Introduction

The advent of restrictive immigration policy on both local and federal levels has placed the spotlight on undocumented immigrants and migrants living and working in the United States. It was estimated that nearly 11.2 million undocumented immigrants resided in the US in 2010, with the largest group consisting of Mexican immigrants and migrants (Pew Hispanic Center 2010). This population faces significant marginalization as they are seen to be outside of the protection of the law, easily deportable and exploitable (Taran 2000).

Day laborers, mainly comprised of young Latino and undocumented men, are one such vulnerable group of migrants. Latino day laborers (LDLs) are exposed to significant work and life stressors as they seek open-ended employment in highly visible public street corners and storefronts in an underground economy that is rife with workers’ rights abuses (Valenzuela 2003). LDLs experience routine denial of payment for work rendered, employer abuse, exposure to dangerous and difficult work conditions, and inconsistent employment opportunities (Quesada 1999). LDLs also have limited access to medical care even though they are at higher risk for work injury and on-the-job deaths compared to White or African Americans (Walter et al. 2002). Furthermore, their public employment seeking and congregation in public street corners subjects them to increased surveillance and subsequently has led to significant community backlash and anti-solicitation ordinances (Turnovsky 2004).

Literature indicates that such persistent stress, or minority stress experienced by oppressed populations, such as LDLs, due to their stigmatized social position, may have a deleterious impact on mental health (Meyer 1995, 2003). However, despite the significant hardships endured by LDLs, there is minimal theoretical understanding of the etiology of psychological distress and its correlates among this population (Organista 2007). This study seeks to examine factors related to the psychological distress of a street-recruited sample of LDLs. An understanding of potentially protective and risk factors associated with the psychological distress of LDLs is important in the development of culturally-responsive programming with this population. Furthermore, such examination can assist mental health providers and other advocates with information on how to best work with the existing strengths of this community.

Literature Review

There is a dearth of information regarding the correlates of poor mental health outcomes among undocumented Latinos (Grzywacz et al. 2006), with even less information regarding the mental health of sub-groups of Latino migrants such as LDLs (Organista and Kubo 2005). Latino farm workers, in light of the scant research focusing on urban-based LDLs, provide an imperfect yet available proxy (Organista 2007). Both groups are comprised mainly of young, Latino men, with low levels of educational attainment, who often experience physical isolation, discrimination, and limited opportunities. Studies on the mental health of Latino farmworkers have consistently found that this is a socially marginalized population with heightened risks for poor psychological health (Hovey and Magana 2000, 2002; Magana and Hovey 2003; Vega et al. 1985).

Although no known study to date has identified the prevalence of psychological distress among LDLs, there are some indications that LDLs may be at elevated risk for compromised mental health. Specifically, a survey of HIV risk-taking behavior and related contextual problems of LDLs (N = 102) revealed that sadness was one of the problems LDLs most frequently reported (Organista and Kubo 2005). The feeling of desesperación (despair) due to LDLs’ stressful life and work conditions was also identified (Organista et al. 2006). Similarly, ethnographic studies indicate that suffering, sadness, and hopelessness are salient factors in LDLs’ lives (Quesada 1999; Turnovsky 2006; Walter et al. 2002).

Minority Stress Theoretical Model

The Minority Stress theoretical model (Meyer 1995, 2003) postulates that minority individuals experience significant stress due to the stigmatizing and discriminatory nature of the dominant culture. Stress is conceptualized as an experience dependent upon the relationship between the individual and their environment and the process whereby the individual appraises a demanding event (Meyer 2003). Thereby, stigmatized individuals not only experience negative events due to discrimination but the confluence of these events leads to incongruence between the individual’s needs and existing social structures (Meyer 1995). The framework suggests that these stressors are uniquely additive to the general stressors experienced by majority populations and are rooted in sociocultural systems, institutions, and processes that are beyond the individual (Szymanski and Sung 2010). Specifically, LDLs’ undocumented status and subsequent racist and discriminatory experiences may require an adaptation effort above and beyond than those who do not experience such stressors.

