Goleen Samari

Islamophobia and Public Health in the United States

Anti-Muslim sentiments are increasingly common globally and in the United States. The recent rise in Islamophobia calls for a public health perspective that considers the stigmatized identity of Muslim Americans and health implications of Islamophobic discrimination. Drawing on a stigma, discrimination, and health framework, I expand the dialogue on the rise of Islamophobia to a discussion of how Islamophobia affects the health of Muslim Americans. Islamophobia can negatively influence health by disrupting several systems-individual (stress reactivity and identity concealment), interpersonal (social relationships and socialization processes), and structural (institutional policies and media coverage). Islamophobia deserves attention as a source of negative health outcomes and health disparities. Future public health research should explore the multilevel and multidimensional pathways between Islamophobia and population health.

Cross-border ties and Arab American mental health.

Due to increasing discrimination and marginalization, Arab Americans are at a greater risk for mental health disorders. Social networks that include ties to the country of origin could help promote mental well-being in the face of discrimination. The role of countries of origin in immigrant mental health receives little attention compared to adjustment in destination contexts. This study addresses this gap by analyzing the relationship between nativity, cross-border ties, and psychological distress and happiness for Arab Americans living in the greater Detroit Metropolitan Area (N = 896). I expect that first generation Arab Americans will have more psychological distress compared to one and half, second, and third generations, and Arab Americans with more cross-border ties will have less psychological distress and more happiness. Data come from the 2003 Detroit Arab American Study, which includes measures of nativity, cross-border ties--attitudes, social ties, media consumption, and community organizations, and the Kessler-10 scale of psychological distress and self-reported happiness. Ordered logistic regression analyses suggest that psychological distress and happiness do not vary much by nativity alone. However, cross-border ties have both adverse and protective effects on psychological distress and happiness. For all generations of Arab Americans, cross-border attitudes and social ties are associated with greater odds of psychological distress and for first generation Arab Americans, media consumption is associated with greater odds of unhappiness. In contrast, for all generations, involvement in cross-border community organizations is associated with less psychological distress and for the third generation, positive cross-border attitudes are associated with higher odds of happiness. These findings show the complex relationship between cross-border ties and psychological distress and happiness for different generations of Arab Americans.

Syrian Refugee Women's Health in Lebanon, Turkey, and Jordan and Recommendations for Improved Practice

Since 2011, an estimated nine million Syrian refugees have fled to neighboring countries, and over four million have fled to neighboring countries of Lebanon, Turkey, and Jordan. Seventy five percent of Syrian refugees are women and children. In times of conflict, womens health disproportionately suffers. Based on an assessment of academic literature and international policy and development reports, this study explores the vulnerabilities of Syrian women and girls in Lebanon, Turkey, and Jordan, and how these countries approach Syrian refugee womens health care. In all settings, sexual and gender-based violence, reduced use of modern contraceptives, menstrual irregularity, unplanned pregnancies, preterm birth, and infant morbidity are ongoing issues. Recommendations for improved practice include taking a multilevel approach to eliminate social and service delivery barriers that prevent access to care, conducting thorough needs assessments, and creating policy and programmatic solutions that establish long term care for Syrian refugee women.

The 2009 Lebanese National Mammography Campaign: Results and Assessment Using a Survey Design

Background: Breast cancer screening and early detection lead to better prognosis, survival rates and quality of life. The Lebanese Ministry of Public Health (MoPH) organizes yearly national-subsidized mammography campaigns in October, since 2002. This paper describes the characteristics of women attending the 2009 MoPH mammography campaign and explores factors influencing their first-time participation. Materials and Methods: Data from 83 mammography centers on 10,953 women (gathered during October- December 2009) were analyzed. The data were collected by the radiology technicians at the centers, using a closedended questionnaire. Data management and analysis was done using SPSS. Analysis included descriptive, bi-variate statistics and backward logistic regression. Results: The mean age of women attending the campaign was 49 (SD 9.67) years. 84.1% of the women were married, 13.6% had some form of university education, and 40.7% were current smokers. 82.9% indicated to have ever breast fed, and 36.9% were current or ever users of OCP. As for family history, 8.9% indicated to have an aunt on the mother’s side with breast cancer, 8.8% have a sister, 7.5% an aunt on the father’s side, and 7.3% have a mother. 68.2% of the women participated in the campaign for the first time. 97.8% indicated they would repeat the exam next year. 88.8% considered the price acceptable. 51.6% had normal diagnosis. Television messages and a friend were the two most common routes via which the woman heard of the campaign. Women who participated in the campaign before compared to those participating for the first time: were more likely to be independently-significantly: older, of higher educational levels, non-smokers, and with a family history of breast cancer. Conclusion: Such an assessment is important in order to enhance outreach as well as identify factors that could contribute to better service delivery, capacity and quality.

Women’s empowerment and short- and long-acting contraceptive method use in Egypt

Abstract Egypt is ranked one of the most gender unequal countries, and fertility is at a two-decade high of 3.5 births per woman. Women’s empowerment is a strategy used to promote contraceptive use and lower fertility, yet evidence from the Middle East is limited. This study uses 2005, 2008 and 2014 Egyptian Demographic and Health Survey data to examine recent patterns of contraceptive method choice and how women’s empowerment is associated with contraceptive method type: none, short-acting or long-acting reversible contraceptive (LARC) methods. Using a nationally representative sample of 47,545 married women in their childbearing years, multinomial logistic regression models examine women’s agency, specifically household decision-making and attitudes towards intimate partner violence and contraceptive method type. In 2014, LARC use significantly declined and short-acting method use was higher than in 2008. Women who made household decisions and were less accepting of intimate partner violence were more likely to use LARC (vs. no method). Women who made more joint decisions with spouses were more likely to use LARC (vs. no method) compared to those making individual decisions. Findings have implications for family planning programmes, and efforts involving men to increase household gender equality and lower the acceptance of intimate partner violence may promote LARC use in Egypt.

