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Migration, detention, and deportation are often rife with violence. This study sought to examine associations between pre-migration experiences, detention conditions, and mental health among Mexicans deported from the U.S. to Mexico between 2020 and 2021. Data from the Migrante Project (N=306, weighted N=14,841) were analyzed using descriptive statistics and unadjusted and adjusted multivariate regression models. The prevalence of a lifetime mental health diagnosis was 18.5%. Exposure to adverse conditions in detention (adjusted odds ratio [AOR]=17.56, p<.001) and having been detained in both immigration and non-immigration facilities (AOR=9.70, p=.042) were significantly associated with increased odds of experiencing abuse during migrants' most recent detention. Experiencing abuse during migrants' most recent detention was, in turn, associated with increased odds of a lifetime mental health diagnosis (AOR=4.72, p<.005). Targeted, trauma-informed mental health services are needed for deported Mexican migrants.

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Latino immigrant families in the United States were disproportionately affected by intensified interior immigration enforcement under the Trump administration. US-citizen children are victimized by policies targeting their immigrant parents; research is sparse regarding how these polices affect children who experience parental deportation and children who are at risk for parental deportation. Additionally, anti-immigrant rhetoric can result in increased discrimination that also threatens children's psychological health. This qualitative study (N = 22) explores children's lived experiences of discrimination, parental deportation or threat of parental deportation, and perceived impacts on mental health. Interviews conducted from 2019 to 2020 revealed that children who are directly affected by or at risk for parental deportation experience detrimental impacts to their psychological well-being. Children experience discrimination as Latinos and children of immigrants, which is also detrimental to their mental/emotional health. Incorporating children's perspectives is critical to informing public health interventions. Findings demonstrate the need for family-friendly immigration reform.

Las familias inmigrantes latinas en los Estados Unidos se vieron desproporcionadamente afectadas por las acciones del servicio de inmigración bajo la administración de Trump. Los niños y niñas con ciudadanía estadounidense son víctimas de las políticas dirigidas a sus padres inmigrantes; las investigaciones son escasas con respecto a cómo estas políticas afectan a los menores afectados por la deportación de sus padres así como los que corren riesgo de que sus padres sean deportados. Además, la retórica antiinmigrante puede provocar un aumento en la discriminación, lo cual también representa una amenaza para la salud psicológica de estos niños y niñas. Este estudio cualitativo (N = 22) explora las experiencias de discriminación y de deportación o amenaza de deportación de los padres vividas por los menores así como los impactos percibidos en su salud mental. Las entrevistas realizadas entre 2019 y 2020 revelan que las niñas y niños directamente afectados por la deportación o el riesgo de deportación de sus padres sufren un impacto perjudicial en su bienestar psicológico. Los menores experimentan discriminación como latinos e hijos de inmigrantes, lo cual también perjudica su salud mental y emocional. Es crucial que se incorporen las perspectivas de estos menores al informar las intervenciones de salud pública. Los hallazgos demuestran la necesidad de una reforma migratoria que sea solidaria con las familias.

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Background: Mexican migrants traveling across the Mexico-United States (U.S.) border region represent a large, highly mobile, and socially vulnerable subset of Mexican nationals. Population-level health data for this group is hard to obtain given their geographic dispersion, mobility, and largely unauthorized status in the U.S. Over the last 14 years, the Migrante Project has implemented a unique migration framework and novel methodological approach to generate population-level estimates of disease burden and healthcare access for migrants traversing the Mexico-U.S. border. This paper describes the rationale and history of the Migrante Project and the protocol for the next phases of the project. Methods/design: In the next phases, two probability, face-to-face surveys of Mexican migrant flows will be conducted at key crossing points in Tijuana, Ciudad Juarez, and Matamoros (N = 1,200 each). Both survey waves will obtain data on demographics, migration history, health status, health care access, COVID-19 history, and from biometric tests. In addition, the first survey will focus on non-communicable disease (NCD), while the second will dive deeper into mental health and substance use. The project will also pilot test the feasibility of a longitudinal dimension with 90 survey respondents that will be re-interviewed by phone 6 months after completing the face-to-face baseline survey. Discussion: Interview and biometric data from the Migrante project will help to characterize health care access and health status and identify variations in NCD-related outcomes, mental health, and substance use across migration phases. The results will also set the basis for a future longitudinal extension of this migrant health observatory. Analyses of previous Migrante data, paired with data from these upcoming phases, can shed light on the impact of health care and immigration policies on migrants' health and inform policy and programmatic responses to improve migrant health in sending, transit, and receiving communities.