The minority stress model, as previously applied to sexual minority populations, proposes three processes of minority stress: internalized homophobia, perceived stigma and prejudicial events (Meyer 1995). Although internalized homophobia is not within this study’s purpose and scope, among LDLs, preliminary evidence suggests that discrimination and stigmatization are salient predictors of psychological distress (Organista and Kubo 2005). Ethnography suggests that the day labor corner places LDLs into a stigmatized social category of “illegal aliens”—which often renders them vulnerable to scapegoating, repression, and exploitation by employers (Quesada 1999). Segmented into marginal and unskilled jobs, LDLs are exposed to employer abuse, lack of labor mobility and job security, residential exclusion, as well as segregation and social isolation. Blinded Manuscript’s (2010) qualitative investigation of the psychosocial stressors of LDLs found that this social isolation may often be a response to discrimination—whereby, LDLs may deliberately isolate themselves to shield themselves from the stressful experience of discrimination. However, this same study further found, that the experience of social isolation was in of itself a stressor in the lives of these immigrant workers. It is then possible that social isolation is a unique social process of minority stress among LDLs. The Minority Stress model further proposes that some individual and group resources may be protective of psychological distress. Meyer (2003) suggests that both individual and group factors may attenuate the impact of difficult life conditions. Among Latino migrant workers, religiosity has been found to have a positive effect on mental health (Hovey and Magana 2000). Other studies on Latino populations have found spirituality to be linked with positive mood and increased psychological well-being (Tovar 2003). Furthermore, ability to send remittances to support family in country of origin may be protective as it has been shown to be positively associated to psychological well-being among Latino migrant farmworkers (Grzywacz et al. 2006). Similarly, Blinded Manuscript’s (2010) qualitative study indicates that LDLs identified sending remittances to support family and religiosity as potential protective factors of psychological distress. However, the impact of such potential protective factors on psychological distress has not been examined quantitatively.

This study utilizes the Minority Stress model, adapted to include social isolation, through a mixed methods (quantitative and qualitative) approach (Tashakkori and Creswell 2007) to identify potential predictors of psychological distress among this population. In particular, the quantitative phase investigates the extent to which discrimination and social isolation as well as potential protective factors such as religiosity and sending remittances are related to psychological distress. In the qualitative phase, the quantitative findings are shared and discussed with LDLs using focus group to further explore and contextualize the quantitative results as well as elaborate upon the minority stress processes associated to psychological distress among this population. Based on theory (Meyers 2003), this study hypothesizes that LDLs who report more experiences with perceived discrimination and social isolation will have higher levels of psychological distress. Furthermore, LDLs who report higher endorsement of LDL identified protective factors will have lower levels of psychological distress.

Method

Design

This study utilized a mixed methods design which includes the collection and analysis of both quantitative and qualitative data. Mixed methods integrates both quantitative and qualitative findings, and draws inferences using both approaches in a single study (Tashakkori and Creswell 2007). This design is particularly relevant when studies seek to ˙expand an understanding from one method to another, to converge or confirm findings from different data sources (Creswell 2007). The current study’s mixed methods design is appropriate as it aims to qualitatively validate the quantitative results with the lived experiences of LDLs. The integration of LDLs’ voice is participatory in nature and recognizes participants as ˙experts of their lives. The larger study was comprised of three phases including an ethnographic phase that elucidated LDL identified protective factors, such as sending remittances, and religiosity (Blinded Manuscript 2010). The current study, reports on phase II (quantitative survey) and phase III (qualitative member checking). The quantitative survey examined the association between discrimination and social isolation as well as LDL-identified protective factors related to psychological distress. Measures are described below. Focus group methodology was used with the goal of ascribing meaning and contextual understanding to the quantitative results and thereby “unpacking” the quantitative results by incorporating the perspectives and lived experiences of LDLs.

Procedures

Creative methodological approaches have been recommended in research with day laborers as this is a highly transient and hard-to-reach population (Valenzuela 2000). To this end, gatekeepers were essential (Sifaneck and Neaigus 2001). A local organization working with day laborers was identified as a gatekeeper, providing knowledge of all the day labor sites in the large Southwest city where this study was conducted. It should be noted that any direct involvement with the organization was discontinued while conducting research to avoid any conflict of interest problems. Establishing trustworthiness with LDLs was also critical as this population may be understandably distrusting of research studies due to their immigration status and experiences with discrimination. The Principal Investigator’s (PI) consistent presence, visibility, and prolonged engagement for nearly 2 years at the corner aided the process of building rapport and trustworthiness with LDLs. Field visits were conducted at different times between 7:00 a.m. and 3:00 p.m. to facilitate inclusion of maximum workers moving in and out of the street corner seeking employment. Several strategies to approach LDLs were also implemented to further establish trustworthiness and facilitate comfort with the research process. Specifically, all interactions with LDLs were initiated with a handshake, to connote respect, and an introductory statement that included the researcher’s name, affiliation (name of the university), and purpose for being on the corner (to conduct research on the well-being or bien estar of LDLs).

