Part 2 essay

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University of California, Riverside

School of Public Policy Course Syllabus

Winter 2021

Name and Number of Course: PBPL 190 Special Studies: Immigrant Health and Wellbeing

Instructor Information: Cecilia Ayón, MSW, PhD [email protected] | 951.827.5577 Office Hours: T/TH 1-1:45PM and by appointment Course Description:

Informed by the social determinants of health framework, students gain an in-depth understanding on

the significant role that physical, social, and policy environments play on immigrants’ health. Students

will examine factors that strain immigrants’ health and restrict their access to care as well as factors that

protect immigrants’ health. Students examine the health and wellbeing of vulnerable immigrant groups

including older adults, children, undocumented, and mixed status families.

Learning Objectives:

This course is focused on the circumstances, conditions, and health experiences of immigrants, who are

a marginalized group in the United States, particularly around legality, race/ethnicity, and

socioeconomic status. Specific learning outcomes include:

1. Become familiarized with and provide a critical analysis of current theories on immigrant health,

risk, and wellbeing.

2. Apply a comprehensive and holistic model of health that includes structural and social

determinants of health, to the understanding of immigrant health.

3. Critically examine various domains of health in immigrant communities, such as physical health,

mental health, and resilience.

4. Understand various determinants of health in immigrant communities, such as health promoting

behaviors, and family, community, and social contexts and policy, and recognize ways in which

discrimination is embedded in policies and contexts.

5. Critically examine how immigration and healthcare policy currently promote or hinder the

health of immigrant communities, and examine how inequities in health are inextricably linked

to inequities in immigration policy.

6. Develop/enhance analytical skills and written communication skills in public policy.

Course Format

Class format will include seminar discussions around course readings, individual and small group work

activities. Course readings address multiple topics on immigrants’ health such as mental health, physical

health, risk and protective factors, and access to health care. This class assumes students will be

prepared for class and actively engage in class discussion.

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Assignments and Evaluative Procedures

The table below lists the assignments, due dates, and the points allocated to each assignment. A

separate handout, also on ilearn, details each assignment and provides grading criteria.

Assignment Due Date Points

1. Response Papers TBD; Throughout the quarter 50

2a. Immigrant health paper – part 1 Week 5 20

2b. Immigrant health paper – part 2 Week 9 20

3. Participation Throughout the quarter 10

Total 100

1. Response papers (50 points total): Students will synthesize the week’s readings. Five response

papers will be completed during the quarter, each worth 10 points. A sign-up sheet will be made

available online. Every effort will be made to accommodate students’ preferences, but it will be

based on a first come first serve basis. The response papers should be completed in essay format

with an intro and conclusion. The body of the essay should address the prompt (all parts). Papers

should be two pages in length (double-spaced). See rubric for additional details. Select one of the

following writing prompts:

a. Critique the articles: What are the limitations and strengths of the articles? What gaps

remain in the research?

b. What are two prevalent themes in the week’s readings? Support your response with

examples from the readings.

c. What are the major findings in the articles? What are the implications for policy?

Note: Response papers should reflect a critical analysis of the readings. Summaries of papers will not

receive credit.

2. Immigrant Health Paper (40 points total): This assignment will integrate course material on

different aspects of immigrant health. There are two parts to this assignment; each part is worth 20

points. The two parts will be integrated to form a final research paper due at the end of the quarter;

for a total of 10 pages - double-spaced with one inch margin, and 12-point font. Essays should draw

from course readings, supplemental readings, and other material. Each essay should include

references and be formatted according to the American psychological Association’s (APA) style

guide. Students may consult the following resources regarding APA style: Purdue University’s Online

Writing Lab

(https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/ge

neral_format.html).

a. Part 1: Students will select an immigrant group to focus on (e.g., older adults, children of

immigrants, undocumented youth, undocumented adults, Mixed status families, can also

focus on an ethnic group – i.e., Latinx mixed status families, or Japanese immigrants, etc).

