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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2009.12.010 Byline: William D. Lopez (a), Patrick M. Krueger (b)(c)(d), Scott T. Walters (e) Keywords: High-risk; Drug use; Aging; Life course; Sexual behaviors Abstract: High-risk injection drug use and its accompanying sexual behaviors have large social and financial costs. However, little is known about how age and age at first drug use are related to high-risk injection or sex behaviors. The current study draws on life course perspectives and data from the NIDA Cooperative Agreement to examine the relationship between eight high-risk behavior variables and age and age at first drug use. Random effects negative binomial regression models reveal that the frequency of high-risk sexual behaviors in the past month decreases up to 28% with each decade of age, although the frequency of high-risk injection behaviors in the past month increases by up to 62% with each decade of age. Both high-risk injection and high-risk sex behaviors are lower among those who initiated first drug use at later ages. Previous research has indicated the importance of interventions to reduce the high-risk sexual behaviors of older drug users. The current study suggests a refocusing of public health efforts on their high-risk injection habits. Author Affiliation: (a) University of Michigan, Research Center for Group Dynamics, Institute for Social Research, 6120 ISR, 426 Thompson Street, Ann Arbor, MI 48104, United States (b) University of Colorado Denver and Health Sciences Center, 1380 Lawrence Street, Denver, CO 80217, United States (c) University of Colorado Population Program, Institute of Behavioral Science Bldg 3, University of Colorado at Boulder, 484 UCB, Boulder, CO 80309-0484, United States (d) University of Pennsylvania, Leonard Davis Institute of Health Economics, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104, United States (e) University of Texas School of Public Health, Dallas Regional Campus, 5323 Harry Hines Blvd., Dallas, Texas 75390-9128, United States

Social scientists are increasingly interested in the detrimental health impacts of immigration enforcement, including surveillance, arrest, detention, and deportation. In most empirical research—as well as the legal process itself—the family or household serves as the social unit for understanding ripple effects of immigration enforcement beyond the individual. While the mixed-status family analytic framework foregrounds the experiences of millions of individuals and valuably extended immigration scholarship to move beyond its heavy focus on individual behavioral choices, we argue that a continued reliance on the family as an analytic framework reproduces normative conceptualizations of kinship and care, obscures how the process of illegality is mediated by empire, racism, and (hetero)sexism, and risks reproducing narratives about the "deserving" immigrant. We propose the mixed-status community as an analytic framework to better understand the detrimental health impacts of immigration enforcement by accounting for the synergistic influence of 1) a fuller range of social and intimate relationships; 2) spatial arrangements of risk; 3) presumptions of immigration status; and 4) racialization of immigration law and enforcement practices. We draw on a case study of an immigration raid as well as contemporary examples to illustrate the added value of this analytic framework. • The frame of "mixed-status community" may better explain how deportation harms health. • Immigration enforcement harms health across a range of relationships. • Community members avoid public spaces and places when they fear arrest. • Immigration enforcement is rooted in racial profiling. [ABSTRACT FROM AUTHOR]

Background The prevalence of posttraumatic stress disorder (PTSD) in the United States is higher among pregnant women than women generally. PTSD is related to adverse birth outcomes via physiological and behavioral alterations, such as smoking. Methods We utilize salivary cortisol measures to examine how traumatic stress, smoking and the hypothalamic-pituitary-adrenal axis interact. Pregnant women (n=395) gave cortisol specimens as part of a cohort study of PTSD and pregnancy at three health systems in the Midwestern United States. Women were divided into three groups: nonsmokers, quitters (who stopped smoking during pregnancy), and pregnancy smokers. Mean cortisol values at three points, sociodemographics, trauma history, and PTSD were compared across groups. We assessed the association of smoking group and PTSD with late afternoon cortisol levels. Results Smokers, quitters, and nonsmokers differed on demographic risk factors and PTSD symptom load. Late afternoon and bedtime cortisol measures were significantly positively correlated with smoking in pregnancy, with smokers with PTSD presenting the highest cortisol levels. Regression analysis showed that smoking in pregnancy was associated with higher late afternoon cortisol in an additive manner with PTSD symptoms. Conclusions Smoking appears to have a different relationship with cortisol level for those with and without PTSD. This is the first study to show additive effects of smoking and PTSD on cortisol levels in pregnant women. Since high cortisol, smoking, and PTSD have been shown to adversely affect perinatal outcomes, and since those continuing to smoke in pregnancy had the highest PTSD symptom load, PTSD-specific smoking cessation programs in maternity settings are warranted. [ABSTRACT FROM AUTHOR]

Abstract: Intersectionality is a term used to describe the intersecting effects of race, class, gender, and other marginalizing characteristics that contribute to social identity and affect health. Adverse health effects are thought to occur via social processes including discrimination and structural inequalities (i.e., reduced opportunities for education and income). Although intersectionality has been well-described conceptually, approaches to modeling it in quantitative studies of health outcomes are still emerging. Strategies to date have focused on modeling demographic characteristics as proxies for structural inequality. Our objective was to extend these methodological efforts by modeling intersectionality across three levels: structural, contextual, and interpersonal, consistent with a social–ecological framework. We conducted a secondary analysis of a database that included two components of a widely used survey instrument, the Everyday Discrimination Scale. We operationalized a meso- or interpersonal-level of intersectionality using two variables, the frequency score of discrimination experiences and the sum of characteristics listed as reasons for these (i.e., the person''s race, ethnicity, gender, sexual orientation, nationality, religion, disability or pregnancy status, or physical appearance). We controlled for two structural inequality factors (low education, poverty) and three contextual factors (high crime neighborhood, racial minority status, and trauma exposures). The outcome variables we modeled were posttraumatic stress disorder symptoms and a quality of life index score. We used data from 619 women who completed the Everyday Discrimination Scale for a perinatal study in the U.S. state of Michigan. Statistical results indicated that the two interpersonal-level variables (i.e., number of marginalized identities, frequency of discrimination) explained 15% of variance in posttraumatic stress symptoms and 13% of variance in quality of life scores, improving the predictive value of the models over those using structural inequality and contextual factors alone. This study''s results point to instrument development ideas to improve the statistical modeling of intersectionality in health and social science research. [Copyright &y& Elsevier]

Social support is a key determinant of physical and mental health outcomes. Implementation of restrictive immigration policies in the U.S. under the Trump administration impacted the way mixed-status Latino families (i.e., those with varying legal statuses, including undocumented) maintained social relationships and provided social support. This paper examines how federal immigration policies introduced after the 2016 U.S. presidential election impacted social networks and support related to health for undocumented and mixed-status Latino families. We interviewed 23 clients and 28 service providers at two Federally Qualified Health Centers and one non-profit organization in Southeast Michigan. The interviews were audio-recorded, transcribed, and analyzed thematically. Policies introduced during the Trump administration increased opportunities for deportation and contributed to the isolation of mixed-status Latino families by transforming safe spaces of social interaction into prime locations for immigration enforcement activity. Despite the limitations created by these restrictive policies, mixed-status families employed alternative mechanisms to maintain access to vital informal and formal support systems while simultaneously navigating emerging immigration-related threats. Elections have health consequences and immigration policies are needed that promote the health and well-being of Latino immigrant communities. • Introduction of "zero-tolerance" policies are fragmenting Latino social networks. • Mixed-status Latino families experienced increased isolation after 2016 elections. • Increased fear of deportation and separation impacted Latino mental health. • Mixed-status Latino families are mobilizing and responding to emerging needs. • Service providers are a source of social support for mixed-status Latino Families. [ABSTRACT FROM AUTHOR]