Four research assistants and the PI administered all phases of the research at day labor corners. The research assistants included one Mexican–American Bachelor in Social Work (BSW) student, two social workers with Masters in Social Work degrees of which one is Mexican–American and the other is Peruvian American, and one first year social work doctoral student who is Caucasian and lived and worked in Ecuador as a Peace Corps Volunteer. The PI is South Asian and was raised in Bogota, Colombia, among other countries. All research assistants had previous experience working with Latino immigrants and were trained by the PI prior to conducting any interviews. The training included in-depth discussion about the context of day labor corners (for example, what each corner looks like, how many workers to expect, what type of work the LDLs are engaged in, etc.), and how to approach the workers and notify them about the study. Each research assistant conducted a mock interview with the PI before going to the field. Also, all research assistants shadowed the PI until they felt comfortable enough to conduct interviews on their own. The PI was present at the day labor corners with each research assistant at all times. Only two interviewers (the PI and one research assistant) were present at the corner at any given time to ensure that the LDLs did not feel overwhelmed. All researchers, including the PI, are fluent in Spanish.

All interviews were administered in Spanish. As some LDLs may have limited reading and writing abilities and may be unfamiliar with completing survey instruments, the surveys were conducted face–face and in the field at day labor corner sites. The face-to-face interview was preferable because it allowed the interviewer an opportunity to establish rapport and gain the cooperation and trust of the person being interviewed. A full waiver of written informed consent was obtained from the Institutional Review Board (IRB) thereby participants were told the purpose of the study and asked to provide verbal consent but were not asked to sign or retain a consent form. A full waiver of informed consent was sought because this study posed minimal risk to participants. More importantly, a written consent form may have elicited fear from potentially undocumented day laborers as they may be unfamiliar with formalized documents, especially research documentation.

Purposive sampling was used to recruit LDLs on-site at one of the 3 day labor sites for the member checking focus group. Respondents were asked to participate in a focus group to discuss the results of the quantitative survey. The member checking focus group was conducted at a taqueria at one of the day labor corners. The PI conducted this member checking focus group in Spanish and a research assistant took extensive notes as well as assisted in observing group dynamics and process. This focus group lasted approximately two and half hours.

Site Selection and Inclusion Criteria

Based on initial field observations and key informant input, the three largest and most active day labor sites in the Southwest city were selected. To be eligible to participate in the study, participants had to be Latino, male, aged 18 or older, and currently working as a day laborer. LDLs were also told that if they agreed to participate, they could terminate the interview at any time. In particular, participants were informed that if an employment opportunity appeared while they were being interviewed or participating in the member checking focus group, data collection could be terminated immediately. All survey participants, including those who terminated the interview because of work related reasons, were provided with a $10 gift certificate to a grocery store. During member-checking focus groups, non-alcoholic beverages and lunch were provided to participants.

Measures

Demographics

Specific demographic items included, age, country of birth, times immigrated to the United States, years in the United States, education, weekly income, remittances sent, number in household, and marital status. A majority of the demographic questions were taken from a Spanish language survey developed specifically to study Latino day laborers (Organista and Kubo 2005).

Acculturation

The Short Acculturation Scale for Hispanics (SASH; Marin et al. 1987) was used to assess acculturation. The shortened SASH consists of four language related items that are rated on a 5-point Likert scale (1 = Only Spanish to 5 = Only English). Items include, “What language do you read and speak?” “In general what language do you speak to your friends in?” It has been widely used and has been shown to be a good indicator of acculturation among LDLs with fair internal consistency reliability (α = .73) (Organista and Kubo 2005). The internal consistency reliability coefficient for this current study was α = .75.

