Research has found a strong inverse association between discrimination and health and well-being. Most of these studies have been conducted among African-Americans, and have examined the relationship at the individual-level. To fill these gaps in knowledge we estimated the prevalence of perceived discrimination among a nationally representative sample of Latino adults in the US, and investigated the association between state-level anti-immigrant policies and perceived discrimination. We merged survey data with a state-level anti-immigrant policy index. First, we fit hierarchical logistic regression models to test the crude and adjusted association between anti-immigrant policies and perceived discrimination. Second, we specified cross-level interaction terms to test whether this association differed by relevant individual characteristics. Almost 70% of respondents reported discrimination (68.4%). More anti-immigrant policies were associated with higher levels of discrimination (OR=1.62, 95% CI 1.16, 2.24, p=0.01). The association between anti-immigrant policies and discrimination differed by place of origin (p=0.001) and was marginally moderated by generation status (p=0.124). Anti-immigrant policies stigmatize both foreign and US-born Latinos by creating a hostile social environment which affects their experiences of discrimination. These non-health policies can adversely affect Latino health, in part through exposure to discrimination, and may help explain health patterns among Latinos in the US.

IntroductionDespite substantial research on school-based obesity prevention programs, it is unclear how widely they are disseminated. It is also unknown whether schools use obesity programs that inadvertently promote weight stigma or disordered weight-control behaviors.MethodsIn spring 2016, we distributed an online survey about school wellness programming to a simple random sample of US public school administrators (N = 247 respondents; 10.3% response rate). We analyzed survey responses and conducted immersion/crystallization analysis of written open-ended responses.ResultsSlightly less than half (n = 117, 47.4%) of schools offered any obesity prevention program. Only 17 (6.9%) reported using a predeveloped program, and 7 (2.8%) reported using a program with evidence for effectiveness. Thirty-seven schools (15.0%) reported developing intervention programs that focused primarily on individual students’ or staff members’ weight rather than nutrition or physical activity; 28 schools (11.3% of overall) used staff weight-loss competitions. School administrators who reported implementing a program were more likely to describe having a program champion and adequate buy-in from staff, families, and students. Lack of funding, training, and time were widely reported as barriers to implementation. Few administrators used educational (n = 12, 10.3%) or scientific (n = 6, 5.1%) literature for wellness program decision making.ConclusionEvidence-based obesity prevention programs appear to be rarely implemented in US schools. Schools may be implementing programs lacking evidence and programs that may unintentionally exacerbate student weight stigma by focusing on student weight rather than healthy habits. Public health practitioners and researchers should focus on improving support for schools to implement evidence-based programs.

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