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Objective:
Many Haitian migrants live and work as undocumented laborers in the Dominican Republic. This study examines the legacy of anti-Haitian discrimination in the Dominican Republic and association of discrimination with mental health among Haitian migrants.
Design:
This study used mixed methods to generate hypotheses for associations betwe...
Context in source publication
Context 1
... purpose of our exploratory study was to formally investigate the relationship between perceived anti-Haitian discrimination and migrant mental health in the Dominican Republic. Data were collected during March April 2011 in the Duarte Province, Dominican Republic (Figure 1). In 2008, Duarte Province had a population of 310,357 (SESPAS 2008), mostly concentrated in urban and peri-urban areas. Lying two hours from the capitol Santo Domingo, San Francisco de Macorís is the province ’ s largest city. Smaller communities lie on the outskirts of San Francisco and throughout the province, where production of rice and cacao is common and where many Haitian migrants live and work. Research was facilitated through a longstanding research partnership between US University, Dominican University, and the regional public hospital Blinded. The partnership comprises community-based participatory research, engaging community members, community health workers (CHWs), and in-hospital staff to seek improved quality of care (Foster, Burgos et al. 2010; Foster, Chiang et al. 2010). The study team comprised four multilingual (English-Spanish or Kreyòl-Spanish- French), locally hired research assistants (RAs), including one Dominican and three Haitians. The lead author, proficient in Kreyòl, French, and Spanish, coordinated the study. RAs were trained in obtaining verbal informed consent, confidentiality, and all data collection procedures. Data collection sites included the public hospital, regional clinics, and six predomi- nantly migrant Haitian communities in and around San Francisco de Macorís. We purposively selected Haitian migrant communities through discussions with professional partners in the Ministry of Health, Haitian community members, and Dominican ...
Citations
... Consequently, stigma may become embedded in HIV clinics, resulting in suboptimal engagement in HIV treatment and care of PWH [17]. Moreover, racial background adds another layer to the challenges faced in the Dominican Republic, particularly regarding discriminatory practices against Haitian migrants and their descendants [17,18], possibly resulting in obstacles in healthcare access and utilization [19,20]. A study indicated that PWH of Haitian descent experienced lower rates of being on treatment, decreased viral suppression, and more missed ART doses. ...
Experiencing HIV and intersectional stigmas in healthcare settings may affect antiretroviral treatment (ART) adherence among people with HIV (PWH), given their need for frequent interactions with clinical settings and healthcare providers. Considering the importance of reducing stigmas to promote well-being and the need to elucidate how stigma influences health across various settings, we examined how experienced HIV stigma in Dominican Republic healthcare settings impacts ART adherence through internalized HIV stigma and whether race or sexual orientation stigma moderates this relationship. Participants were 471 PWH (aged 17–71) who were recruited from two HIV clinics in the Dominican Republic in 2021–2022. Results revealed a significant mediation effect (B=-0.10, SE = 0.05, CI [-0.234, − 0.014]) after adjusting for effect of age and time since HIV diagnosis, suggesting that experienced HIV stigma in healthcare settings was associated with more internalized HIV stigma (B = 0.39, SE = 0.11, p = .001), subsequently linked to lower ART adherence (B=-0.26, SE = 0.11, p = .016). The indirect effect was significant at low levels of race stigma (B=-0.16, SE = 0.09, CI [-0.369, − 0.001]) but not at high levels of race stigma (B=-0.06, SE = 0.05, CI [-0.175, 0.038]). This indirect effect was also significant at low levels of sexual orientation stigma (B=-0.19, SE = 0.10, CI [-0.401, − 0.023]) but not at high levels of sexual orientation stigma (B=-0.04, SE = 0.06, CI [-0.160, 0.074]). These findings suggest that addressing experienced HIV stigma in Dominican Republic healthcare settings, along with various dimensions of HIV-related stigma (e.g., internalized stigma) and intersecting stigmas (e.g., race, sexual orientation), is vital for improving health outcomes, such as optimal ART adherence.
... These depictions have compounded already existing stereotypes and negative labels (e.g., "boat people," "voodoo worshipers," and "illiterates") and have reinforced their social isolation as triple minorities. Long-term implications of the distinctive stressors that Haitian immigrants encounter (e.g., stigmatization and mistreatment across many contexts) have resulted in feelings of being rejected and self-doubt, negatively impacting self-esteem and interpersonal relationships, and causing intercultural conflict and poor mental health outcomes Keys et al., 2015;Kretsedemas, 2003Kretsedemas, , 2005Panikkar et al., 2014;Santana & Dancy, 2000). ...