Discrimination

Discrimination was operationalized in accordance with the Minority Stress framework (Meyers 2003). Items from The Social, Attitudinal, Familial, and Environmental (SAFE) Acculturation Stress scale (Mena et al. 1987) were selected as it has been shown to be a reliable measure of stress due to perceived discrimination among Latinos. It has been shown to have good reliability (α = .89) with Latino college students, and an adapted version of this measure has high reliability with Latino farmworkers (α = .88; Hovey and Magana 2000). The original SAFE measure is a 24-item scale that is used to assess stressors associated with acculturation in social, attitudinal, familial, and environmental contexts as well as perceived discrimination towards acculturating populations. Items are rated on a 5-point Likert scale (1 = not stressful to 5 = extremely stressful). Items that directly tapped into stress associated with discrimination and stigma were selected. Specifically, items included: “Many people stereotype my culture or ethnic group, and they treat me as if they are in the right”; “When I look for work, I feel limited due to my ethnicity/race”; “I feel uncomfortable when people laugh at people from my ethnic group” and “Because of my ethnicity, people exclude me from participation in activities”. These items were summed to form a composite of discrimination and stigmatization. The internal consistency reliability coefficient for this current study was α = .74.

Social Isolation

The Social Isolation scale by Diaz et al. (2001) is a six item scale that asks respondents to rate the frequency of time on a 4-point scale they lack company, feel alone, feel excluded (1 = Always to 4 = Never), as well as the extent to which they can find desirable company, someone that understands them on a 4-point scale (1 = Definitely yes to 4 = Definitely no). It has been previously used with LDLs and found to have fair internal consistency as indicated by a coefficient alpha of .71 (Organista and Kubo 2005). The internal consistency reliability coefficient for this current study was .64.

Religiosity

Three questions were asked to assess religiosity based on Hovey and Magana’s (2000) research with migrant Latino farmworkers. Questions include, “How religious are you?”; “How much influence does religion have on your life?”; and “How often do you attend church?” with possible responses ranging from 1 = never; 2 = once or twice a year; 3 = once every 2 or 3 months; 4 = once in a month; 5 = two or three times a month; 6 = once a week or more. Higher scores indicate higher levels of religiosity.

Psychological Distress

The Brief Symptom Inventory-18 (BSI-18; Derogatis 2001) was used to assess psychological distress as a proxy or measure of mental health. The BSI-18 is an 18 item measure that measures level of distress over the previous 7 days on 5-point Likert scale (0 = not at all to 4 = extremely). Scores on each dimension range from 0 to 24. The sum of the scores of all three dimensions is the global severity index (GSI) of distress and ranges from 0 to 72 with higher sums indicating higher levels of psychological distress. A score of 10 indicates psychological distress (Prelow et al. 2005); however, this has not been normed on Latino populations. Although the BSI-18 theoretically has 3 factors (somatization, anxiety, and depression), a principal components analysis found that among a sample of impoverished Central American immigrants (N = 100), the BSI-18 measures one underlying factor: psychological distress. The BSI-18 has been shown to be a good indicator of psychological distress among impoverished Latinos with fair to very good internal consistency reliability estimates that range from .70 to .88 (Prelow et al. 2005). The internal consistency reliability coefficient for this current study was α = .87.

To ensure linguistic equivalence, measures or items that did not have Spanish versions (such as, the religiosity scale and some demographic items) were translated and back translated with the help of two translators. One is a native Spanish speaker who has an undergraduate degree and many years of experience translating documents in her former capacity as an Executive Assistant in El Salvador, her country of origin. The other is a non-native speaker who is a multi-linguist with a graduate degree and experience translating documents for the development of a multi-language dictionary as well as other professional documents. The translators translated the items separately and then met to discuss congruence or lack thereof. In cases where the translated wording of items differed, the translators utilized discussion to reach consensus. These items were then back-translated to ensure the accuracy of the translation.

Participants

A total of 150 Latino day laborers participated in the survey, of which 68 % were born in Mexico, 31 % in Central America and 1 % were born in the United States. Approximately 95 % of all day laborers that were recruited for participation in the study chose to participate. Participants ranged in age from 18 to 68 years old, generally reported lower levels of acculturation (Marin et al. 1987) and less than a high school education. The majority were married (59 %) with their wives living in their country of origin (See Table 1).

Table 1 Sample characteristics of LDL participants in quantitative phase
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Participants in the member-checking focus group were between the ages of 38–47 years old. Three of the participants reported being from Mexico and the fourth participant stated that he was from Nicaragua. A fifth participant agreed to participate in the study but left towards the beginning of the focus group because he received a call about an employment opportunity. The participants relayed having experience in carpentry, tiling, yard and rock work, and construction. However, they all stated that they usually work in whatever types of work are needed. The workers reported having lived in the United States from 1 year to 8 years. Participants’ names were altered to maintain anonymity in the reporting of results.