Students will also select a domain of health, such as a physical/medical condition, a mental

health condition, or an area of wellness and daily living (e.g., physical health among

Japanese immigrants or mental health among children of immigrants). Students will focus

on multiple determinants of health and use the conceptual model discussed in class to link

multiple determinants using literature (from class or external; focus on empirical studies).

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The first part of the assignment will address, for the immigrant group and domain of health

selected:

i. What are the characteristics of the immigrant group (i.e., a demographic profile)? (1

page) Include a description of the population in the U.S. (could address, but not

limited to: number of individuals in the U.S., regions were they primarily reside,

average age, gender, info about family structure, average income etc.)

ii. Brief history of immigration in the U.S. (1 page). What is known about the selected

groups history of migration to the U.S., what is their general experience in the U.S.

(barriers, challenges, resilience), what is known about the documentation status

among the immigrant group?

iii. What are the primary explanations/determinants for their health? (4-5 pages)

Provide an overview of the what is known about the condition that you are

addressing. Present evidence on the determinants of health or factors that influence

how immigrants experience the condition you have identified. Use the SDH

framework to organize the information. Address all domain of the SDH framework.

In addition, address if and how immigrant’s status and/or immigration policy and

enforcement plays a role on the populations health, as it related to your selected

group and topic.

b. Part 2: Students will integrate the sections from the first part of the assignment,

incorporating professor feedback, and will expand by discussing implications for policy,

practice, and research. Part 2 of the assignment should be 3 pages. Include part 1 with

revisions and part 2 when submitting the paper. Implications should be grounded in your

findings from part 1.

i. What policy changes are needed to address the health needs of immigrants? Why

are these changes needed?

ii. How can practice models or access to care be improved for this community?

Practice implications could range from direct practice (interactions with medical

providers) to community based efforts (e.g., to improve access, advocate etc.).

iii. What gaps remain in the research? What additional research is needed to better

understand the health and wellbeing of the immigrant group?

3. Participation (10 points). The instructor may utilize multiple methods for evaluating students’ class participation, including asking students to post comments on ilearn (e.g., discussion board posts) and/or administering pop quizzes related to the readings.

Evaluation/Grading Grading System:

90-100 = A 80-89 = B 70-79 = C 60-69 = D 59 and below= F

An A grade at the undergraduate level means that a student is doing outstanding or excellent work. The student attends class regularly, hands in all of the course assignments and demonstrates a thorough grasp of the material. To receive an A grade a student must go well above and beyond the basic expectations for the course.

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A B grade at the undergraduate level means that a student is doing above average work. The student attends class regularly, hands in all of the course assignments and demonstrates (at the very least) a strong grasp of the material. A C grade at the undergraduate level means that a student is doing at least satisfactory work, and meeting the minimum requirements for the course. The student attends class regularly, hands in all of the course assignments, and demonstrates a basic level of understanding of the course concepts. A D or an F at the undergraduate level means that a student is doing unacceptable work, demonstrating a complete lack of understanding of course concepts.

Required Textbook and Readings

• A text book is not required for this course. All required readings will be available on ilearn.

Instructor Responsibilities

It is the responsibility of the instructor to (1) be well-prepared for each class, (2) be available to students as needed for responding to questions and comments about this course, (3) provide constructive feedback as needed on student assignments, and (4) do their part to provide a space that is intellectually and personally challenging and safe for discussing and critiquing controversial issues and ideas.

Student Responsibilities General Expectations. Please adhere to the following:

• It is the responsibility of each individual student to ensure that their assignments are turned in on time and are received by the instructor. Assignments must be submitted through ilearn: assignments attached to emails will not be opened or graded, unless previously arranged with the instructor.

• Be sure that all written assignments are in one’s own words except where otherwise cited. All direct quotes must appear either in quotation marks or indented, and must include the source, date, and page number(s). Material taken from other authors that is paraphrased must also include source information. Noncompliance with these requirements constitutes plagiarism and is grounds for a failing grade.

• Students are expected to keep a copy of each assignment until the end of the quarter in the event that an assignment is not received.