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Background: Migrants detained and held in immigration and other detention settings in the U.S. have faced increased risk of COVID-19 infection, but data on this population is scarce. This study sought to estimate rates of COVID-19 testing, infection, care seeking, and vaccination among Mexican migrants detained by U.S. immigration authorities and forcibly returned to Mexico. Methods: We conducted a cross-sectional probability survey of Mexican migrants deported from the U.S. to three Mexican border cities: Tijuana, Ciudad Juárez, and Matamoros (N = 306). Deported migrants were recruited at Mexican migration facilities after being processed and cleared for departure. A two-stage sampling strategy was used. Within each city, a selection of days and shifts were selected during the operating hours of these deportation facilities. The probability of selection was proportional to the volume of migrants deported on each day of the month and during each time period. During the selected survey shifts, migrants were consecutively approached, screened for eligibility, and invited to participate in the survey. Survey measures included self-reported history of COVID-19 testing, infection, care seeking, vaccination, intentions to vaccinate, and other prevention and risk factors. Weighted data were used to estimate population-level prevalence rates. Bivariate tests and adjusted logistic regression models were estimated to identify associations between these COVID-19 outcomes and demographic, migration, and contextual factors. Results: About 84.1% of migrants were tested for COVID-19, close to a third were estimated to have been infected, and, among them, 63% had sought care for COVID-19. An estimated 70.1% had been vaccinated against COVID-19 and, among those not yet vaccinated, 32.5% intended to get vaccinated. Close to half (44.3%) of respondents had experienced crowdedness while in detention in the U.S. Socio-demographic (e.g. age, education, English fluency) and migration-related (e.g. type of detention facility and time in detention) variables were significantly associated with COVID-19 testing, infection, care seeking, and vaccination history. Age, English fluency, and length of detention were positively associated with testing and vaccination history, whereas detention in an immigration center and length of time living in the U.S. were negatively related to testing, infection, and vaccination history. Survey city and survey quarter also showed adjusted associations with testing, infection, and vaccination history, reflecting potential variations in access to services across geographic regions and over time as the pandemic unfolded. Conclusion: These findings are evidence of increased risk of COVID-19 infection, insufficient access to testing and treatment, and missed opportunities for vaccination among Mexican migrants detained in and deported from the U.S. Deportee receiving stations can be leveraged to reduce disparities in testing and vaccination for deported migrants. In addition, decarceration of migrants and other measures informed by public health principles must be implemented to reduce COVID-19 risk and increase access to prevention, diagnostic, and treatment services among this underserved population.

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BACKGROUND: The health of Latino migrants is most often studied with samples of immigrants settled in the United States or returned migrants in Mexico. We examine health outcomes and health care access of Mexican migrants traversing the Mexican border region to gain a better understanding of migrant health needs as they transition between migration phases. METHODS: We used data from a 2013 probability survey of migrants from Northbound and Southbound migration flows in Tijuana, Mexico (N=2412). Respondents included Northbound migrants with and without US migration experience, Southbound migrants returning home from the United States or the Mexican border region, and migrants returning to Mexico via deportation. Descriptive statistics and regression models were estimated to characterize and compare their health status, behavioral health, and health care access across migration phases. RESULTS: Northbound migrants with US migration experience, Southbound migrants from the United States, and deported migrants had worse levels of health insurance, health care utilization, and diabetes than Northbound migrants without US migration experience. Southbound migrants returning from the border reported worse self-rated health and deportees had higher odds of reported substance use compared with Northbound migrants without US migration experience. CONCLUSIONS: Mexican migrants' health profile and health care access vary significantly across migration flows and generally are worse for migrants with US migration experience. The results add to our understanding of Mexican migrant health along the migration continuum and can inform services in sending, receiving, and intermediate communities.