Data Analysis

Quantitative Data

Multiple regression was conducted to examine the association between: (1) discrimination (2) religion, (3) social isolation, (4) age, (5) acculturation, and (6) remittances (percentage of income sent to family) with psychological distress. In addition, age and acculturation were controlled for in the regression model. Other demographic variables were excluded due to lack of variance in the study-participants’ scores. Because the psychological distress variable did not meet the assumption of normal distribution, it was log transformed.

The collinearity statistics Tolerance and VIF (variance inflation factor) were inspected prior to interpretation. The criteria of a Tolerance score of less than .20 and a VIF score of greater than 10 were used to detect possible multicollinerity (Cohen et al. 2003). The results revealed no VIF score greater than 1.18, and the lowest Tolerance estimate was .85, indicating no problems with multicollinearity. Little’s (1988) test of MCAR was used to determine if the data were missing completely at random. The findings suggested that the assumption of MCAR was met (χ 2 = 24.97, DF = 20, p = .21). Accordingly, we used full information maximum likelihood (FIML) procedures to handle missing data. Rather than inputting data for missing cases, FIML procedures use all of the available data to estimate the parameters in the model (Enders 2001; Iwamoto et al. 2010).

Qualitative Data

Thematic analysis was utilized to identify common themes across participants (Creswell 2007). Research team members, including the PI, read the data separately and recorded any thoughts without analyzing the data. Next, researchers independently read the data to find, list and identify significant statements. A meeting was then held to reflect upon the significant statements and to determine if the statements could be labeled and grouped together into coherent units or themes. These themes, along with themes that were not consensually identified, were discussed thoroughly until agreement was reached regarding their inclusion or exclusion from analysis. Finally, data was independently coded into each theme and then discussed at length by team members until agreement was reached. A third party auditor, a professor in Psychology, who was told about the aims of the study, was employed for cases in which consensus was not reached. The same researchers were involved at each step, including the PI and a research assistant.

Results

Descriptives and Bivariate Relations

Approximately 39 % of study participants had scores higher than 10. Caution should be attached to interpretation of this data as the clinical cut-off score was not normed on Latino populations. The correlation analysis (See Table 2) revealed that psychological distress was positively related with discrimination (r = .49, p < .01) and social isolation (r = .40, p < .01). Age was positively related with religiosity (r = .20, p < .05), while acculturation was negatively associated with percent of income sent home (r = −.18, p < .05) and social isolation (r = −.23, p < .05). Finally social isolation was positively associated with discrimination (r = .36, p < .01).

Table 2 Correlations between the variables psychological distress, age, percent of income sent home, religiosity, acculturation, discrimination, and social isolation
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Multiple Regression

The first research question examined the extent to which discrimination, social isolation, acculturation, religiosity, age and remittance were associated with psychological distress. The overall regression model was significant (R 2 = .39, F(6, 144) = 11.9, p < .001). Results indicate that discrimination and social isolation were robust predictors of psychological distress among this sample of LDLs. Specifically, individuals who reported higher levels of reported discrimination (β = .40, p < .001) and social isolation (β = .24, p < .001) were more likely to report greater psychological distress. Acculturation, religiosity, age and remittance were not significantly associated with LDLs’ levels of psychological distress (See Table 3).

Table 3 Multiple regression model for psychological distress among LDLs
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Member Checking Focus Group Results

The purpose of the member checking focus group was to go back to the field and contextualize findings with the lived experiences of LDLs. This method was used to triangulate quantitative findings as well as to extend the minority stress model through the lived experiences of LDLs. Participants not only provided further information regarding the significance of findings but also served as experts on the meaning of the quantitative results. Both significant and non-significant findings were reported to participants who were asked questions such as, “Do you feel like this is true or untrue in your experience?” “Why or why not?”

Participant Validation and Expansion of Quantitative Results

Discrimination

The member checking focus group participants were asked to provide feedback regarding the finding that discrimination was found to be significantly related to psychological distress in the quantitative phase. Participants relayed that daily experiences of discrimination took a toll on their mental health. LDLs described experiences of discrimination to include local and federal policies as they felt these unfairly targeted them. Specifically, participants talked at length about what they perceived to be the city’s discriminatory policies against day laborers and the possibility of the passage of an anti-solicitation ordinance that would prevent LDLs from soliciting work at public street corners. Furthermore, they discussed how increased patrolling by security officials at day labor corners was making it more difficult for them to find employment and their ability to provide for living expenses and send remittances.