• Students are expected to complete all assignments, participate in discussion boards, and engage fully in the learning process. If at any time an emergency arises that compromises a student’s ability to complete the course requirements, it is expected that the student will contact the instructor to discuss options for course completion.

• It is the responsibility of the student to ensure receipt of announcements and email messages through ilearn. Course changes and reminders will be sent via announcements and emails; thus, students should check their email regularly. If you email the professor, she will respond within 48 hours (excluding weekend), if a response is not received within that timeframe then it is the student’s responsibility to follow up by with the instructor.

• Do not hesitate to contact the instructor to get additional help with course content or assignments. Students are encouraged to visit office hours for additional support.

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Course Outline

Date Content Assignment/

Task Due Week 1

Week of January 4

Introduction to course content and logistics Objectives:

• Review the purpose of the course. • Understand the course requirements. • Examine immigrant demographics in the U.S. and CA

Required Readings:

• Syllabus

Week 2

Week of January 11

Topic: The Immigrant Paradox Objectives:

• Examine the immigrant health paradox. a. What is the immigrant health paradox? b. What are the limitations and strengths of this

concept? c. Does this concept apply to all immigrant groups?

Required Readings:

• Teruya, S.A. & Bazargan-Hejazi, S. (2013). The immigrant and Hispanic Paradoxes: A systematic review of their predictors and effects. Hispanic Journal of Behavioral Sciences, 35(4), 486-509. doi:10.1177/0739986313499004.

• Alegría, M., Canino, G., Shrout, P., Woo, M., Duan, N., Vila, D., Torrest, M., Chen, C., & Meng, X. (2008). Prevalence of mental illness in immigrant and non-immigrant U.S. Latino groups. American Journal of Psychiatry, 165, 359-369.

• Ayón, C., Marsiglia, F.F., Bermudez, M. (2010). Latino family mental health: Exploring the role of discrimination and familismo. Journal of Community Psychology, 38(6), 742-756. Doi: 10.1002/jcop.20392

• John, A.D., Castro, A.B., Martin, D.P., Duran, & Takeuchi, D. (2012). Does an immigrant paradox exist among Asian Americans? Associations of nativity and occupational class with self-rated health and mental disorders. Social Science Medice, 75(12), 2085-2098. Doi: 10.1016/j.socscimed.2012.01.035.

Activities:

• View video: Unnatural Causes Video (Becoming American)

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Week 3

Week of Jan 18

Topic: Social Determinants of Health Model Objectives:

• Examine and discuss the social determinants of health model.

• Assess health disparities among immigrant groups.

Required Reading:

• For an Overview on Social Determinants of Health

o Healthy People 2020. Social Determinants of health.

Retrieved from:

https://www.healthypeople.gov/2020/topics-

objectives/topic/social-determinants-of-health

o Artiga, S. & Hinton, E.(2018). Beyond health care: The role

of social determinants in promoting health and health

equity. Retrieved from:

http://files.kff.org/attachment/issue-brief-beyond-health-

care

o CDC Health Disparities and Inequalities Report – U.S. 2013

Activities:

• Identify a research article that identifies one of the social determinants of health and its relation to health outcomes among immigrants. Prepare a short summary statement in preparation for class and post on the discussion board before class (1/2 page single spaced).

Due on Th (1/21): see activities, post on discussion board Extra Credit Opportunity

Week 4

Week of Jan 25

Topic: Immigration as a social determinant of health Objectives:

• Analyze immigration as a social determinant of health. • Understand evidence used to position immigration as a social

determinant of health. • Critique the notion ‘immigration policy as health policy.’

Required Readings

• Castañeda, H., Holmes, S., Madrigal, D.S., DeTrinidad Young, M., Beyeler, N., & Quesada, J. (2015). Immigration as a social determinant of health. Annual Review of Public Health, 36, 375- 392.

