Colon cancer stage at diagnosis strongly predicts survival, yet racial disparities remain underexplored for Asian American, Native Hawaiian, and Pacific Islander (AANHPI) subpopulations. In light of COVID-19 and rising anti-Asian hate, we examined temporal changes in colon cancer stage at diagnosis among disaggregated AANHPI populations before and during the pandemic. Using the National Cancer Database, we examined colon cancer stage at presentation (0-IV) among AANHPI subgroups in pre-pandemic (2004-2019) and pandemic (2020-2021) periods. Ordinal logistic regressions with race-year interaction terms evaluated odds of higher-stage diagnosis, adjusting for demographic, socioeconomic, and clinical factors. Among 913,119 patients, 28,845 (3.2%) were AANHPI. The yearly increase in odds of advanced-stage diagnosis was greater for Black than White patients (AOR, 1.008; 95% CI, 1.005-1.010; P < .001). Within-AANHPI subgroups, Thai patients had lower yearly odds of than the Chinese reference (AOR, 0.943, 95% CI, 0.903-0.986; P = .01). During the pandemic, disparities persisted or widened: Chinese (AOR 1.21, 95% CI, 1.05-1.38), Korean (AOR 1.35, 95% CI, 1.11-1.65), Vietnamese (AOR 1.26, 95% CI, 1.04-1.54), and Hmong (AOR 2.15, 95% CI, 1.19-2.36) patients exhibited higher odds of advanced-stage presentation than White patients. Significant heterogeneity exists in colon cancer stage at presentation among AANHPI subgroups. Disparities worsened during the pandemic, showing the importance of addressing subgroup-specific inequities in post-pandemic cancer care.

There are approximately 24,600 women and girls with FGM/C currently living in Switzerland. Women and girls with FGM/C have health care needs related to FGM/C that Swiss health workers may not have adequate knowledge to address, or they may experience attitudes toward FGM/C and/or communities which practice FGM/C that result in poor experiences of care. Further, there are no current studies that assess Swiss health worker clinical practice in the care of this group. The aim of this study was to survey a national sample of Swiss health workers using a conceptual framework and valid measures of health worker knowledge, attitudes, and practices for care of women and girls with FGM/C. We conducted a cross-sectional web-based survey of multidisciplinary health workers including physicians, nurses, and midwives employed at the five Swiss University hospitals. 467 health workers completed the full survey. General knowledge of FGM/C and its associated health complications was high; however, knowledge of management of those complications was low. Health worker attitudes toward FGM/C overwhelmingly opposed the practice but demonstrated neutral or ambivalent attitudes toward ethical challenges and the provision of FGM/C-related care. There is a clinically important gap between health worker knowledge and practice with deficits in interpreter use, mental health screening and referral, and clinical documentation. This study is the first national assessment of health care provider knowledge, attitudes, and practices for FGM/C-related care in Switzerland. There are significant opportunities to improve health worker knowledge for FGM/C care, promote attitude and values clarification, and ensure that clinical practice is aligned with evidence-based practices for high quality FGM/C care. Competency-based strategies for health worker education can improve health care quality and outcomes for women and girls with FGM/C.

Occupational attainment is central to the immigrant experience, yet little research has explored the role of occupational skill in shaping the immigrant health advantage (IHA). Furthermore, whether citizenship status - an increasingly critical structural determinant of immigrant health - moderates the effects of occupational attainment on health remains underexplored. Drawing on linked 2000–2018 National Health Interview Survey and O*NET job skills data, findings reveal that noncitizen immigrants employed in low- and mid-skill occupations demonstrate the largest self-rated and mental health advantages, whereas their same-skill U.S. citizen immigrant peers exhibit outcomes more similar to those of the U.S. born. Furthermore, noncitizen immigrants persistently report less healthcare access and lower likelihoods of having health insurance than the U.S. born, even at the highest occupational skill levels. Together, analyses suggest important heterogeneity in immigrant well-being by skill and citizenship status, adding important nuance to the existing IHA literature.