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The aim of the study was to assess the relationship between educational attainment and health care access and use among Mexican-origin populations. Data from the 2012 Mexican National Health and Nutrition Study, the 2013 Project Migrante Health Care Access and Utilization Survey, and the 2013-2014 California Health Interview Survey were used to examine educational gradients in health insurance, medical home, and hospitalization among Mexicans in Mexico, northbound, southbound, and deported migrants, and U.S.-and foreign-born Mexican Americans. College graduates had greater odds of being insured relative to those with less than a high school degree among Mexicans (AOR = 1.48, p < 0.001), northbound migrants (AOR = 3.69, p < 0.001), and the foreign-born (AOR = 2.01, p < 0.01), and of having a medical home among Mexicans (AOR = 1.95, p < 0.001) and the foreign-born (AOR = 2.14, p < 0.05). Eliminating differences by educational attainment in the U.S. will require policy changes like making immigrants eligible for public insurance. In Mexico, it will require targeted outreach to enroll underserved populations in existing public insurance programs.

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Despite acquiring lower levels of attainment and earnings, Mexican immigrants exhibit favorable health outcomes relative to their native-born counterparts. And while scholars attempt to reconcile this so-called paradoxical relationship with a variety of theoretical and empirical approaches, patterns of selective migration continue to receive considerable attention. The present study contributes to the literature on health selection by extending the healthy migrant hypothesis in a number of ways. First, we rely on a unique combination of data sets to assess whether the healthy are disproportionately more likely to migrate. We use the latest wave of the Mexican Family Life Survey and the 2013 Migrante Study, a survey that is representative of Mexican-born persons who are actively migrating through Tijuana. Pooling these data also allow us to differentiate between internal and US-bound migrants to shed light on their respective health profiles. Results provide modest support for the healthy migrant hypothesis. Although those who report better overall health are more likely to migrate, we find that the presence of certain chronic conditions increases migration risk. Our findings also suggest that internal migrants are healthier than those traveling to the US, though this is largely because those moving within Mexico reflect a younger and more educated population. This study takes an important step in uncovering variation across migrant flows and highlights the importance of the timing at which health is measured in the migration process.

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OBJECTIVE: Migration is a structural factor that increases HIV vulnerability. Acculturative stress represents a possible mechanism through which migration may negatively impact HIV risk. This study investigated socio-ecological factors associated with acculturative stress levels and examined the association between acculturative stress and HIV-related behavior among Mexican im/migrants. METHODOLOGY: We used data from a probability survey of Mexican im/migrants (N = 1383) conducted in Tijuana, Mexico, in 2009-2010. The sample included migrants returning to Mexico via deportation or voluntarily after a recent stay in the USA. Linear regression models were estimated to identify individual, migration, and contextual factors independently associated with overall acculturative stress levels. Logistic regression models were used to test for associations between acculturative stress, sexual HIV risk, and HIV testing history behavior. RESULTS: We found that levels of acculturative stress were significantly and independently related to socio-economic markers, acculturation level, legal residence status, and sexual minority status. The analyses also showed that acculturative stress was positively related to sexual HIV risk behavior and negatively related to recent HIV testing. CONCLUSIONS: The results underscore that both individual and environmental factors contribute to levels of acculturative stress among Mexican im/migrants. In turn, acculturative stress may exacerbate sexual HIV risk and impede testing among this im/migrant population. Targeted interventions to prevent and decrease acculturative stress represent a potential strategy to reduce sexual HIV risk behavior and promote HIV testing among this vulnerable population of im/migrants in the USA.

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OBJECTIVES: We examined differences in, and factors associated with, access to health services among Mexican im/migrants to the U.S. across migration phases, including pre-departure, destination, interception, and return. METHODS: Using data from a cross-sectional survey conducted in Tijuana, Mexico (N = 1,541), we computed descriptive statistics and staged logistic regressions to estimate health care access indicators and factors associated with access to services. RESULTS: Im/migrants at post-migration phases had lower likelihood of receiving health care and having a usual source of care, and higher rates of forgone care, than their counterparts at pre-departure. These differences were partly explained by length of migration phase, health insurance status, transportation barriers, and detention or imprisonment. CONCLUSIONS: Mexican im/migrants face challenges in accessing health services across the migration continuum, especially at post-migration phases. Binational efforts to provide affordable insurance coverage and reduce transportation limitations and incarceration could contribute to improving health care access among Mexican im/migrants.

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