• Ayón, C., Nieri, T., & Gurrola, M. (2020). Latinx immigrant health and mental health. Encyclopedia of Social Work. [READ pages x-x ONLY]

• Cabral, J., & Cuevas, A.G. (2020). Health inequities among Latinos/Hispanics: Documentation status as a determinant of health. Journal of Racial and Ethnic Health Disparities. https://doi.org/10.1007/s40615-020-00710-0

Activities:

• Small group discussion

Due Response paper

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Week 5

Week of Feb 1

Topic: Policies and Access to health care for immigrants Objectives:

• Appraise the social and health policies that impact upon immigrant’s health.

• Examine promising practices to support immigrant’s accesses to care.

Required Reading (Select four of the following articles):

• Kaiser Family Foundation (2018). Key facts about the uninsured population. Retrieved from https://www.kff.org/uninsured/fact- sheet/key-facts-about-the-uninsured-population/

• Wallace SP, Torres J, Sadegh-Nobari T, Pourat N, Brown RE. Undocumented immigrants and healthcare reform. UCLA Center for Health Policy. [Online]. Retrieved from http://healthpolicy.ucla.edu/publications/Documents/PDF/undoc umentedreport-aug2013.pdf [Read executive summary]

Activities:

• Film: CoverAge

DUE, Immigrant Health Paper, Part 1

Week 6

Week of Feb 8

Topic: Older immigrant adults and health [and end of life issues] Objectives:

• Examine health needs and barriers experienced by undocumented older adults.

Required reading: [Select three]

• Cervantes, L., Fischer, S., Berlinger, N., Zabalaga, M., Camacho, C., Linas, S., & Ortega, D. (2017). The illness experience of undocumented immigrants with end -stage renal disease. JAMA Internal Medicine, 177(4), 529-535. DOI: 10.1001/jamainternalmed.2016.8865

• Ayón, C., Santiago-Ramos, J., & Lopez Torres, A.S. (accepted 12.20.2019). Latino Undocumented Older Adults, Health Needs and Access to Healthcare. Journal of Immigrant and Minority Health. DOI 10.1007/s10903-019-00966-7

• Gray, N.A., Boucher, N.A., Kuchibhtla, M., & Johnson, K.S. (2017). Hospice access for undocumented immigrants. JAMA Internal Medicine, 177(4), 579-580. DOI: 0.1001/jamainternmed.2016.8870

• Rodriguez, N., Parades, C.L, & Hagan, J. (2017). Fear of immigration enforcement among older Latino immigrants in the United Stated. Journal of Agin and Health 29(6), 986- 1014.

Activities:

• Small group discussion

Due Response paper

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Week 7

Week of Feb 15

Topic: Undocumented youth and health Objectives:

• Examine health needs and barriers experienced by undocumented youth.

Required reading:

• Gonzales, R. G., Suárez-Orozco, C., & Dedios-Sanguineti, M. C. (2013). No place to belong: Contextualizing concepts of mental health among undocumented immigrant youth in the United States. American Behavioral Scientist, 57(8) 1174–1199.

• Enriquez, L.E., Hernandez, M.M., Ro., A. (2018). Deconstructing immigrant illegality: A mixed methods investigation of stress and health among undocumented college students. Race and Social Problems,10, 193-208. doi: 10.1007/s12552-018-9242-4

• Cha, B.S., Enriquez, L.A., Ro, A. (2019). Beyond access: Psychosocial barriers to undocumented students’ use of mental health services. Social Science and Medicine, 233, 193-200. Doi: 10.1016/j.socscimed.2019.06.003

• [Optional] Terriquez, V. (2015) Dreams delayed: Barriers to degree completion among undocumented community college students. Journal of Ethnic and Migration Studies,41(8), 1302- 1323. doi: 10.1080/1369183X.2014.968534

Activities:

• Small group discussion

Due Response paper

Week 8

Week of Feb 22

Topic: Children of immigrants and health Objectives:

• Examine health needs and barriers experienced by children of immigrants.