Relocating and starting a new life in a foreign country may entail a constellation of new stressors for Haitian immigrants; thus, research that enhances our understanding of how this vulnerable population contextualizes migration-related stress is necessary. The objectives of this study were to: (a) identify what factors are associated with migration-related stress, and (b) describe which and why specific migration-related stressors were most significant from the perspective of those suffering from high migration-related stress post migration via the stress proliferation lens of the stress process model. In this mixed-methods, sequential, explanatory pilot study, first-generation Haitian immigrants (N = 76) were recruited to operationalize migration-related stress, using the Demands of Immigration Scale (DIS). Participants (n = 8), who scored 25 or higher on the DIS, completed an in-depth audio-recorded follow-up interview that consisted of open-ended questions and a stressor-ranking questionnaire. Descriptive statistics, Pearson correlations, multiple linear regression (quantitative), and thematic analysis with a double-coded approach (qualitative) were employed to analyze the data. Female gender, older age, English fluency, and migration after the age of 18 years were associated with higher migration-related stress. However, only gender and English fluency predicted migration-related stress. In interviews, participants ranked five migration-related stressors as most stressful: language barriers, financial strains, loss of social networks, family conflicts, and exposure to discrimination/stigma. A nuanced depiction of migration-related stressors and proliferation mechanisms of migration-related stress may help identify areas where support and preventive efforts should be directed to improve social integration, stress levels, and mental well-being among immigrants.
... Extreme precipitation may lead to mobility through loss of arable land, damages to housing and infrastructure, reduced income, water insecurity, and inadequate food supply [4]. Case studies have linked drought to mobility in several settings including Mali, where drought was associated with short-term migration by women and children [5], Mexico, where drought was associated with urban-rural migration [6], Ethiopia, where drought was associated with increased men's labor migration and declines in women's marriage-related migration [7], and Haiti, where drought, poverty, and deforestation were associated with migration to the Dominican Republic [8]. While there is less empiric evidence linking heavy rain to mobility, there is some evidence that these events have modest impacts on human mobility in Bangladesh [9]. ...
Background
Precipitation anomalies are associated with a number of poor health outcomes. One potential consequence of precipitation extremes is human geographic mobility. We evaluated the associations between precipitation anomalies (droughts and heavy rains) and short-term mobility in 23 sub-Saharan African countries by linking satellite data on precipitation to cross-sectional representative surveys.
Methods
Using data from 23 Demographic and Health Surveys from 2011 to 2017, we estimated the associations between deviations in long-term rainfall trends and short-term mobility among 294,539 women and 136,415 men over 15 years of age. We fit multivariable logistic regression models to assess potential non-linear relationships between rainfall deviations and short-term mobility, adjusting for survey month and socio-demographic covariates, and stratified by participant gender. Furthermore, we assessed whether these associations differed by marital status.
Results
Rainfall deviations were associated with short-term mobility among women, but not men. The relationship between rainfall deviations and mobility among women was U-shaped, such that women had increased marginal probabilities of mobility in instances of both lower and heavier precipitation. Differences between married and unmarried women were also revealed: among married women, we found positive associations between both rainfall deviation extremes (drought and heavy rains) and mobility; however, among unmarried women, there was only a positive association for heavy rains.
Conclusion
Precipitation anomalies were associated with short-term mobility among women, which may be in turn associated with poor health outcomes. More research with longitudinal data is needed to elaborate the associations between weather shocks, mobility, and downstream health impacts.
... In the scientific literature, it is possible to find several reviews that provide evidence of the negative impact of discrimination on health and well-being [3][4][5][6][7][8][9][10][11]. In the migrant population, the two most studied types of discrimination are those of racial and ethnic origin, always associated with poorer health, both physical and mental, as well as lower levels of well-being [12][13][14][15][16][17][18][19][20][21][22][23]. ...
(1) Background: Migration causes effects on the people who migrate and on the societies that receive them, which can be positive or negative, depending on the characteristics of the interaction. One negative effect is the emergence of mental health disorders associated with the presence of discrimination, a relationship for which there is abundant evidence, although there is less research on factors that may alter this effect. (2) Objective: To evaluate the possible mediating role of optimism and intolerance to uncertainty in the relationship between discrimination and mental health. (3) Method: Nine hundred and nineteen adult Colombian migrants residing in Chile, 49.5% were men and 50.5% women, ages from 18 to 65 years, were evaluated. The Discrimination Experience Scale, BDI-IA Inventory, BAI, LOT-R and the Intolerance to Uncertainty Scale were applied. The effects were estimated using structural equation modeling. (4) Results: A mediating effect of both dispositional optimism and intolerance to uncertainty on the relationship between discrimination and mental symptomatology was observed. (5) Conclusions: The impact on individual suffering and the social cost of mental health problems require investigating variables on the relationship between discrimination and mental health, including mediators of this relationship, which turn out to be central elements in the development of future strategies for the reduction of anxiety and depression symptoms.