Alberto:

Discrimination affects us on a daily basis. For example, at the Home Depot corner, security does not let us look for work in peace. It is then difficult to find work

Diego:

Yes, the patrones stop coming to pick us up too because of this (increased patrolling by security)

Participants expressed that these policies classified them as trespassers and loiterers, or categorized them as panhandlers who solicit money on the streets, instead of workers who want to support their families. LDLs relayed that they were very aware of the community’s negative perception of them and felt as if American society, as a whole, found them objectionable. Subsequently, this stigmatization marginalized them and often made them feel uncomfortable attending mainstream restaurants or even grocery stores. Workers also expressed feeling that local businesses in their neighborhoods discriminated against them because of their appearance and would often accuse them of trespassing despite the fact that many were frequent patrons or customers of these businesses. One worker asked, “If they know that we are here to work and that we are bringing them more business then why do they harass us with the police?”

Social Isolation

LDLs contextualized the role of social isolation on their mental health by discussing its complex role in their lives. A majority of the men reported migrating to the United States for work alone and without other family members. Accordingly, participants indicated that it was difficult not to have the social support that they were used to in their country of origin. Many indicated that social isolation, due to being far away from family members including parents, wives and children, caused them deep sadness. LDLs further conveyed that, while they would maintain contact with family by calling them often, communication became difficult as family members’ idealized image of America, influenced by film and media, was in sharp contrast to LDLs’ daily struggles. LDLs reported that during difficult times, such as periods of unemployment or when victimized by wage theft, they wouldn’t call family in country of origin because “they wouldn’t understand.” In addition, LDLs would avoid discussing details of their daily struggles with family as they wanted to protect them from worrying about their health or general well-being. This would lead to lack of communication with family members, increasing feelings of isolation and compound their feelings of desesperación or despair.

The LDLs in the member checking focus group also elucidated the interrelated nature of social isolation and discrimination based upon their lived experiences. Specifically, the LDLs reported that experiences of discrimination by security guards or community members, among others, as well as the societal stigma of being illegal led them to often avoid mainstream social venues (such as, bars, restaurants, movie theaters, etc.). The LDLs conveyed that they would shield themselves from such associated stress by isolating themselves. One worker stated, “I just stay at home. I don’t want the police to accuse me of stealing…” Despite the fact that isolation was viewed as purposive and as an active coping process against discrimination and stigma, it exacerbated many of the LDLs feelings of distress. One worker stated, “Life is hard. I get sad and often stay in my apartment suffering.”

In contrast, developing new social networks and friendships was perceived as highly important in providing essential instrumental and emotional support. The LDLs discussed the importance of having roommates and other people that could be relied upon for their financial survival in the United States.

Beto:

If there are four or five of us that live together, and one of us doesn’t get along with the others and decides to live on his own, he is worse off. Now he needs to pay more [sic: bills and rent] and he has to look for things and work alone

Diego:

He doesn’t have support and everything goes down

Emotional support through caring and accessible peer and familial networks was also indicated to be an important buffer of psychological distress. One participant stated, “Those that have relationships with more people do better. They make better decisions. If you don’t have any friends, one feels bad and very sad.”

Divergent Results Compared to Quantitative Analysis

Participants disagreed with several of the quantitative findings and expressed that religiosity and sending remittances had a positive impact on their lives and mental health, despite not being statistically significant in this study. Participants discussed religiosity in regards to church attendance and expressed those who were more involved in church had better social networks. These social networks, according to the workers, assisted church involved LDLs in procuring more and better paying jobs which in turn had a positive impact on their mental health.

Antonio:

They (LDLs involved in church) help each other out at church

Beto:

Yes, they are united

Furthermore, participants talked about how those who attended church probably had better moral and emotional support through their pastor and other church members.

Juan:

Moral support they have too

Antonio:

To support one’s emotions that is important

Diego:

The pastor listens. You can speak to him and then the pastor helps

While participants relayed the protective attributes of religiosity, they all stated that they rarely attended church in the United States as their primary objective was to work to support family. Participants further stated that their church attendance in country of origin was higher as they felt more integrated in their communities and their wives or other female relatives would facilitate their attendance.

