the social science concept of "structural vulnerability" to make it a useful concept for health care. Defined as a positionality that imposes physical/emotional suffering on specific population groups and individuals in patterned ways, structural vulnerability is a product of class-based economic exploitation and cultural, gender/sexual, and racialized discrimination, as well as complementary processes of depreciated subjectivity formation. A good-enough medicalized recognition of the condition of structural vulnerability offers a tool for developing practical therapeutic resources. It also facilitates political alternatives to the punitive neoliberal policies and discourses of individual unworthiness that have become increasingly dominant in the United States since the 1980s. Copyright © 2011 Taylor & Francis Group, LLC
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                Author and article information

                Contributors
                Journal
                SSM Popul Health
                SSM Popul Health
                SSM - Population Health
                Elsevier
                2352-8273
                25 April 2024
                June 2024
                25 April 2024
                : 26
                : 101676
                Affiliations
                [a ]School of Public Health, University of California, Berkeley, CA, USA
                [b ]Division of Equity and Social Justice, County of Santa Clara, San Jose, CA, USA
                [c ]Division of Prevention Science, School of Medicine, University of California, San Francisco, CA, USA
                [d ]Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA, USA
                Author notes
                [* ]Corresponding author. University of California Merced, Public Health, 5200 N. Lake Rd, Merced, CA, 95340, USA. mariaelena@ 123456ucmerced.edu
                Article
                S2352-8273(24)00077-6 101676
                10.1016/j.ssmph.2024.101676
                11070755
                38711566
                77fb3a76-0067-4744-8abe-480679f98a14
                © 2024 The Authors. Published by Elsevier Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 3 November 2023
                : 23 April 2024
                : 24 April 2024
                Categories
                Regular Article

                employment exclusions,immigrant health,policy,self-rated health,psychological distress

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