Afghan refugees in the US face significant challenges, including limited access to healthcare. This study investigates the relationship between social determinants of health (SDOH), including-material circumstances, psychosocial circumstances, behavioral and/or biological factors - and self-rated health among recently resettled Afghan refugees (who received Special Immigrant Visas) in Oklahoma. Data were collected from 348 Afghan refugees using a community-based survey administered in English, Pashto, or Dari in 2022. Measures included sociodemographic characteristics, SDOH, and self-rated health (assessed using a single-item question asking participants to rate their health as poor, fair, good, very good, or excellent). Multivariable logistic regression analyses examined the associations between sociodemographic factors, SDOH, and self-rated health. Of the 348 participants, 59.5% of participants were male, with an average age of 31.5 years. In terms of behavioral factors, high rates of inadequate fruit and vegetable consumption (55.2%), insufficient sleep (58.0%), and insufficient physical activity (83.6%) were observed. With regard to material circumstances-defined based on the World Health Organization's Commission on Social Determinants of Health (CSDH) framework as physical and economic living conditions-chronic health conditions (12.6%) and disabilities (7.8%) were noted. In adjusted models, chronic health conditions (AOR = 0.41, 95% CI: 0.19-0.86), disability (AOR = 0.31, 95% CI: 0.12-0.79), and inadequate sleep (AOR = 0.46, 95% CI: 0.24-0.89) were significantly associated with poor self-rated health. There were no significant associations found between psychosocial factors and self-rated health. This study highlights the significant impact of SDOH, especially material circumstances and behavioral factors on the well-being of Afghan refugees. Future interventions aimed to improve Afghan refugee health need to consider the roles of SDOH in order to optimize their care.

Over 80% of tuberculosis cases in the United States are due to reactivation of untreated latent tuberculosis infection (LTBI), most of whom were foreign born. LTBI treatment can greatly lower the risk of progression to active TB disease, and shorter treatment regimens increase the potential of migrants and other persons in vulnerable conditions, to complete treatment. We conducted across-sectional study to assess willingness to complete a one-month course of LTBI treatment among internal and international migrants living in Tijuana, BC, Mexico, and to identify factors associated with treatment unwillingness between November 2020 and April 2021. Prior to administering TB skin tests (TST), participants were asked if they would accept LTBI treatment if indicated by test results and clinical examination. Recruitment occurred in migrant shelters throughout Tijuana and at a storefront office conducting research and harm reduction services for people who use drugs. Among 595 participants, 80.4% were living in shelters, 3.5% were recruited at shelters but living independently, and 16.1% were recruited through the storefront office. Overall, 71 (11.9%) indicated that they were unwilling to take LTBI treatment and 109 (18.3%) had positive TST results. Unwillingness to take LTBI treatment was more common among participants from the storefront office compared to the shelter (64.6% vs. 1.8%, p<0.001). Since only 1.8% of shelter participants were unwilling to receive treatment, multivariable Poisson regression with robust variance estimation via GEE for identifying factors independently associated with LTBI treatment unwillingness was restricted to storefront participants. Treatment unwillingness among storefront participants was positively associated with perceiving health status as "good" or "very good" (prevalence ratio [PR]=2.37, 95% confidence interval [CI]: 1.52, 3.99) and heroin use in the past six months (PR=1.70; 95% CI: 1.33, 2.19). Unstable housing was reported as a barrier to treatment. These findings suggest that most migrants in Tijuana were willing to receive short-course LTBI treatment if indicated, yet willingness was lower among those at greatest risk of TB. Efforts to increase testing and treatment, as well as further research on overcoming barriers to treatment willingness are needed.

The rapid expansion of digital health during COVID-19 transformed healthcare delivery, offering new opportunities for remote care. However, health access remains inequitable, with barriers such as technology access, language barriers, and financial constraints disproportionately affecting immigrants and marginalized populations. This study applied an intersectional approach to examine digital health utilization trends by immigration status and key sociodemographic factors. This study analyzed nationally representative data from the 2021-2023 National Health Interview Survey (NHIS) for adults (N = 83,116). Immigration status was cross-classified with race/ethnicity, gender, marital status, education, income, health insurance, chronic conditions, and rural residency. Weighted logistic regression models examined disparities and moderation effects. While digital health utilization generally declined post-pandemic with increased access to in-person care, disparities across populations persisted. While naturalized immigrants had similar odds of digital health use compared to U.S.-born individuals, noncitizen immigrants had significantly lower odds. The findings also reveal noncitizen immigrants, particularly those with lower income, no insurance, and living in rural areas, face significant barriers in accessing digital health services. These disparities highlight the need for targeted policies to ensure equitable access to digital health resources for immigrant populations.