Overview

The Center seeks to foster and conduct collaborative and transdisciplinary research with global partners through the lens of implementation science, leveraging theories and methods from diverse disciplines to influence migrant health programs and policy.

Sponsored research includes both domestic and international topics through strategic partnering in NYC, NYS and in major immigrant and refugee population centers in the US and abroad.

Governance structures of migrant-serving, Civil society organizations

This qualitative study seeks to document the governance practices of civil-society organizations in New York City through the collection of both key-informant and in-depth interviews.

Study findings aim to assess how organizational practices at the city level can be scaled and adapted to create trans-local solidarity and intercity networks.

Preliminary Findings

Analysis is ongoing, but the preliminary findings from interviews collected between Summer 2024 to Spring 2025 are detailed below.

Key-informant interviews:

  • Punitive, complex US immigration policy generates intersecting harms.
  • Collabortion and adaptability are key organizational governance strategies employed in an ever-changing legal environment.

  • Organizations tend to employ a top-down, reformist approach to advocacy.

In-depth interviews:

  • Migrants perceive more stability in the US and aspire to citizenship and full-time employment, though a lack of instrumental support, legal uncertainty, and a restrictive political climate affect safety and self-determination.
  • Migrants acknowledged the contributions of service staff, friends, and family to their health, though they expressed difficulties connecting to others due to lack of trust.
  • In NYC, migrant-serving CSOs mostly empower migrants and help them integrate in society by offering resources (i.e., education, job training) and assisting in building community connections.

Well-established and legally defined nonprofit organizations play an important role in providing services to migrants, but the established literature underlines a “need to unpack the urban character of asylum” (Darling, 2017) to capture the complexities and unique characteristics of Civil-Society Organizations (CSO) and expand on the established models of migrant organizations.

Government policies can perpetuate health inequalities in the migrant population. Local policy in NYC is generally more friendly to migrant communities and migrant health, providing some protection against the harms of federal policies. NYC is also home to a robust network of CSOs providing wide-ranging services to migrant communities. Thus, this study explores the ways that CSOs navigate and interact with the complex interplay between federal, state, and local policy environments and the ways in which their governance structures mitigate or exacerbate policy effects.

How do civil-society organizations in NYC mitigate, reflect, or exacerbate public policy?

Other Research Questions Include:

  • Do CSOs engage in advocacy or attempt to influence policy?
  • How do CSOs in NYC position themselves vis-a-vis government policy and the immigration process?

This qualitative study leverages key-informant interviews with organizational stakeholders and in-depth interviews with immigrants in NYC to map CSO governance structures/strategies and assess their downstream effects. Interviews were collected from Summer 2024 to Spring 2025.

Analysis of combined results is ongoing; publication is expected in 2026.

Adoption of Online Grocery Shopping by Low Income Households:
Assessment of New York City’s Groceries to Go Program

The adoption of online grocery services accelerated during the COVID-19 pandemic in response to the health risks of in-person shopping and the expansion of a federal pilot program allowing Supplemental Nutrition Assistance Program (SNAP) participants to use their benefits at online supermarkets.

In NYC, rising food insecurity and concerns about supermarket access led to Groceries to Go (G2G), a program providing a monthly stipend to buy groceries through an online portal serving independent supermarkets and specialty grocers to low-income clients of NYC Care.

Key Study Findings

The results indicate that participants were satisfied with the program, reporting improvements in their nutrition and mental and physical health, and offered recommendations to improve the program, including increasing the number of available stores, increasing the monthly stipend, and allowing use of funds in person in addition to online.

Our study suggests that providing low-income households with funds to buy groceries online is a viable approach to improve grocery access and nutrition, offering cities a policy alternative to subsidizing the development of brick and mortar supermarkets.

The COVID-19 pandemic provided a window of opportunity for innovative responses to growing food insecurity and barriers to food access. In New York City, responses led to Groceries to Go, a city-run program providing participants monthly funds (“credits”) to purchase groceries through an online platform that connects shoppers to independent local supermarkets. Participants of Groceries to Go are members of NYC Care, a public hospital system healthcare access program, with hypertension or diabetes, and who are at risk for food insecurity. NYC Care serves New Yorkers unable to qualify for or afford health insurance.  

The key research question sought to assess whether and to what extent the Groceries to Go program is an effective way to improve food access, increase food security, and improve the health of program participants.

