Episode 23 – How do migration related stresses influence Latinx substance use and abuse?

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Episode 23. How do migration related stresses influence Latinex substance use and abuse? I’m your host? Carmen Chavez as part of our series, featuring researchers affiliated with the Latino research Institute. Our guest today is Dr. Miguel Pinedo and assistant professor in the department of kinesiology and health education, and an affiliate with the Latino research Institute here at the university of Texas at Austin.

His work investigates, how social and structural level factors associated with migration to the U S relate to the epidemiology of substance abuse, HIV risk and related harms in a recent research paper published in the international journal of drug policy. Dr. Benito investigates, how the deportation of others influences the substance use of us citizen Latinos.

He concludes that the detentions and deportations of others may in fact influence how us citizen Latinos use and abuse substances. A very interesting finding indeed, such a finding has important implications for both public health and policy. And I’m excited to get into that today. So, Dr. Pinedo welcome to, uh, Latin X.

Okay. So, you know, a couple of weeks ago on this show, we had Dr. Karma Valdez. So I think is one of your collaborators. Yeah. Okay. And we were discussing some of her work related to mixed status, immigration status families, which makes it clear, of course, that what happens to immigrants would impact the citizens in their lives.

If that’s kind of an obvious point in one arena, why is it that before your work? No one has studied how something like deportation might influence you a citizen Latinos substance use. So I would say that the health implications of deportations are, have been understudied for the last couple of years.

And now. We’ve been doing a lot of work in terms of what are the impacts of deportations on health. And there’s been a focus on mental health because that seems to be kind of an obvious health outcome because this deep, the deportation of a family member is very disruptive. It’s a very traumatic experience.

And so my work has been looking more so at extending that work in terms of mental health, from the ability in substance use, That, that makes a lot of sense. And I guess I just never really thought about kind of the, the, the different ways to look at this and that did a porch deportation. Actually. Wasn’t something that was considered so much in this arena.

Um, want to move in a little bit into the, the study itself. So you, you apply what you call a migration as a social determinant of health as your analytic. And so I want, I wonder, first of all, you can explain to us. This analytic offers. And then also tell us why it’s appropriate in a study investigating the behavior of us citizens who were born in the U S so when we studied Latino populations, migrant health has received a lot of focus.

Um, and in the last couple of years that have been this shift or this highlight of looking at our migration as a social determinants of health. And so we know that, um, migrants migrate for. For various reasons in terms of economic labor, um, fleeing, uh, dangerous situations and so forth, but in the United States, um, we can look at that as a social determinants of health because that experience.

Their health and their health behaviors are largely shaped by the migraine experience. So in terms of, for instance, policies, dictate access to resources, so access to, uh, social institutions, to health, healthcare services, transportation, to housing, to education, and all these, these, uh, policies that are at the federal state and local level have an influence on people’s.

Um, and so migrants, health behaviors are largely products of their migrant experiences. And so my work also extends this by highlighting that migration is also an important component in migration related factors is, is important. And when, among us born and us citizen Latinos, because with migrate with my community, That, that, that makes a lot of sense.

And it just wasn’t something that right away, it made sense. And it does now. So I really appreciate you taking the time to explain that. So getting in a little bit then to the studies design, will you just tell us how you designed this? Yeah. So this was, um, this was a collaboration with some colleagues of mine at the university of New Mexico, actually.

And so they were getting ready to, to implement a national study focused on diverse topics and they were going to ask and part of that study on deportations. Um, if you, if people was personally deported, um, and who, who was that? The social relationship with that. Um, and so what we did is we, I added questions on specifically on mental health, uh, alcohol and drug use too, so that we can better understand these health outcomes, but then within this context.

And so we used. They’re called web panel. So these are web panels are comprised of people who have already agreed to participate in survey research. So they get a higher and higher response rate. Um, and they also try to, so they’re targeted. So we try to create panels that are nationally representative of actual population.

Um, and so we did that and then collected data. Um, and we recruited over a sample of about 30, 32. Hundred participants of black and white and Latino descent. And one question I did have about your studies design, given that a division between black, white and Latino was, uh, there any representation of, uh, Afro-Latinos in the study.

Uh, I would have to go back and check, but I believe we only asked, um, if you self identified as Latino and w where are you given the option to select more than one, or was it discreet? No, it was discrete in that way. Yeah. Okay. Okay. I was just, just interested in that. Um, and so what did you expect to find in your study and then how does that compare with what you actually found?

Uh, well, my hypothesis was that, um, people that have close relationships with, with, uh, immigrants who have been detained or deported would report worse substance use outcomes. Um, and that kinda, you know, when I present this work, when I presented people kind of always go, you know, well, yeah, that makes sense.

Right? Because they experienced this traumatic experience, but there were some surprising findings that weren’t totally expected. So when we saw that, Saw was that if we stratified the sample. So there was a significant proportion. We over-sampled Latinos purposely. Um, so we can have a proportion of Latinos who reported that they didn’t know anyone who had been deported or detained.

