Identifying with the Struggle: Positive Youth Development within Peer to Peer Health Promotion in the Immigrant Community of Chicago

Background and Purpose: As a result of the Affordable Care Act (ACA) 1.5M Illinois residents who were not insured two years ago are now guaranteed affordable healthcare coverage. However, it is estimated that between 425,000 and 625,000 undocumented immigrants in the state do not qualify for or have health insurance. Although undocumented people may receive emergency medical care, they have no rights to any other type of treatment. As a result, many low-income, undocumented immigrants face significant barriers to comprehensive, high-quality medical care.  Centro Sin Fronteras (CSF), in partnership with medical students at Rush Medical Center, have developed the Youth Health Service Corps (YHSC) campaign to respond to the health care dilemma of uninsured, new immigrants within Chicago.  The Chicago area YHSC builds on youth capacity to develop community outreach,  promote health and increase health literacy, as well as enhance individual and community -level empowerment.  The goal of this study is to examine the impact of the YHSC program with regard to its outreach within immigrant communities, as well as its influence on high school participant youth and their motivation for civic action.  Research questions include: to what extent does the YHSC program: 1) affect public health awareness within new and undocumented immigrant communities; 2) build social capital among high school participants as they aspire to pursue career and work within the healthcare field; and 3) assist in individual critical youth and community level empowerment?

Methods: This study utilized a CBPR (Community Based Participatory Research) and mixed methods approach to understanding the experiences of immigrant youth empowered by YHSC. In partnership with CSF, surveys were conducted with 67 participant youth and in-depth, semi-structured qualitative interviews were conducted with 24 participant youth.  Considering narrative and social network theory and utilizing a frame analyses that engages neighborhood narratives (Small, 2002), this study examined the impact of networks among new immigrant youth in Chicago on the health behaviors among immigrant families in their communities.  A thematic analysis of the transcribed interviews (Fereday & Muir-Cochrane, 2006) was conducted in order to appreciate common experiences within the sample.  Results:  Findings suggest that the political and social position of immigrant youth and/or the family members, often being uninsured and vulnerable to deportation, brought increased salience and ethnic and racial identity centrality in their identity development.  Through narratives from the study, immigrant and minority youth articulate how they identify with the struggle of undocumented and new immigrants, and how this motivates them to engage in civic action. The individual narratives of youth participants particularly provide insight on how their involvement with YHSC has strengthened their identity, raised their critical consciousness, and increased their civic engagement and leadership as they engage in health promotion within their community.  Conclusions and Implications:  Findings inform practice, policy and developing knowledge on positive youth and ethnic identity development, by highlighting elements of a peer to peer health promotion program that successfully facilitates positive youth development, social activism, and community level empowerment that increases health literacy among new and undocumented immigrants.