We conducted a cross-sectional qualitative study comprising in-depth interviews (IDIs) and a brief post-interview survey with individuals who have participated in the DOHMH Groceries to Go program for at least six months. Key areas of interest pertained to initial program awareness and experience, how participants use the program, self-assessed program impact, and overall satisfaction and recommendations.

This evaluation study involved close collaboration between university investigators and a city health department, including development of the data collection instruments, sampling frame, participant recruitment, and review of the findings. The research protocol was approved by the CUNY SPH Human Research Protection Program’s Institutional Review Board on June 27, 2023.

This study reports participants’ experiences, barriers and facilitators of program participation, and self-assessed effects on health and wellbeing.

We conducted 51 in-depth interviews with participants and administered a 7-question post-interview survey on program engagement and impact.

Publications are under peer-review, with an expected publication date in 2026.

Gender & Refugee Healthcare

In 2022, we worked with the Institute for Migration Studies at the Lebanese American University (LAU) to conduct a study on the intersectionality of gender and refugee status and its effects on healthcare access in Lebanon.

Findings from convenings

Convenings with participants from UN Agencies, international humanitarian organizations, health facilities, and local non-government organizations (NGOs) and civil society organizations (CSOs) that work at the intersection of health, refugees and gender were conducted in May 2022. Prominent themes are listed below:

  • Lack of registration as potenial vulnerability
  • The economic crisis has a similar effect on refugee and host population
  • Need for multidisciplinary, intersectional, holistic and inclusive approach and services
  • Notable increase in gender-based violence in light of COVID-19
    Conservative region in Northern Lebanon and stigma does not allow for open access of services to gender minorities
  • Main barriers to accessing healthcare: Transportation, cost of fuel, internet connection, lack of privacy, possibility of harassment, retaliation and outing when seeking gender-inclusive services
  • Lack of healthcare providers trained in dealing with gender-minority cases and hence lack of gender-inclusive services

Over the past decade, more than 1.5 million Syrian refugees have fled to Lebanon. With a total population approaching 4 million people, Lebanon presently hosts the highest number of refugees per capita in the world. The Lebanese government’s response to the influx has been a series of patchwork legislation and ad hoc policies. In this climate, refugeehood, gender, and health remain at a sensitive and overlooked intersection particular regarding their access to health services. The country’s highly privatized healthcare system is expensive, inaccessible, and unattainable for many migrants and refugee groups. And while the UNHCR financially supports this marginalized group, it only covers life-saving services or parts of doctor’s feeds, leaving few options for those with serious or chronic health conditions such as cancer and kidney disease.

Beyond the economic and financial challenges, geographic disparity poses a major obstacle for the refugee community in Lebanon. Most recently, the country’s ongoing fuel crisis has exacerbated barriers to accessing healthcare. Additionally, women and LGBTQI+ refugees in Lebanon continue to endure extreme forms of violence, discrimination, stigmatization, and isolation in the “safe” places they seek. Their specific needs are often discounted from mainstream refugee services, and very little humanitarian programming is tailored specifically for them. More research is needed to understand the lived experience of refugees living at the intersectionality between immigration status and gender, and to inform gender and LGBTQI-inclusive policies and humanitarian programming.

How has gender identity impacted access to healthcare services in Tripoli and Akkar
since 2019 for the registered refugee community?

Other Research Questions Include:

  • How does this impact women, LGBTQI+, and children refugees’ access to healthcare specifically?
  • How does registration with UNHCR assist/impede healthcare access? How has the ongoing economic and financial crisis in Lebanon impacted the health sector, as well as the provision of health services to the refugee community in general?
  • What specific impediments to access to healthcare services are associated with this region specifically in Tripoli?

This case study focused on the region of Tripoli in North Lebanon. The city of Tripoli has been marred by decades of armed conflict and instability, resulting in a fragile economy that is struggling to support the local population, let alone the influx of refugees from neighboring Syria in the past decade.

Syria and northern Lebanon have a long-shared history, with common cultural and religious characteristics. With the influx of Syrian refugees, the ongoing economic crisis and the COVID-19 pandemic, Tripoli’s capacity to meet host community and refugee health needs is severely strained, particularly when it comes to the most vulnerable refugees such as women and LGBTQI+ populations.

