Addressing Differential Impacts of Covid-19 in NYS: Towards a Framework for Addressing Immigrants’ Social Determinants of Health

Abstract

This study seeks to adapt and validate the National Institute of Minority Health Disparities Research Framework to immigrant communities who are culturally and linguistically diverse, defined in this study as foreign-born individuals who are Limited English Proficient. The Immigrant Social Determinants (ISD) Framework depicts the multidimensional, multilevel, intersectional, and complex factors that shape health outcomes across the lifespan. The framework for addressing health disparities posits that health outcomes are shaped by the interplay between determinants related to the (a) behavioral; (b) biological; (c) political and socio-cultural; (d) physical built environment, and (e) 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 immigrant 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, and then we validate the framework using the perspectives of health and social service providers who serve immigrant individuals and their communities. Data are gathered using (a) a survey of healthcare professionals; and (b) focus groups of healthcare, social service providers, and community leaders. Following the validation of the framework, we 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 culturally and linguistically diverse immigrant communities. Policy and practice recommendations will specify interventions at the moderators and mediators’ levels that can bring about positive health outcomes for immigrant individuals.