Towards a Framework for Addressing Immigrants’ Social Determinants of Health

Presenter Information

Dina Refki, University at Albany, State University of New YorkFollow
Rukhsana Ahmed, University at Albany, State University of New YorkFollow
Jeanette Altaribba, University at Albany, State University of New YorkFollow
Andrea Shaw, SUNY Upstate Medical UniversityFollow

Start Date

28-6-2021 10:55 AM

End Date

28-6-2021 11:40 AM

Topic

Systematic Inequities or Institutional Discrimination

Session Chair

Tomoko Udo

Abstract

Towards a Framework for Addressing Social Determinants of Health Affecting Culturally and Linguistically Diverse (CLAD) Communities Refki, D., Ahmed, R., and Altarriba, J. This study seeks to adapt and validate the National Institute of Minority Health Disparities Research Framework to Culturally and Linguistically Diverse (CALD) communities, defined in this study as foreign-born individuals who are Limited English Proficient. The framework depicts the multidimensional, multilevel, intersectional, and complex factors that shape health outcomes across the lifespan. The framework for addressing minority health disparities posits that health outcomes are shaped by the interplay between determinants related to the (a) behavioral and biological; (b) political and socio-cultural; (c) physical built environment, and (d) healthcare system forces. These determinants operate at four levels of influence: individual, interpersonal, community, and societal. Adaptation and validation of the Framework will deepen understanding of the interplay of these forces in the lives of members of CALD communities, illuminate levers of change, inform the development and implementation of effective interventions, and track progress and success in alleviating disparities. In this study, we adapt the Framework based on a systematic review of literature, then we validate the Framework using the perspectives of health and social service providers who serve CALD individuals and their communities. Data are gathered using (a) survey of healthcare professionals; and (b) focus groups of healthcare and social service providers and community leaders. Following the complete validation of the framework, we will provide recommendations for policy and practice. Validating the framework through the prism of healthcare professionals’ perspectives leverages a moment in time during a global pandemic that exposed vulnerabilities at all levels of influence and domains and that allows us to capture the determinants of health affecting CALD communities. Policy and practice recommendations will specify interventions at the moderators and mediators’ levels that can bring about positive health outcomes.

Author Bio

(Presenter)

Dina Refki is Clinical Associate Professor and Executive Director of the Center for Women in Government & Civil Society, Rockefeller College of Public Affairs & Policy, University at Albany, State University of New York. Refki's research tackles the impact of gender and its intersections with race, ethnicity, class, and nativity status. Her work focuses on the barriers facing immigrant women and their families, and the structural changes needed, to better respond to their needs. She directs the Immigrant Integration Index, a multiyear effort which measures the inclusion of foreign-born New Yorkers in their communities.

My primary research interests lie at the intersections of health, organizational, interpersonal, and intercultural communication. In particular, my research embraces the cross/trans/inter-disciplinary nature of communication scholarship, with specific focus on exploring the role of communication processes in improving health outcomes among marginalized communities and promoting broader organizational and social changes and innovations in local, national, and international health contexts. I study the interaction of people involved in the health care process and the dissemination and interpretation of health-related messages by individuals, groups, organizations, and/or mass media and technology. I pay attention to how these messages are mediated through various socio-cultural, political, and economic factors. My research agenda is often shaped by questions such as: How do organizational, interpersonal, intercultural, mass mediated, and technological factors shape people’s perceptions of and experiences with health, illness, and health care? How do health and illness experiences, as both physiological and social constructs, vary across race, ethnicity, culture, gender, social class groups, and religion? Using surveys (both face-to-face and online), in-depth interviews, and focus group discussions, in these explorations and examinations, I have used cultural competence models, communication accommodation theory, relational dialectics, ecological perspective, social capital theory, and uses and gratifications theory, among others.

Dr. Jeanette Altarriba is a Cognitive Psychologist with a program of research that focuses on bilingualism, cognition, language, memory, multiculturalism and mental health, and emotion. Her MA and PHD degrees were earned at Vanderbilt University, Nashville, Tennessee, and she spent two years as a Postdoctoral Research Fellow at the University of Massachusetts, Amherst. She founded and directs a vibrant research Laboratory—The Cognition and Language Laboratory—that includes undergraduate, graduate, and postdoctoral collaborators both local and abroad. Professor Altarriba has spent several decades understanding the ways in which bilingual speakers store concepts, words, and phrases in memory and how those items are distinct depending on the language in which they are coded. Bilingualism plays an important role in the processing of emotional language as well, with the native language often playing a larger role in the expression of emotion, as compared to a second language or one learned later in life. Dr. Altarriba has also investigated the ways in which new and experienced bilinguals respond to emotional stimuli in eye-tracking, priming, Stroop and a variety of other paradigms. She has been exploring both basic and applied research perspectives the area of healthcare and health disparities in LEP (Limited English Proficient) populations focusing on the roles of language and culture in messaging and communicating with these populations. Her research has had an impact in applied areas such as healthcare practice and the interviewing of bilingual and multilingual speakers. She has published over 80 peer-reviewed research articles in journals such as Professional Psychology: Research and Practice, Memory & Cognition, and Current Directions in Psychological Science and has given many presentations and plenary addresses locally, nationally, and internationally. She is editor or co-editor of eight volumes of research published by presses including Cambridge University Press, Springer Science, and Routledge. She is now Professor of Psychology and Dean of the College of Arts and Sciences at the University at Albany, State University of New York.

Andrea Shaw, MD. from Syracuse, NY. Completed Undergraduate Bachelors of Science from Cornell University, Medical Degree from Upstate in 2009, and combined Internal Medicine & Pediatric Training at Duke University in 2013. She worked at UCLA in primary care for a few years before returning to Syracuse to work in refugee medicine. She has over a decade of experience engaging in Global Health work in East Africa. In her current role at Upstate, she directs primary care services for refugee families at Upstate and works with the global health site in Kisumu, Kenya for the Institute for Global Health and Translational Sciences.

Document Type

Extended Abstract

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