... Demographics. Participants were asked about their age (continuous), sex or gender (male/man, female/woman, transgender man, transgender woman, other), and self-identified nationality (Dominican, Haitian, or other), which was dichotomized as Haitian background versus none, given previous work showing that those with Haitian backgrounds in the DR disproportionately experience healthcare access barriers [31] and non-adherence to ART because of lacking food [32]. ...
A pilot cluster randomized controlled trial involving two HIV clinics in the Dominican Republic assessed preliminary efficacy of an urban garden and peer nutritional counseling intervention. A total of 115 participants (52 intervention, 63 control) with moderate or severe food insecurity and sub-optimal antiretroviral therapy (ART) adherence and/or detectable viral load were assessed at baseline, 6- and 12-months. Longitudinal multivariate regression analysis controlling for socio-demographics and accounting for serial cluster correlation found that the intervention: reduced the prevalence of detectable viral load by 20 percentage points at 12 months; reduced any missed clinic appointments by 34 and 16 percentage points at 6 and 12 months; increased the probability of “perfect” ART adherence by 24 and 20 percentage points at 6 and 12 months; and decreased food insecurity at 6 and 12 months. Results are promising and warrant a larger controlled trial to establish intervention efficacy for improving HIV clinical outcomes.
Trial registry Clinical Trials Identifier: NCT03568682.
... Haitian migrants have a history of migrating to countries within Latin America and the Caribbean, such as Colombia and the Dominican Republic, where they have experienced discrimination, xenophobia, and racism. These have issues translated into social and geographical segregation, and issues regularizing their migration status, and thus Haitian migrants eventually decided to migrate to other countries such as Chile and Brazil [27][28][29]. The first wave of Haitian migrants arrived in Chile in 2015 as this country showed economic and political strength and had relatively welcoming migration policies prior to the 2018 migration reform [30,31]. ...
This paper explores the migration experiences, perceived COVID-19 impacts, and depression symptoms among Haitian migrants living in Santiago, Chile. Ninety-five participants from eight neighborhoods with a high density of Haitian migrants were recruited. Descriptive statistics, univariate analysis, and logistic regression analysis were conducted. Chi-squared tests were used to confirm univariate results. We found that 22% of participants had major depressive symptoms based on the CESD-R-20 scale, 87% reported major life changes due to COVID-19, and 78% said their migration plans had changed due to the pandemic. Factors associated with more depressive symptoms were being in debt (OR = 3.43) and experiencing discrimination (ORs: 0.60 to 6.19). Factors associated with less odds of depressive symptoms were social support (ORs: 0.06 to 0.25), change in migration plans due to COVID-19 (OR = 0.30), and planning to leave Chile (OR = 0.20). After accounting for relevant factors, planning to leave Chile is significantly predictive of fewer symptoms of depression. Haitian migrants living in Chile had a high prevalence of depression. Planning to leave Chile was a significant protector against depressive symptoms. Future studies should explore how nuanced experiences of uncertainty play out in migrants’ lives, mental well-being, and planning for their future.
... In the literature, many quantitative studies have reported associations between social factors and mental health problems in the Moroccan-Dutch population, including discrimination (Ikram et al., 2015;Wamala et al., 2007). We are aware of only one study in which qualitative methods (together with quantitative methods) were used to investigate the association between discrimination and mental health problems in Haitian migrants in the Dominican Republic (Keys et al., 2015). Haitian migrants experienced 'humiliation,' which was not recognized by Dominican citizens, and was associated with mental health problems. ...
Migrants and their offspring are at increased risk of developing mental disorders. Previous research has shown associations between adverse social factors (e.g., discrimination, lack of social support) and mental health problems in migrants, but it is unknown how these associations are understood by migrants themselves. In this study, we aimed to gain explorative insight into the way young Moroccan-Dutch people experience their social environment, and how they relate this social environment to the development of mental health problems. At www.marokko.nl , the largest online discussion platform for young Moroccan-Dutch people, contributors discuss a broad variety of subjects, including societal, cultural, religious, and mental health issues. Combining deductive and inductive approaches to qualitative data analysis, we analysed 22 forum discussions at marokko.nl about mental health problems, after which data saturation was reached. Contributors described feeling isolated and experiencing discrimination in their social environment. Contributor comments identified social challenges arising from Dutch society, Dutch culture (e.g., being too individualistic), Moroccan culture (e.g., strict parenting style), and living between these two cultures. These social challenges are perceived to be associated with mental health problems. Furthermore, we created a model describing the different types of explanations contributors used for mental health problems, being: religious (e.g., possession); medical (i.e., a bio-psycho-social cause); or a combination of both. This model can help clinicians in delivering culturally sensitive mental health care. Lastly, this study shows the taboo on mental health problems in the Moroccan-Dutch population and the opportunity to open up in the online environment.