This study applied a mixed-methods approach that is participatory, inclusive, and target-group sensitive. The data collection was conducted in hybrid mode (i.e. remote and in-person).

The data collection phase encompassed convenings and key informant interviews with UN Agencies, international humanitarian Organizations, health facilities and local non-government organizations (NGOs) and civil society organizations (CSOs) that work at the intersection of health, refugees and gender.

Subsequently, Focus Group Discussions were held with Syrian refugees in Tripoli.

Diab Jasmin Lilian , Samneh Bechara , Masoud Dima , Cravero Kathleen. Gender identity as a barrier to accessing adequate and inclusive healthcare for Syrian refugees in Lebanon’s Northern regions. Frontiers in Human Dynamics, Volume 5 (2024) DOI 10.3389/fhumd.2023.1205786

Migrant Health CBOs in NY

In January 2021, CIRGH launched a cross-sectional survey of migrant-serving organizations in NYC to collect important information on their early experiences with COVID-19, focusing on the five areas of funding, staff capacity, technological capacity of communities served, resources in communities served, and difficulty working remotely.

Key Study Findings

Organizational capacity is somewhat correlated with number of groups served and types of services offered:

  • Smaller organizations tend to offer health and social services, i.e., more day-to-day “survival” assistance
  • Larger organizations report greater involvement in areas related to education and employment
  • All organizations offer legal assistance

Fear and ineligibility due to legal status are the service barriers cited most frequently

Topics and resources frequently identified for support include: support for advocacy and communications around migrant policy (86%), provision of best practices and policies through a resource hub (55%), access to interns (55%), connections to researchers (50%), and convening spaces (50%)

In NYC there are hundreds of migrant-serving organizations (MSO) with deep, long-standing connections to immigrant communities. Throughout COVID-19, they have provided critical lifelines to community members. Many MSOs are struggling to survive, lacking the human and financial resources to meet the increasing demand for services and support, including food, housing, cash assistance, employment, legal assistance, health care and mental health services, among others. Moreover, immigrants have been avoiding federal and local COVID-19 relief aid because of legal concerns.

What are the early experiences of migrant-serving organizations with the COVID-19 panemic?

Other research questions include:

What are the main effects of COVID-19 on the communities served?

Are there barriers/factors that exacerbate hardships during the pandemic?

What would be the most valuable tools or useful services MSOs could benefit from?

In January 2021, CIRGH launched a cross-sectional survey of migrant-serving organizations (MSOs) in NYC to collect important information on their early experience with COVID-19 while being cognizant to minimize demands on their limited time and resources. Additionally, as an academic research institution whose mission is to advance public health within a social justice framework, we were interested in determining if MSOs would be interested in collaboratively developing a migrant health resource hub and in what ways it might be useful. We developed a brief survey focusing on three domains:

  1. General organizational information (i.e., staff, budget, target populations)
  2. Special challenges (service or policy-related) posed by COVID-19
  3. Interest in learning more about and collaborating with the Center

The survey was distributed to 122 MSO contacts. Of the 41 organizations that responded to the survey, 38 with complete data were included in analysis (RR=31%). Survey data was examined to identify the areas in which organizations were most affected by the pandemic and problems associated with limited access to services. A proxy measure for organizational capacity was created.

We developed a brief (13-item) survey focusing on three domains: (1) general organizational information (e.g., staff, budget, target populations); (2) special challenges (service or policyrelated) posed by COVID-19; and (3) potential interest in collaborating with an academic research center on a migrant health resource hub. The survey was emailed via Qualtrics (12/2020-1/2021) to 122 MSOs in NYC collecting data about the organizations; challenges posed by COVID-19; and, interest in potential intersectoral collaboration. Descriptive analysis focused on the pandemic’s impact on service provision, type of MSO and organizational capacity.

Hobbs LA, Masoud D, Cravero K, Figueroa EM and Romero D (2024) “The perfect storm”: community worker perspectives on the impact of COVID-19 on New York City immigrants and migrant-serving organizations. Front. Public Health 12:1387182. doi: 10.3389/fpubh.2024.1387182

Cravero K, Hobbs LA, Figueroa EM, Romero D. Supporting organizations to improve migrants’ access to health services in New York City. J Migr Health. 2024 Jul 18;10:100249. doi: 10.1016/j.jmh.2024.100249. PMID: 39132290; PMCID: PMC11315229.