Latinos make up 47% of immigrants living in the U.S. and represent one of the most socioeconomically disadvantaged and marginalized populations. Data suggest that some Latino immigrant groups experience a disproportionate burden of substance abuse, exposure to domestic and community violence, and HIV/STIs. Studies have also shown high rates of depression, anxiety, and post-traumatic stress syndrome among Latino immigrants. These conditions have been found to cluster, interact synergistically, and stem from common socio-ecological determinants within certain communities, thereby creating a syndemic. Support has begun to emerge for a syndemic model of Substance Abuse, Violence victimization, HIV/AIDS, and poor MEntal health (SAVAME) among Latinos and other vulnerable populations. Yet, syndemic research specifically focused on Latino immigrants has been scarce and little is known about the role of social, cultural, and contextual factors on Latino immigrants' risk of SAVAME. Evidence regarding effective approaches to tackle the syndemic, including increasing prevention and treatment service utilization, is also sorely lacking. This community- academic collaboration is aimed at increasing our understanding of the scope and determinants of the SAVAME syndemic among Latino immigrants in the City of Philadelphia, which is home to a small but fast- growing and increasingly diverse Latino immigrant community. This formative study also seeks to expand the evidence on strategies to address the factors contributing to this syndemic, with emphasis on promoting collaboration and partnerships between Latino immigrant-serving organizations to increase utilization of SAVAME prevention and treatment services among the Latino immigrant community. Over a 2-year period, we will complete in-depth interviews (N=30), key informant interviews (N=30), and a community survey (N=400) to characterize the extent and impact of the SAVAME syndemic among Latino immigrants in Philadelphia and to identify socio-ecological determinants that may serve as targets of future multilevel interventions. We will also implement a community resource survey (N=40) to identify, map, and characterize community services and other resources that can be engaged, mobilized, and leveraged to address the SAVAME syndemic afflicting Latino immigrants in the future. We will use social network analyses to investigate the level, nature, and role of collaborations across organizations and agencies that provide health, social, legal, and other support services to Latino immigrants ?a key element of community resilience. Findings from this study will inform a future R01 or R34 application aimed at developing, implementing, and evaluating a communitywide intervention to strengthen interagency collaboration, increase access to prevention and treatment services, and reduce the prevalence and impact of SAVAME on Latino immigrants.

Public Health Relevance

Latino immigrants experience a disproportionate burden of substance abuse, exposure to violence, HIV/AIDS, and poor mental health (SAVAME). For this population, these syndemic conditions and their determinants are neither well understood nor effectively addressed by current prevention and treatment efforts. This study will increase our understanding of the extent and determinants of the SAVAME syndemic afflicting Latino immigrant communities and inform a future communitywide intervention to reduce its prevalence and impact.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Exploratory/Developmental Grants (R21)
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Health Disparities and Equity Promotion Study Section (HDEP)
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Jones, Nancy Lynne
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Drexel University
Public Health & Prev Medicine
Schools of Public Health
United States
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