Required reading:

• Ezlemazi, B., Fahey, C.A., Kogut, K., et al., (2019). Association of perceived immigration policy vulnerability with mental and physical health among US-Born Latino adolescents in California. JAMA Pediatrics, 173(8), 744-753. Doi: 10.1001/jamapediatrics.2019.1475

• Kim, S.Y., Schwartz, S.J., Perreira, K.M., & Juang, L.P. (2018). Culture’s influence on stressors, parental socialization, and developmental processes, in the mental health of children of immigrants. Annual Review of Clinical Psychology, 14, 373- 370. DOI: 10.1146/annurev-clinpsy-050817-084925.

• Mendoza, M. M., Dmitrieva, J., Perreira, K. M., Hurwich-Reiss, E., & Watamura, S. E. (2017). The effects of economic and sociocultural stressors on the well-being of children of Latino immigrants living in poverty. Cultural Diversity and Ethnic Minority Psychology, 23(1), 15–26.

Due Response paper

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https://doi.org/10.1037/cdp0000111

• [Optional]Landale, N.S., Hardie, J.H., Oropesa, R.S., & Hillemeier, M.M (2015). Behavioral functioning among Mexican-Origin children: Does parental leagal status matter? Journal of Health and Social Behavior, 56(1), 2-18.

• [Optional] Yoshikawa, H. & Kalil, A. (2011). The effects of parental undocumented status on the developmental context of young children in immigrant families, Child Development Perspectives, 5(4), 291-297.

Activities:

• Small group discussion

Week 9

Week of March 1

Topic: Immigrant health: Protective factors and resilience Objectives:

• To examine factors that are protect immigrants’ health. Required reading:

• Ayón, C., & *Bou Ghosn, M. (2013). Latino immigrant families’ social support networks: Strengths and limitations during a time of stringent immigration legislation and economic insecurity. Journal of Community Psychology, 41(3), 359-377. doi: 10.1002/jcop.21542

• Mikell, M., Snethen, J., & Kelber, S. (2020). Exploring factors associated with physical activity in Latino immigrants. Western Journal of Nursing Research. DOI: 10.1177/0193945919897547

• Cardoso, J.B., & Thompson, S.J. (2010). Common themes of resilience among Latino immigrant families. A systematic review of the literature. Families in Society: The journal of contemporary social services, 91(3), 257-265. Doi: 10.1016/1044-3894.4003.

Activities: • Small group discussion

Due Response paper Due Immigrant Health Paper (part 1 revisions, and part 2)

Week 10

Week of March 8

Topic: Immigrant health: Implications for practice Objectives:

• To examine practice models used to support immigrants’ health. Required reading: [Select three]

• Crosnoe, R. et al., (2012). Promising practices for increasing immigrant’s access to health and human services. Retrieved from: https://aspe.hhs.gov/system/files/pdf/76466/rb.pdf

• Hawkins, J.M., Posadas, L., Manale, A., & Bean, R.A. (2020): Culturally competent therapy with Latinxs: Addressing isolation. The American Journal of Family Therapy, DOI: 10.1080/01926187.2020.1777912

• Martinez Tyson, D., Arriola, N.B., & Corvin, J. (2016). Perceptions

Due Response paper

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of depression and access to mental health care among Latino immigrants: Looking beyond one size fits all. Qualitative Health Research, 26(9). 1289-1302. DOI: 10.1177/1049732315588499

• Falgas-Bague, I., Wang, Y., Banerjee, S., Ali, N., DiMarzio, K., Vidal, D.P., & Alegria, M. (2019). Predictors of adherence to treatment in behavioral health therapy for Latino immigrants: The importance of trust. Frontiers in Psyschiatry, 10, 1-11. DOI: 10.3389/fpsyt.2019.00817

• Doshi, M., Lopez, W.D., Mesa, H., et al (2019). Barriers and facilitators to healthcare and social services among undocumented Latino(a)/Latinx immigrant clients: Perspectives from frontline service providers in Southeast Michigan. PLoSONE 15(6):e023383

• Bloemraad, I. & Terriquez, V. (2016). Cultures of engagement: The organizational foundations of advancing health in immigrant and low—income communities of color. Social Science and Medicine, 165, 214-222.

Activities:

• Small group discussion

Finals Week

March 13-19