Parental Gender Expectations by Socioeconomic Status and Nativity: Implications for Contraceptive Use

Parental gender expectations, which may be egalitarian or not, could vary by nativity and socioeconomic status. Parental gender expectations provide a model for children’s gender role attitudes and could also have effects on reproductive health over the life course, including women’s contraceptive choices. Yet, parental gender expectations are not often studied quantitatively. Using the National Longitudinal Study of Adolescent to Adult Health, we examine how parental gender expectations in the United States vary by immigrant generation and socioeconomic status, whether parental gender expectations in adolescence are associated with young women’s contraceptive use, and if nativity moderates that relationship. Results show that parental gender expectations vary significantly by immigrant generation and parental socioeconomic status. Both first and second generation women are significantly less likely to have lived in households with equal gender expectations compared to the third generation. Higher socioeconomic status is associated with equal gender expectations. Among participants from households with equal gender expectations, the second generation is more likely than the third generation is to use a male-controlled contraceptive method versus no method. Using a nationally representative sample, our study demonstrates that parental gender expectations vary by nativity and by the socioeconomic context of the family in which they are embedded as well as have a unique effect on the contraceptive behavior of second generation women.

Socioeconomic Status and the Physical and Mental Health of Arab and Chaldean Americans in Michigan

Research that explains health of Arab and Chaldean Americans relative to the health of non-Arab White Americans is limited but steadily increasing. This study considers whether socioeconomic status moderates the relationship between race/ethnicity and physical and mental health. Data come from a state representative sample of Arab and Chaldean Americans—the 2013 Michigan Behavioral Risk Factor Survey and the 2013 Michigan Arab/Chaldean Behavioral Risk Factor Survey (N = 12,837 adults with 536 Arab/Chaldean Americans). Structural equation models examine whether socioeconomic status, operationalized as educational attainment, moderates the relationship between Arab/Chaldean identity and health, and whether physical activity, access to healthcare, and depression mediate the relationship between educational attainment and health. Results indicate that while Arab/Chaldean Americans have poor health relative to non-Arab White Americans, these differences are largely explained by educational differences. Depression, access to healthcare, and physical activity mediate the relationship between socioeconomic status and health of Arab/Chaldean Americans.

‘He supported me 100%’: Mexican-immigrant fathers, daughters, and adolescent sexual health

ABSTRACT Objective: First and second generation Mexican-origin adolescents in the U.S. face social and economic disadvantage and sexual health disparities. Although fathers can support child and adolescent development, the literature has portrayed Mexican-origin immigrant fathers as emotionally distant and sexist. This study aims to treat migration as a social determinant of health to examine father-daughter relationships and adolescent sexual health in Mexican-origin immigrant families. Methods: Integrating qualitative data from life history interviews with 21 Mexican-origin young women in immigrant families with quantitative data on first and second generation Mexican-origin young women in the National Longitudinal Study of Adolescent to Adult Health, this study describes father-daughter relationships, examines the association between father-daughter relationships and daughters’ early sexual initiation, and considers the impact of migration on the father-daughter relationship and sexual health among Mexican-origin young women. Results: Qualitative data identify four types of father-daughter relationships: ‘good,’ hostile, distant, and conflicted. Supporting the qualitative patterns, quantitative data find that positive or ‘good’ father-daughter relationship quality is significantly associated with reduced risk of early sexual initiation. Importantly, father-daughter separation across borders and economic inequality facing immigrant families is associated with hostile or distant father-daughter relationship quality and increased risk of early sexual initiation. Conclusions: Reports of good father-daughter relationships are common and may protect against early sexual initiation in Mexican-origin immigrant families. Policies that keep families together and reduce economic inequality among immigrants may also reduce sexual health disparities among immigrant adolescents.

First birth and the trajectory of women’s empowerment in Egypt

BackgroundWomen’s empowerment is often used to explain changes in reproductive behavior, but no consideration is given to how reproductive events can shape women’s empowerment over time. Fertility may cause changes in women’s empowerment, or they may be mutually influencing. Research on women’s empowerment and fertility relies on cross-sectional data from South Asia, which limits the understanding of the direction of association between women’s empowerment and fertility in other global contexts. This study uses two waves of a panel survey from a prominent Middle Eastern country, Egypt, to examine the trajectory of women’s empowerment and the relationship between first and subsequent births and empowerment over time.MethodsUsing longitudinal data from the 2006 and 2012 Egyptian Labor Market Panel Survey, a nationally representative sample of households in Egypt, for 4660 married women 15 to 49 years old, multilevel negative binomial, ordinary least squares, and logistic regression models estimate women’s empowerment and consider whether a first and subsequent births are associated with empowerment later in life. Women’s empowerment is operationalized through four measures of agency: individual household decision-making, joint household decision-making, mobility, and financial autonomy.ResultsA first birth and subsequent births are significantly positively associated with all measures of empowerment except financial autonomy in 2012. Women who have not had a birth make 30% fewer individual household decisions and 14% fewer joint household decisions in 2012 compared to women with a first birth. There is also a positive relationship with mobility, as women with a first birth have more freedom of movement compared to women with no births. Earlier empowerment is also an important predictor of empowerment later in life.ConclusionsIncorporating the influence of life events like first and subsequent births helps account for the possibility that empowerment is dynamic and that life course experiences shape women’s empowerment. This and the notion that empowerment builds over time helps portray women’s lives more completely, demonstrates the importance of empowerment early in the life course, and addresses issues of temporality in empowerment fertility research.