And then that allowed us to do, um, comparisons by desegregating those, those two groups. And so what we found was that. Among Latinos who reported that they don’t know anyone who has been detained or deported their substance use behaviors didn’t differ from black and white white participants. So they were, the findings were not statistically significant.

Um, and so they were relatively the same. So we didn’t see any differences or any. Where we saw the differences was among the subgroup of Latinos who personally knew someone who has, who was deported. So that was a very unique and interesting. So there’s something about the relationship between. Knowing someone that’s been deported, I may be causing additional stressors that then influence risk to Automobility to substance use

And will you talk a little bit about the different kinds of quote unquote knowing of someone who’s been deported? So, uh, the, the differences between say it’s just someone in your community versus someone you consider a friend versus say someone you consider a family member. Yeah. Yeah. So we always, we were also interesting, interested in knowing.

The relationship, uh, the social relationships and how they differ. So we hypothesized naturally that having someone in your family, having a family member would be, um, what increased the risk to substance use, given that those are, uh, tend to be close-knit relationships. But from the study, we also found that it was, it’s not just having, um, a family member, but even having a close friend or even someone in your community or a coworker.

Um, that also increases your risk to substance use. So it extends beyond just your, your immediate family members, which is, which was quite a remarkable finding as well. And forgive me for this next question, because I am a humanity scholar and I did take a quantitative class close to 20 years ago. So forgive me for my ignorance on this.

But one of the questions that I had on, on this was how. Is it that we’re making meaning about this correlation between a substance use and knowing someone who’s been deported? What were the other factors that you considered and sort of, um, decided weren’t necessarily as significant as the relationship between these two.

Um, so you’re talking about other other factors that we control. That’s probably the word I’m looking for. Yeah. Yeah. So we controlled for a diversity of other of other, um, uh, variables basically. So we looked at. Um, and biological sex at age marital status also, um, if you were us form versus naturalized, um, your education employment stat is household income and then also psychologic psychological distress because clearly it, uh, mental health status is associated with substance use.

And then we also, um, uh, Controlled for where people were, what state people lived in, because there are differences in terms of anti-immigration policies or these anti-immigration environments. We call them sometimes for instance, living in California, which is one of the most inclusive states for immigrants is very different from Arizona, which is considered a very punitive, has a very punitive, um, immigration policy.

So we took all of that into account. And so that’s what makes this finding so significant is that there’s not a ready explanation outside of this. There, this is maybe not causal, but it’s just strongly related. Is that fair to say? Exactly. Exactly. Okay. I think it’s really clear in hearing you discuss this article, which by the way, I really enjoyed reading.

Um, even as I don’t understand tables and stuff very well, again, humanities. Um, but, uh, one of the things that I also thought was interesting that I wanted to give you a chance to talk a little bit about. The definitions that we’re using here of substance use substance misuse, because I was actually surprised at what those definitions were for substance misuse, um, within the study.

And I think, uh, some listeners may also be surprised about that as well. So would you be willing to talk a little bit about what those definitions are? What counts as some sort of, uh, potentially problematic, uh, relationship to seven. Yeah, you handled the terminology. So now I’m trying to, we tend to, so the DSM-V was updated too.

And before we used to measure substance use by either abuse or dependence or alcohol abuse, alcohol dependence, and now it’s just one continuous definition. We use alcohol use disorder. And so the way that we distinguish, um, misuse is. We also recognize that people use substances and don’t have a disorder per se.

Um, so you can, do you think this drugs recreationally and not necessarily have a substance use disorder? And so when we do analysis, we will talk about, uh, misuse, we’re talking about, uh, thresh pool that, um, would characterize, um, which would be directly impacting your health. So we know for instance, Um, hazardous drinking is, is considered having four, four more drinks on, in a weekday for women in five or more drinks, um, format.

And in a week, then the reason that’s hazardous is because of the potential, uh, physical health effects or mental health effects or, or both. Uh, both but also physical, right? So for instance, within the Latino population, we have, um, disproportionate impacts in terms of kidney and liver disease. And so hazardous drinking would be contributing to, to those outcomes.

So then this, this leads me to something I want us to spend some time talking about, which really are the public health and policy takeaways, uh, and, and who, who might really, I mean, obviously, uh, people who might be engaging in. These practices, uh, of hazardous drinking are one group who could take a lot from this study, but thinking about a public health policy, what are the biggest takeaways, um, for, you know, all sorts of practitioners or policies.

Yeah. Yeah. So I’ll start with, uh, the policy level. So one, one thing that this is highlighting is that, uh, you know, deportations in new tensions have exponentially increased. They’ve been increasing since the early two thousands. Um, in 2012, we had the record number of more than 408,000 migrants were deported from the U S and that’s more than any time.

The history of that you asked, um, they’ve decreased a little bit, I’ll put a still significant try and increasing. And so part of the study or the pub, uh, the public, the public policy implications of this is that there’s also a spillover effect, right? So we’re seeing that it’s not just impacting, uh, when someone is the impact is felt that the community level and extends to us citizens.