Sending remittances was perceived to be an important protective factor by the LDLs in the member-checking focus group. The participants conveyed that the ability to send remittances provided them with an emotional reward that allowed them to endure the many difficulties and hardships associated to life as a day laborer. In addition, they reported that sending remittances was an important component of well-being as it was aligned with many of the workers’ objectives in immigrating to the United States and working as a day laborer.

Juan:

One feels good about sending money home because that is our objective. When you cannot send money home, you feel bad because you were not able to help

Beto:

You feel obliged and try to work more even if your family doesn’t say anything (about not receiving any money), the responsibility weighs on you

Antonio:

It’s (sending remittances) emotional. One feels that they are able to support their family it feels good. But when one cannot it feels bad, emotionally

To this end, wage theft (unpaid wages) by employers was reported to take a psychological toll on the immigrant workers as it had a large impact on LDLs’ ability to send remittances. Most workers indicated that they had been victimized by wage theft and had not reported this crime to the police due to fear of deportation. Furthermore, they often did not relay this victimization to their families. Despite, the high presence of wage theft and other workers’ rights abuses, participants attributed their drive to work and ability to fight (batallar) through the hard times to their desire to provide for their families. Thus, sending remittances to family members was identified by participants to be protective of mental health.

Discussion

This is one of the first mixed methods studies to examine LDL identified risk and protective factors associated to psychological distress among this hard to reach population. The use of mixed methods is aligned to researchers’ call for participatory methodologies with vulnerable populations (Papadopoulos and Lees 2002; Pinto et al. 2008). Furthermore, the member checking focus group results provide contextual understanding and depth to the quantitative findings through the lived experiences of the immigrant workers themselves. The mixed methods approach utilized in this study offers a richer and more complex illustration of LDLs’ lives and their mental health than what would have been possible through one approach alone.

This study hypothesized that LDLs who reported more experiences with perceived discrimination and social isolation will have higher levels of psychological distress. As predicted, both quantitative and qualitative member checking focus group results indicated that discrimination and social isolation have an adverse and significant impact on LDLs’ mental health. While discrimination was operationalized to include LDLs’ interpersonal experiences of ethnic/racial discrimination in the quantitative phase, the member checking focus group revealed a more nuanced conceptualization. Specifically, immigration policy or city ordinances were perceived by the LDLs to be a part of their experiences of ethnic/racial discrimination as they felt that these policies unfairly targeted Latino immigrants. This finding suggests the importance of using measures of discrimination that include structural discrimination in their operational definition. Caution should be attached to this finding as it is possible that immigration status (and related attempts to enforce labor laws) and ethnic/racial discrimination have an independent and interactive influence on psychological distress. Further qualitative and longitudinal quantitative studies design can explore this distinction and the impact of these processes on LDLs’ outcomes, and can also assist in this understanding by measuring any changes in perceptions of discrimination among LDLs who receive legal authorization over time.

The member checking focus group also extended our understanding of the process of social isolation in LDLs’ lives by revealing that isolation was often in response to experiences of discrimination. Interestingly, a post hoc t test reveals no differences in social isolation with respect to married men who had spouses living abroad versus spouses who lived with them, F(1,85) = 1.84, p < .19. It is possible that this lack of difference further underscores the importance of examining the impact of experiences of discrimination on social isolation. This is especially relevant as findings indicate that even as, LDLs often purposively isolated themselves to shield themselves from the stress of being discriminated, the experience of isolation served to intensify their feelings of psychological distress. The LDLs in this study did not make the distinction between social isolation as a result of discrimination versus the threat of deportation; however, it is conceivable that these would weigh differently on psychological distress. Future studies are recommended to qualitatively examine whether and how deportation threat and discrimination can be disaggregated within the lived experiences of LDLs.

It was additionally hypothesized that LDLs with higher endorsement of protective factors (such as religiosity and sending remittances) would have lower levels of psychological distress. These participant identified factors were not quantitatively found to be significantly associated to psychological distress. However, the qualitative member-checking results reveal that religiosity and sending remittances may provide some psychological benefits to this population of LDLs and that it is possible that the quantitative measures used for this study lacked construct validity. It is also possible that while religiosity was ideally viewed to be protective of psychological distress, LDLs singular drive to work to earn money trumped as well as prevented many from attending church. Therefore, while spirituality remained an important component of their daily lives, church attendance did not.