... In migrant populations, two of the most studied types of discrimination are those based on ethnicity and race, which have been associated with poorer physical and mental health [16][17][18][19][20][21][22][23][24], low self-esteem [25,26], and reduced well-being [27][28][29][30][31][32][33]. ...
There is not much evidence on the effects of south–south migration and its consequences on physical and mental health. Our objective was to examine the mediating role of Acculturative Stress in the association between ethnic discrimination and racial discrimination with physical and mental health. This research is a non-experimental, analytical, cross-sectional study. A total of 976 adult Colombian migrants living in Chile were interviewed. We used the Everyday Discrimination Scale, the acculturative stress scale, and the Medical Outcomes Study Short Form (SF-12) for health status; we found that racial and ethnic discrimination had a negative effect on physical and mental health. In the simultaneous presence of both types of discrimination, racial discrimination was completely absorbed by ethnic discrimination, the latter becoming a total mediator of the effect of racial discrimination on mental and physical health. Our findings are consistent with the literature, which suggests that there are various types of discrimination which, individually or in their intersectionality, can have negative effects on health.
... A review of recruiting research participants from refugee backgrounds recognised such research as having particular practical and ethical challenges [49]. Participants can be difficult to identify and engage in the research process [50]. Language and cultural differences can create barriers to engagement, as can participant vulnerability and confidentiality, particularly with respect to new arrivals leading to a difficulty in reaching and recruiting these groups. ...
There is a growing body of evidence indicating poorer working conditions for migrant workers, particularly refugees, compared with native-born workers. Our objectives were to compare exposure to workplace psychosocial stressors in working refugees with other migrant groups and Australian-born workers of Caucasian ancestry and to describe the working experience of refugees. Cross-sectional surveys collected information on the workplace stressors of job complexity, control, security, bullying, and racial discrimination from six migrant groups (n = 1062) and Caucasian Australians (n = 1051); semi-structured face-to-face interviews were used with currently employed refugees (n = 30). Content analysis examined the qualitative data. Compared to all other groups, working refugees were more likely to report experiencing racial discrimination in the workplace and to report exposure to more than three hazards. Content analysis indicated that working refugees are working below their capacity, in terms of hours and qualifications, and in jobs that were low status and lacked security. Despite challenging work conditions, participants reported adequate health and safety training and feeling a sense of pride in their work. These findings highlight the need for better support for refugees in negotiating the workplace once they find employment and the importance of employers providing an inclusive and equitable workplace.
... Conflict and migration-related experiences, socioeconomic disadvantage, social marginalization, and a sense of sacrifice and sadness are critical elements for explaining this health disadvantage [12][13][14][15]. Evidence suggests that self-perceived discrimination among migrants profoundly affects their physical and psychological wellbeing in European and Asian countries [16][17][18][19][20][21]. In general, the relationship between the risk of mental illness and international migration continues to be complicated and difficult to disentangle. ...
... In England, a study reported that discrimination experiences were associated with common mental disorders; however, magnitudes varied by migration status and race/ethnicity [18]. A Dominican Republic study suggested that perceived discrimination and humiliation contributed to Haitian migrant mental ill-health [19]. In Brazil, discrimination was associated with posttraumatic stress disorder, anxiety and depression symptoms in Haitian immigrants [16]. ...
Background: The association between international migration and mental health is conditioned to several factors, and discrimination may play a significant role. Currently, Peru is one of the principal Venezuelan migrant-receiving countries in Latin America. There are around one million Venezuelan refugees and migrants in the country. This study evaluates the association between self-perceived discrimination and mental health problems in Venezuelan population living in Peru.
Method: We analyzed data from the Venezuelan Population Residing in Peru Survey 2018, a nationally representative urban sample aimed at collecting information on several dimensions of Venezuelan population wellbeing. We applied logistic regression models to assess the association between self-perceived discrimination and mental health problems. Moreover, we applied the propensity score matching method as a robustness check of our results.
Results: Of 9487 Venezuelans surveyed, 6806 included complete information. From this sample, 6.3% reported mental health problems related to fear, anger, anxiety, or stress. Logistic regression models showed that Venezuelans who perceived being discriminated against had 2.4 higher odds of presenting mental health problems than their non-discriminated counterparts. Moreover, propensity score matching models showed that Venezuelans who perceived being discriminated against increased by 3.5 percentage points their probability of presenting mental health problems compared to their non-discriminated counterparts.
Conclusions: There is evidence that self-perceived discrimination is associated with mental health deterioration in Venezuelan migrants living in Peru. Our findings are relevant in the current geopolitical context and could be useful in the decision making processes in international health.