Um, not necessarily just the immigrant individual who’s being deported. In a sense causing harm, um, to, to us citizens. The other point is that deeper. A lot of times we see that, um, migrants were deported for very innocuous reasons. So traffic violations, driving, you know, running a red light, getting a traffic traffic ticket, um, and some other, you know, The common narrative of white people is a deport is a shift on criminal migrants.

Um, and most of the times we see that the reasons why people are deported are not necessarily doing any harm to society. And so this is also highlighted that we need to take into account what the impact of the deportation. Is going to have at the, for the health of us citizens or the health of Latinos in general.

Um, and sometimes deporting someone may cause more harm than benefit society. And then four, go ahead. No, go ahead. I’ll let you go then I’ll ask, well, let’s talk about the clinical implications. And so for substance use, uh, in terms of prevention and clinical settings, um, for instance, we’ve found that. Um, Clint, when commissions take into account, when working with minority or vulnerable populations, when they take into account social context, uh, That interventions are more, more produced, more, better outcomes.

So for instance, if you do an intervention, that’s focused on preventing, uh, heavy drinking or reducing heavy drinking interventions are more effective. When we talk about experiences of discrimination, um, immigrant experiences and cultural, for instance factors. And so this is also highlighting. We need to include deportations and detentions as part of, uh, interventions that are, that are focused on Latino populations.

And is there support for such interventions or such approaches? I mean, is this something, uh, that there’s capacity to actually get. Yeah, and I’m actually currently working. So this, this part of this work is uneasiness scientific rationale to, to do a clinical of clinical trial. Um, looking at adapting, a motivational interviewing, um, intervention that takes into account deportation related factors.

So that’s a project that you’re planning to roll out, um, shortly. Is that, is that. Yeah. Um, I’m currently working on the grant. Uh, it’s been well received by the NIH, but COVID has introduced many barriers. Um, so it’s been on delayed, it’s been paused. Um, and that has to do in terms of, you know, it requires some sort of human interaction.

Yeah, that makes sense. I wanted to return, um, just briefly to what you had said about deportation and, uh, the kind of focus on, on that in I’m wondering if you think that. The fact that your study suggests that deportation, uh, is bad, not just for immigrants, which most people would, would agree with, but that it’s bad for us citizens.

Do you think that that is potentially a message that, uh, might be heard by politicians that otherwise wouldn’t be. Yeah, thank you for the question. And actually that’s, uh, that’s why I’ve been focusing more on us citizen and us born Latinos currently. Uh, because as we know historically, um, anti-immigration policies or immigration control policies that have been designed to be punitive, um, and even policies that restrict access to immigrants, um, Access to schooling, to education, to health goals, healthcare services, uh, Also create harm, right?

And so for politicians, if the story or the narrative that’s being presented is these immigration, anti immigration policies, including deportations of the attentions are causing harm for immigrant communities. It kind of becomes, you know, like duh, that’s what they were designed to do. And so I’ve been trying to kind of shift that focus to, to say, They’re also impacting us citizens who have heard, should have seen protections under the law, including their health.

And then these, these immigration policies are causing harm to us, immigrate to us citizens, then reform. Maybe that message will be heard, uh, louder. Um, and.

Yeah, absolutely. Miguel, is there anything else that you want to say about this work that I haven’t asked you about, that you were just hoping to convey to the. Um, yeah, the, I would say that this work, um, so this, this study is focused just on deportations. Um, but we’ve also done a lot of quality. We’ve done, uh, qualitative studies that, that suggests that.

Um, that it’s not just deportation so that our, that increased ability to poor mental health and substance use, but others, other immigration related factors in terms of worrying about family members being detained or deported, um, experiences of anti-immigration mental though, you’re not, this is among us born.

So. Being being told to go back to your country, for instance, um, a lot of fear of being detained, detained, or questioned relation status, even though you’re a us born citizen is also do some stress. Um, and there’s also, what’s interesting is that in that qualitative work, us citizens or us humans also mentioned that they fear being detained, detained, or deported, even though they’re legally protected from deportations.

And there hasn’t been cases. Uh, us Lauren and us citizen, or they’re being detained. And in some cases, uh, we’re actually been to afford it. And there’s been lawsuits, um, on. And so in one sense, then that might suggest based on the point where you made earlier, that may be the fact that us citizens are being impacted would be more persuasive to politicians.

But then we also see these instances where us citizens, but who happened to be Latino, uh, are treated as if they don’t belong as well. Which is I suppose, the ultimate, uh, conundrum, uh, for us in our community. Yeah, exactly. So, yeah, so we know that, um, immigration practices. Or a highly racialized and, and rooted in racism and racial profiling.

Yeah. Well, you know, I would love to continue this conversation, but I think we’re at the end of our time. And so, uh, I wanted to thank you so much for being here today, doctor. Yeah, thank you for having me. This was a very insightful, yeah, so this is a lot of fun. Again, our guest today was Dr. Miguel Pinedo assistant professor in the department of kinesiology and health education, and an affiliate with the LRI.

I’m your host Carmichael. And this has been Latin experts. Hi, this is Ashley. the communications associate Ella Fino studies. Thank you for listening to this week’s episode, make sure to check out the Latino studies, Instagram page. Follow us at Athena studies UTI to keep the conversation going.