Transcript SOCIAL INTEGRATION OF LATIN AMERICAN IMMIGRANTS TO …

SOCIAL INTEGRATION OF
LATIN AMERICAN IMMIGRANTS
TO THE UNITED STATES FROM
A BEHAVIORAL-MEDICINE
PERSPECTIVE
Fabiana Franco, Ph.D. LLC
The George Washington
University
• Paper prepared to be presented at the
Conference: The Social Integration of
Immigrants in Maryland: A New
Comprehensive Approach, sponsored by
the Social Integration and Community
Development Association (SICDA),
Annapolis, MD September 22, 2009.
CURRENT TRENDS IN
INTERNATIONAL MIGRATION OF
LATIN AMERICAN IMMIGRANTS
• Note: My presentation is based on research
data, my experience as a Latin American
immigrant, and my experience as a clinician who
specializes in multicultural psychology,
behavioral medicine, trauma, law and forensics.
Seventy percent of my current patient population
is from another culture and from that seventy
percent of international patients, ninety percent
of them are of Latin American origin.
Background Data
• International migration is a complex phenomenon where
on the one hand is tightly linked to the United States
social integration trends and on the other, it refers to the
inclusion and exclusion process of a global society.
Within such context, international migration of Latin
American immigrants has dramatically changed its flow
intensity and orientation.
• The 1980 decade was a critical point in the migration
scenario of Latin American immigrants migrating to the
United States. Furthermore, Immigration to the United
States is the most important migratory flow of Latin
American countries in the last two decades.
MIGRATION IS A COMPLEX
PHENOMENON
• The Latin American immigrant population in the United
States is characterized by its rapid growth. Approximately
35.3 million individuals identify themselves as
Hispanic/Latin Americans. This number is expected to
increase to 97 million by 2050, nearly one fourth of the
U.S. population. Latin Americans are considered the
fastest growing ethnic group. It is believed that by the
year 2010 which is shortly approaching, Latin Americans
will be considered the largest minority group in the
country.
• According to the US Census Bureau, two out of every five
Latin Americans born out of the United States who reside
in the country migrated during the last decade. It is worth
noting that 40% Latin Americans residing in the US are
foreign born and more importantly, 46% of this non US
born Latin American immigrant group immigrated during
the decade of 1990.
REASONS FOR IMMIGRATION
• Latin Americans migrated to the United States essentially
for a few reasons:
• 1-Labour
• 2-Education
• 3-Reunification with family members
• 4-Polytical Asylum/Safety
• 5-Opportunity
• Latin American immigrants are usually located in the inferior
and superior extremes of the labor force, depending on their
social strata, qualification levels, education level, and/or capital.
Interestingly enough, although the labour model of the United
States is usually praised, it is also highly censured as it
paradoxically while on the one hand it exhibits relatively low
levels of unemployment on the other, it maintains a wide
discrepancy in terms of salary inequity. The social context of
our society is marked by uncertainty, social inequity, and
growing poverty. Latin Americans in this context are
considered one of the most the affected and economically
marginalized immigrant groups.
• Interestingly, continued migration also suggests continued
residential segregation of new waves of immigrants. Thus,
continued levels of Latin American immigration, would
presumably translate into continued levels of high segregation
for this ethnic group. Therefore, policies that promote social
integration of immigrants, such as increasing access to
English-as-a-Second language courses and facilitating
naturalization, are highly needed given the existing realities of
labor migration to the United States. The current body of
literature offers much food for thought as the Nation strives to
guarantee the civil rights of all ethnic minorities in this countryUS citizens and immigrants alike.
MULTIPLE ORIGINS, UNCERTAIN FUTURES
• Latin Americans currently recognized as the fastest growing
ethnic minority group. Numbering 40 million today and
growing by more than 1.5 million annually from both
continuing migration and natural increase. Currently Latin
Americans are scattering nationally and communities are
facing the multiple challenges presented by a new and
quickly growing immigrant population. The Latin American
population is characterized by a youthful age structure, a
large number of foreign born immigrants including many
undocumented, low levels of education, and disproportionate
concentrations of low skilled/low wage jobs. Its presence now
more than ever, is being felt intensively in the Nation’s
schools, labor market, health care system, mental health
system, and political life. It is worth noting that the economic
and social integration of Latin Americans at that level will
highly depend on educational investments and the acquisition
of job-related skills made today for future generations.