It is also worth noting that while LDLs identified sending remittances as being protective of mental health, the qualitative results also reveal that the pressure to send remittances created significant stress. Specifically, inability to send remittances seemed to negatively impact communication with family members as LDLs often temporarily discontinued communicating with family members due to associated feelings of shame. This is aligned with previous qualitative findings from a study of LDLs in San Francisco that found that injury among Latino day laborers had an adverse effect on communication with family in country of origin (Walter et al. 2004). Though the quantitative results did not find a significant association between sending remittances and psychological distress, it is recommended that future studies examine this factor in the mental health of LDLs.

While this cross-sectional investigation limits the ability to test the causal relationship of minority stress, it meets the call to advance theory through its application to a marginalized population of Latino immigrant day laborers (Meyer 1995). Furthermore, it extends the minority stress theory through the elucidation of the multiplicity of discrimination related stressors, such as federal and local immigration policies, extensive workers’ rights abuses and marginalization, experienced by this population. Specifically, the minority stress process for LDLs may then include stigma (such as undocumented status and community members’ perceived disdain of the workers) as well as prejudicial experiences (such as, discrimination by businesses or stores) which are exacerbated by social isolation. Future studies can advance our understanding of how variations in LDLs’ immigration status can alter stressors. This is especially relevant as the minority stress process may operate differently for those LDLs who have legal immigration status. It is likely that these immigrants’ mental health may be less impacted by immigration policies as they do not contend with the fear of exposure and deportation. To the contrary, there is evidence to indicate that documented Latino immigrants continue to experience deportation fear as they continue to avoid some social activities as a direct result of this fear (Aborna et al. 2010). This has been found to be especially true in periods where restrictive immigration policies are enacted and legal Latino immigrants receive increased questioning about their immigration status (Hagan et al. 2003).

As with any study, this study has several limitations including limited generalizability due to its use of non-probability sampling and small sample size. The results of this study are also based on 3 day labor corners in one city. However, as LDLs are a “hard to reach” population, the use of purposive theoretical sampling greatly facilitated the location and recruitment of study participants. Future studies with LDLs can utilize more representative sampling techniques to examine whether the risk and protective variables found in this current study hold true. In addition, the risk and protective variables elucidated by this current study can be utilized for future larger-scale epidemiological study with this population. It is also possible that the LDLs who participated in the focus group were not representative of the larger quantitative sample. Therefore, findings from this member checking focus group should be viewed as exploratory. Regardless, conducting one member checking focus group with a small sample size was appropriate as it yielded more in-depth data per participant (Tashakkori and Creswell 2007). This phase also allowed LDLs to provide insight and offer feedback on the validity of the quantitative findings in accordance with their experiences as day laborers. This study could have also been impacted by several threats to its internal validity. As LDLs are a vulnerable population, participants could have been reluctant to discuss their psychological distress with a researcher. Several strategies were used to maximize the internal validity of this study such as prolonged field work to gain trust, the use of verbatim accounts from participants, and multiple researchers (Valdez and Kaplan 1999). Multiple interviewers were used to mitigate researcher subjectivity in data collection and multiple researchers and consensus building were used in the qualitative analysis to minimize the effects of researcher subjectivity in the interpretation of the qualitative results. Then again, research assistants that were blind to the study could have been employed to reduce bias in coding. The mixed methods approach used in this study was another important way of maximizing internal validity. The use of participant identified variables allowed for the incorporation of the lived experiences of LDLs in the study.

This study advances the literature by identifying distinct psychosocial factors that impact the psychological distress of LDLs. Social service and advocacy organization should focus outreach efforts for this hard-to-reach population at day labor corners and use popular education strategies to facilitate discussion regarding discrimination and psychological well-being. These organizations can also facilitate social activities, such as soccer games, to help ameliorate social isolation found to be associated to psychological distress. In addition, as family in country of origin can be important sources of social support, binational efforts by social service providers to facilitate effective communication between family members are highly recommended. For example, these organizations could coordinate the use of SKYPE, an online service offering free telephonic services to internet users, across borders. While such efforts are rare, the importance of binational outreach to ensure the well-being of family members on both sides of the border is increasingly being underscored by researchers (Negi and Furman 2009; Furman et al. 2008). The unique contextual factors influencing psychological distress and an understanding of the minority stress process experienced by this population can be further utilized to inform effective public health and social service interventions. In light of rising anti-immigrant sentiment, advocacy and policy interventions are also highly recommended to ensure the psychological health of this population of immigrant workers.