Forced migration and reproductive rights: Pregnant women fleeing Venezuela

Numerous pregnant Venezuelan women have fled Venezuela, given the health system crisis that has increased risk to their lives and their children. Thousands of them have arrived in Colombia in search of reproductive health care. Notwithstanding Colombia’s government efforts to provide some relief measures to the massive influx of Venezuelan migrants, pregnant women are not receiving the prenatal and postnatal care they need. One of the primary barriers to health care access is their immigration status and the health system structure regarding migrants. Therefore, this paper studies Colombia’s international human rights obligations concerning their immigration status and the right to reproductive health to conclude that government measures have been insufficient to meet these obligations.

The Impact of Supervisor Support on the Job Satisfaction of Immigrant and Minority Long-Term Care Workers

The need for long-term care workers (LTCW) will grow significantly as the American population ages. Understanding the factors that impact job satisfaction of this workforce has important implications for policy and practice. Previous research has demonstrated the effect of supervisor support on the job satisfaction of these workers; however, much less is known about how this effect differs among different race/ethnicity or immigration groups. This study examined how supervisor support mediates the associations between race/ethnicity, immigration status, and job satisfaction among nursing assistants (NAs). Data of 2,763 NAs were extracted from the National Nursing Assistant Survey (2004). Race/ethnicity groups included White (54%), African American (30%), Asian (2%), Hispanic (10%), and others (4%). Immigration status included U.S.-born citizens (87%), naturalized (7%) and resident/alien (6%). Bivariate analyses showed that Asian NAs perceived higher levels of supervisory support than other races, whereas U.S.-born NAs reported lower levels of supervisory support than naturalized and residents/aliens. Findings from multivariate analyses indicated that non-Hispanic Asians and Resident/Alien workers reported significantly higher levels of job satisfaction than their counterparts, and the associations were fully mediated by NAs’ perceived supervisor support. These findings support prior research that supervisor support is important to improving job satisfaction and contribute to the literature that Asians/Residents/Aliens long-term care workers may be more sensitive to supervisory support and may be more grateful if they received support from supervisors. Managers should be aware of these racial differences and by being supportive they may improve NAs job satisfaction and reduce turnover rates.

What Happened to the Immigrant Life Satisfaction Gap?

Numerous studies have found that immigrants to Canada are less satisfied with life than comparable Canadian-born individuals. Yet recent data from the Canadian Community Health Survey (CCHS) suggest that this immigrant satisfaction gap may be disappearing. This article traces the evolution of the immigrant–Canadian born life satisfaction gap from 2009 to 2018 and explores two competing explanations for the declining gap: improved immigrant outcomes and changes to the CCHS design introduced in 2015–2016. The article finds little evidence for the improved outcomes explanation. Indeed, the immigrant satisfaction gap is somewhat illusory—the more substantial gap is between the life satisfaction of White individuals and that of members of certain racialized groups, regardless of immigration status. The 2015–2016 CCHS redesign, however, may be a plausible explanation for the increase in reported life satisfaction. This article provides more evidence that researchers using life satisfaction measures need to be cautious when survey designs change.

SARS-CoV-2 testing and COVID-19 related primary care use among people with citizenship, permanent residency, and temporary immigration status in British Columbia: Cross-sectional analysis of population-based administrative data

Background: Having temporary immigration status affords limited rights, workplace protections, and access to services. There is not yet research data on impacts of the COVID-19 pandemic for people with temporary immigration status in Canada. Methods: We use linked administrative data to describe SARS-CoV-2 testing, positive tests, and COVID-19 primary care service use in British Columbia from January 1, 2020, to July 31, 2021, stratified by immigration status (Citizen, Permanent Resident, Temporary Resident). We plot the rate of people tested and the rate of people confirmed positive for COVID-19 by week from April 19, 2020, to July 31, 2021, across immigration groups. Results: 4.9% of people with temporary immigration status had a positive test for SARS-CoV-2 over this period, compared to 4.0% among people with permanent residency and 2.1% among people who hold Canadian citizenship. This pattern is persistent by sex/gender, age group, neighborhood income quintile, health authority, and in both metropolitan and small urban settings. At the same time we observe lower access to testing and COVID-19 related primary care among people with temporary status. Interpretation: People with temporary immigration status in BC experience higher SARS-CoV-2 test positivity; alarmingly, this was coupled with lower access to testing and primary care. Interwoven immigration, health and occupational policies place people with temporary status in circumstances of precarity and higher health risk. Extending permanent residency status to all immigrants residing in Canada and decoupling access to health care from immigration status could reduce precarity due to temporary immigration status.

Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults

Background We evaluated whether immigration status modified the association between sex and the quality of primary cardiovascular disease prevention in Ontario, Canada. Methods and Results We used a population‐based administrative database‐derived cohort of community‐dwelling adults (aged ≥40 years) without prior cardiovascular disease residing in Ontario on January 1, 2011. In the preceding 3 years, we evaluated screening for hyperlipidemia and diabetes in those not previously diagnosed; diabetes control (HbA 1c <7%); and medication use to control hypertension, hyperlipidemia, or diabetes in those with previous diagnosis. We calculated the absolute prevalence difference (APD) between women and men for each metric stratified by immigration status and then determined the difference‐in‐differences for immigrants compared with long‐term residents. Our sample included 5.3 million adults (19% immigrants), with receipt of each metric ranging from 55% to 90%. Among immigrants, women were more likely than men to be screened for hyperlipidemia (APD, 10.8%; 95% CI, 10.5–11.2) and diabetes (APD, 11.5%; 95% CI, 11.1–11.8) and to be treated with medications for hypertension (APD, 3.5%; 95% CI, 2.4–4.5), diabetes (APD, 2.1%; 95% CI, 0.7–3.6) and hyperlipidemia (APD, 1.8%; 95% CI, 0.5–3.1). Among long‐term residents, findings were similar except poorer medication use for diabetes (APD, −2.8%; 95% CI, −3.4 to −2.2) and hyperlipidemia (APD, −3.5%; 95% CI, −4.0 to −3.0]) in women compared with men. Conclusions The overall quality of primary preventive care can be improved for all adults, and future research should evaluate the impact of observed equal or better care in women than men, irrespective of immigration status, on cardiovascular disease incidence.

Importance of accounting for loss to follow-up when comparing mortality between immigrants and long-term residents: a population-based retrospective cohort

ObjectivesTo evaluate the association between immigration status and all-cause mortality in different disease cohorts, and the impact of loss to follow-up on the observed associations.DesignPopulation-based retrospective cohort study using linked administrative health data in Ontario, Canada.SettingWe followed adults with a first-ever diagnosis of ischaemic stroke, cancer or schizophrenia between 2002 and 2013 from index event to death, loss to follow-up, or end of follow-up in 2018.Primary and secondary outcome measuresOur outcomes of interest were all-cause mortality and loss to follow-up. For each disease cohort, we calculated adjusted HRs of death in immigrants compared with long-term residents, adjusting for demographic characteristics and comorbidities, with and without censoring for those who were lost to follow-up. We calculated the ratio of two the HRs and the respective CL using bootstrapping methods.ResultsImmigrants were more likely to be lost to follow-up than long-term residents in all disease cohorts. Not accounting for this loss to follow-up overestimated the magnitude of the association between immigration status and mortality in those with ischaemic stroke (HR of death before vs after accounting for censoring: 0.78 vs 0.83, ratio=0.95; 95% CL 0.93 to 0.97), cancer (0.74 vs 0.78, ratio=0.96; 0.95 to 0.96), and schizophrenia (0.54 vs 0.56, ratio=0.97; 0.96 to 0.98).ConclusionsImmigrants to Canada have a survival advantage that varies by the disease studied. The magnitude of this advantage is modestly overestimated by not accounting for the higher loss to follow-up in immigrants.

Discrimination in digital immigration status

The UK has recently adopted a policy of granting digital-only proof of immigration status for certain groups of migrants. More than 4.5 million individuals are reliant on this form of status and the number is growing. In this paper, we argue that this policy, as currently operationalised, is unlawful as a result of its discriminatory impact. If it remains unchanged, the roots of digital discrimination in immigration policy and administration will be allowed to spread, with potentially disastrous consequences.