LATIN AMMERICAN IMMIGRATION TRENDS IN THE WASHINGTON
METROPOLITAN REGION
• In the latter decades of the twentieth century, the number
of Latin American immigrants to the Washington
metropolitan region grew, in large part due to the
economic stability offered by the expansion of the federal
government, international organizations and embassies,
and universities, all of which affect both native and foreign
born populations. In addition, since the late 1970s, the
U.S. government has resettled thousands of refugees in
the region, as civil wars intensified in several countries
and as natural disasters further devastated already
damaged living conditions and local economies. While
Washington’s increasing internalization began largely with
professionals and students has continued with both highand low skilled immigrants arriving through various
networks that join them to family and friends already living
in the region or simply in search of a better future.
CURRENT IMMIGRATION
TRENDS IN THE US
• Currently, the United States is in the midst of a National
debate over the role of immigrants in the economy and
society. One of the consequences of this debate is that
Latin American immigrants are increasingly becoming
targets of local legislation designed to restrict access to
services which makes them feel rejected and
unwelcome. While most of the proposed policy changes
are aimed at those without legal status, public officials
failed to present a reassuring scenario that legal
immigrants will not be caught up in the enforcement of
new provisions intended for the undocumented.
Therefore, immigrants of Latin American origin fear being
singled out based on the way they look or speak. A
deliberate blurring and luck of clarity of those distinctions
has created a hostile social atmosphere throughout the
Washington DC metropolitan region
• Latin American immigrants that live in the Washington DC
metropolitan region have a relatively recent history of
settlement in the region, marked by a small early flow of
professionals and continuing with a much larger flow of
immigrants from the ravaged countries of Central
America. While Latin American immigrants live all across
the Nation, they are relative new comers to some of the
farther-flung suburbs of the DC metropolitan region. In
these farther-flung regions, we have seen this immigrant
population grow quickly over a very short period. Thus,
the economic and social integration of Latin American
immigrants to the Washington DC metropolitan region is
vital for its viability to be able to grow in this globalized
economy. It is in the best interest of local institutions,
leaders, and the public-as well as immigrants-for true
social integration on a grand scale to take place. This
includes a dual process of immigrants adapting to and
becoming actively involved in their new communities and
learning English, as well as members of their
communities to provide a welcoming and supportive
environment.
NEW POLICIES
• The new policies proliferating across the United States
are partly a result of the increase number of immigrants
and partly a result of the larger national immigration
debate. The society at large is understandably wary
about the changes they see happening around them.
Local officials and leaders are feeling pressure to control
immigration at the local level, leading to some highly
charged debates in the political sector. Local officials
and leaders should take the next step in leading the
public to a new awareness of their local immigrant
populations while at the same time working with the
immigrant community-newcomers and long-term
residents alike-to help them understand the current
changes better,aiming at working together toward the
difficult and long-term process of true social integration
LATIN AMERICAN IMMIGRANTS: IMMIGRATION
FROM A BEHAVIORAL MEDICINE APPROACH
• Studies have found that Latino youth experience
proportionally more anxiety-related and delinquency
problem behaviors, depression, and drug use than do non
Latino youth. Older Latin American immigrants, studies
found that more than 26% are depressed but in most
cases the depressive symptoms were related to physical
health and only 5.5% of those in the studies, reported
depressive symptomatoloty in the absence of a medical
condition. Culture-bound syndromes frequently seen in
the Latin American cultures include susto (fright), nervios
(nerves), mal de ojo (evil eye), and ataque de nervios
(nervous breakdown). Reported symptoms may include
crying uncontrollably, trembling, screaming, verbal or
physical aggression, dissociative experiences, fainting
episodes, feelings of helplessness and hopelessness, and
suicidal ideation
PSYCHIATRIC CONDITIONS
• Although some studies found a 6% suicide rate for Latinos
compared with 13 percent for whites, in a national survey of
high school students, Latinos reported more suicidal ideation
and attempts than whites. From the prison population, 9% of
Latin Americans compared to 3% of whites are incarcerated.
Latino men are nearly four times as likely to be incarcerated
at some point during their lifetimes, than are white men.
