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      Deferred depression? Mediation analysis of Deferred Action for Childhood Arrivals and immigration enforcement among Undocumented Asian and Pacific Islander students


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          Undocumented Asians and Pacific Islanders (UndocuAPI) comprise 25% of undocumented students. Yet few studies have examined UndocuAPI mental health in the context of the contradictory political environment which encompasses both inclusionary policies, such as Deferred Action for Childhood Arrivals (DACA), and exclusionary policies, like immigration enforcement.


          Using cross-sectional survey data collected in 2019 from UndocuAPI college students and recent alumni in California (n = 174), we used multiple logistic regression to estimate the effect of DACA status on clinical levels of depressive symptoms. We tested whether immigration enforcement experiences mediated this relationship using the Karlson, Holm, and Breen (KHB) method.


          Adjusted logistic regression results revealed that UndocuAPI with DACA had significantly lower odds of depression (OR = 0.32, 95% CI: 0.13–0.79). Out of five immigration enforcement factors, limited contact with friends and family (OR = 2.36, 95% CI: 1.08, 5.13) and fearing deportation most or all of the time (OR = 3.62, 95% CI: 1.15, 11.34) were associated with significantly higher odds of depression. However, we did not detect a statistically significant mediation effect of immigration enforcement using KHB decomposition.


          Findings suggest that the benefits of DACA protected UndocuAPI in California from depressive symptoms, even when accounting for immigration enforcement experiences. Because it was unclear whether immigration enforcement mediates DACA, future research should investigate the underlying mechanisms between immigration policies and mental health with larger samples. Practitioners should consider the short-term need for mental health support and legal services for UndocuAPI students as well as the long-term goal to decriminalize immigrant communities to advance racial health equity.


          • Undocumented Asians and Pacific Islanders with DACA had lower odds of depression.

          • Even in California, UndocuAPI college students experience immigration enforcement.

          • Less fear of deportation was significantly associated with self-reported DACA status.

          • An indirect effect of DACA on depression via immigration enforcement was not detected.

          • History of US immigration policies contextualizes modern forms of structural racism.

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          Most cited references64

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          Reconsidering Baron and Kenny: Myths and Truths about Mediation Analysis

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            STRUCTURAL RACISM AND HEALTH INEQUITIES: Old Issues, New Directions.

            Racial minorities bear a disproportionate burden of morbidity and mortality. These inequities might be explained by racism, given the fact that racism has restricted the lives of racial minorities and immigrants throughout history. Recent studies have documented that individuals who report experiencing racism have greater rates of illnesses. While this body of research has been invaluable in advancing knowledge on health inequities, it still locates the experiences of racism at the individual level. Yet, the health of social groups is likely most strongly affected by structural, rather than individual, phenomena. The structural forms of racism and their relationship to health inequities remain under-studied. This article reviews several ways of conceptualizing structural racism, with a focus on social segregation, immigration policy, and intergenerational effects. Studies of disparities should more seriously consider the multiple dimensions of structural racism as fundamental causes of health disparities.
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              Screening for Depression in Well Older Adults: Evaluation of a Short Form of the CES-D


                Author and article information

                SSM Popul Health
                SSM Popul Health
                SSM - Population Health
                18 December 2021
                March 2022
                18 December 2021
                : 17
                [1]Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
                Author notes
                []Corresponding author. emanalo@ 123456ucla.edu
                S2352-8273(21)00283-4 101008
                © 2021 Published by Elsevier Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).


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