Latinos who served in Vietnam were at higher risk for warrelated Post Traumatic Stress Disorder (PTSD) than their
white counterparts. Refugees from Central America
experienced considerable more war-related trauma and
torture in their homelands. Studies have found rates of
(PTSD) among Central American patients ranging from 35 to
60%. Although in general Latinos have alcohol and drug
abuse rates similar to whites, Latino women have unusually
lower rates of alcohol and other drug use than white women,
whereas Latino men have relatively higher rates of alcohol
and substance abuse than whites.
HEALTH RISKS
• Reviewing available literature regarding Latinos health,
studies found that this ethnic group is at higher risk for
intestinal parasites, gastric cancers, tuberculosis,
hepatitis B, schistosomiasis, leprosy, American
trypanosomiasis (Chagas disease), malaria, HIV
infection, cervical cancers, sickle cell trait, malnutrition,
anemia, iron deficiency, incomplete immunizations,
dental problems, diabetes mellitus, and hypertension.
Even though there is not enough data to evaluate fully
the screening strategies for most of these conditions,
screening is highly recommended for intestinal parasites
and schistosomiasis, tuberculosis, hepatitis B,
particularly in prenatal patients, leprosy tests in
immigrants from high risk areas, yearly Papanicolau
smears, gastric malignancies, dental problems, and
hypertension
AVAILABILITY AND ACCESS TO HEALTH
CARE AND MENTAL HEALTH SERVICES
• While the actual percentage of Spanish speaking mental
health professionals is not known, only about 1% of
licensed psychologists who are also members of the
American Psychological Association identify themselves
as Latin or Hispanic. Furthermore, there are 29 Spanish
speaking mental health professionals for every 100,000
Latinos in the United States. Nationally, 37% of Latinos
are uninsured. This high number is driven primarily by
lack of employer based coverage for this ethnic group.
Among Latin Americans residing in the U.S. fewer than 1
in 11 contact mental health specialists whiled fewer than 1
in 5 contact general care providers. Among Latin
American with diagnosed psychiatric disorders fewer than
1 in 20 receive mental health services while fewer than 1
in 10 use services from health care providers.
NEED FOR ADDITIONAL
RESEARCH STUDIES
• Unfortunately, few studies on the response of Latinos to
mental health care are available. One study found that
low-income Latinos were more likely to suffer from
exacerbated symptoms of psychosis. Several studies
found that bilingual patients are evaluated differently
when interviewed in English as opposed to in Spanish.
Another small study found that Latin Americans
diagnosed with Bipolar Disorder are more likely to be
misdiagnosed with schizophrenia than are whites. One
national study found that only 24% of Latinos with
depression and anxiety received appropriate care,
compared to whites. Yet another study found that
Latinos who visited a general practitioner were less than
half as likely to receive either a diagnosis of depression
or being prescribed antidepressants. Clearly, a lot more
needs to be done to ensure the mental and medical care
of our rapidly growing immigrant communities
SUGGESTED SOLUTIONS FOR A HEALTHIER MORE
INTEGRATED MULTICULTURAL SOCIETY
• -Joint efforts to promote economic equality.
• -Joint efforts to condemned discrimination and protect individual
rights on the basis of their sexual or religious orientation, ethnicity,
age, and/or mental/physical disability.
• -Embrace diversity in all its aspects
• -Implement programs to encourage ethnic minority students to
remain in school.
• -Promote bilingual education
• -Urge congress to pass laws to protect minority employees from
exploitation and discrimination
• -Strengthening partnerships with Latin America
• -Promote affordable access to culturally competent health care for
Latinos (i.e., access to pre-natal care, immunizations, prescriptions,
mental health services).
• -Affordable housing
• -Collaborative efforts to change immigration laws
• -Welfare reforms for those individuals in need of specialized
assistance (i.e., bilingual training, child care funding, increased
minimum wage.)
LETS WORK TOGETHER
TOWARDS A BRIGHTER FUTURE
HAPPIER FAMILIES
HIGHER EDUCATION
ART AND CULTURE
DANCE
UNIFICATION
PROFESSIONALS
ACCESS TO EDUCATION
COLLABORATION
ACCESS TO HEALTH CARE
HAPPIER CHILDREN
REFERENCES
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• Questions?