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“There is no other option for me, I cannot go back,” said Najaf Akhlaqi, 26…”

To summarize, many Afghans are trying to escape into Iran and Pakistan since Afghanistan’s economy has completely collapsed. Only further showcases the sacrifice of those forced into a trapped state with nowhere safe to go.

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Just a few hundred yards away from the Iranian border, the migrants hunch down in a ditch around midnight, waiting to receive the green light from their handlers to move forward, near Zaranj, Afghanistan, in November.

Thousands of Afghans are trying to sneak into Iran and Pakistan each day, as incomes have dried up and life-threatening hunger has become widespread.

Just a few hundred yards away from the Iranian border, the migrants hunch down in a ditch around midnight, waiting to receive the green light from their handlers to move forward, near Zaranj, Afghanistan, in November. Credit...

ZARANJ, Afghanistan -From their hide-out in the desert ravine, the migrants could just make out the white lights of the Iranian border glaring over the horizon.

The air was cold and their breath heavy. Many had spent the last of their savings on food weeks before and cobbled together cash from relatives, hoping to escape Afghanistan's economic collapse. Now, looking at the border they saw a lifeline: work, money, food to eat.

"There is no other option for me, I cannot go back," said Najaf Akhlaqi, 26, staring at the smugglers scouring the moonlit landscape for Taliban patrols. Then he jolted to his feet as the smugglers barked at the group to run.

Since the United States withdrew troops and the Taliban seized power, Afghanistan has plunged into an economic crisis that has pushed millions already living hand-to-mouth over the edge. Incomes have vanished, life-threatening hunger has become widespread and badly needed aid has been stymied by Western sanctions against Taliban officials.

More than half of the population is facing "extreme levels" of hunger, António Guterres, United Nations secretary-general, said last month. "For Afghans, daily life has become a frozen hell," he added.

Now with no immediate respite in sight, hundreds of thousands of people have fled to neighboring countries.

From October through the end of January, more than a million Afghans in southwestern Afghanistan alone have set off down one of two major migration routes into Iran, according to migration researchers. Aid organizations estimate that around 4,000 to 5,00 0 people are crossing into Iran each day.

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The bus terminal in the city of Zaranj, where most migrants arrive hoping to cross into Iran illegally.

Though many are choosing to leave because of the immediate economic crisis, the prospect of long-term Taliban governance - including restrictions on women and fears of retribution - has only added to their urgency.

"There's an exponential increase in the number of people departing Afghanistan through this route, particularly given how challenging this journey is in the winter months," said David Mansfield, a researcher tracking Afghan migration. By his estimates, up to four times as many Afghans were leaving Afghanistan for Pakistan and then Iran each day in January compared with the same time last year.

The exodus has raised alarms across the region and in Europe, where politicians fear a repeat of the 2015 migrant crisis, when more than a million people, mostly Syrians, sought asylum in Europe, setting off a populist backlash. Many fear that this spring as temperatures rise and the snow-covered routesbecome easier to traverse, a deluge of Afghans could arrive at the European Union's borders.

Determined to contain migrants in the region, the European Union last fall pledged over $1 billion in humanitarian aid for Afghanistan and neighboring countries hosting Afghans who have fled.

"We need new agreements and commitments in place to be able to assist and help an extremely vulnerable civil population," Jonas Gahr Store, the Norwegian prime minister, said in a statement at the U.N. Security Council's meeting on Afghanistan last month. "We must do what we can to avoid another migration crisis and another source of instability in the region and beyond."

But Western donors are still wrestling with complicated questions over how to meet their humanitarian obligations to ordinary Afghans without propping up the new Taliban government.

In recent months, Taliban officials have appealed to Western officials to release their chokehold on the economy, making some promises around education for girls and other conditions set by the international community for aid. As the humanitarian situation worsened, the United States also issued some exemptions to sanctionsand committed $308 million in aid last month - bringing the total U.S. assistance to the country to $782 million since October last year.

But aid can only go so far in a country facing economic collapse, experts say. Unless Western donors move more quickly to revive the financial system, Afghans desperate for work will likely continue to look abroad.

Crouching among the migrant group in the desert, Mr. Akhlaqi steeled himself for the desperate dash ahead: A mile-long scramble over churned-earth trenches, a 15-foot-high border wall topped with barbed wire and a vast stretch of scrubland flush with Iranian security forces. Over the past month, he had crossed the border 19 times, he said. Each time, he was arrested and returned over the border.

A police officer under the former government, Mr. Akhlaqi went into hiding in relatives' homes for fear of Taliban retribution. As the little savings that fed his family ran dry, he moved from city to city looking for a new job. But the work was scarce. So in early November, he linked up with smugglers in Nimruz Province determined to get to Iran.

"I'm afraid of the Iranian border guards," he lamented. Still, he said, "I can't stay here."

Even before the Taliban takeover, Afghans accounted for the second highest number of asylum claims in Europe, after Syria, and one of the world's largest populations of refugees and asylum seekers - around 3 million people - most of whom live in Iran and Pakistan.

Many fled through Nimruz, a remote corner of southwest Afghanistan wedged between the borders of Iran and Pakistan that has served as a smuggling haven for decades. In its capital, Zaranj, Afghans from around the country crowd into smuggler-run hotels that line the main road and gather around street vendors' kebab stands, exchanging stories about the grueling journey ahead.

At a parking lot at the center of town known as "The Terminal," men pile into the backs of pickup trucks bound for Pakistan while young boys hawk goggles and water bottles. On a recent day, their sales pitches - "Who wants water?" - were nearly smothered by the sounds of honking cars and the angry shouts of haggling men exchanging tattered Afghani bank notes for Iranian toman.

Standing in line to climb into the back of a pickup, Abdul, 25, had arrived the day before from Kunduz, a commercial hub in northern Afghanistan that was wracked with fighting last summer during the Taliban's blitz offensive. As the thuds of mortar fire engulfed the city, his business sputtered to a halt. After the takeover, his shop stood empty as people saved the little money they had for basics like food and medicine.

As the months dragged on, Abdul borrowed money to feed his own family, plunging further and further into debt. Finally, he decided leaving for Iran was his only option.

"I don't want to leave my country, but I have no other choice," said Abdul, who asked that The Times use only his first name, fearing that his family could face retaliation. "If the economic situation continues like this, there will be no future here."

As the economic crisis has worsened, local Taliban officials have sought to profit off the exodus by regulating the lucrative smuggling business. At the Terminal, a Taliban official sitting in a small silver car collects a new tax - 1,000 Afghanis, or about $10 - from each car heading to Pakistan.

At first, Taliban officials also taxed the city's other main migrant route, a smuggler-escorted journey across the desert and over the border wall directly into Iran. But after accusations in September that a smuggler had raped a girl, the Taliban reversed course, cracking down on this desert route.

Still, such efforts have done little to deter smugglers.

Speeding through a desert road around midnight, one smuggler, S., who preferred to go by only his first initial because of the illegal nature of his work, blasted Arabic pop music from his stereo. A music video with a woman swaying in a tight black dress played on the car's navigation screen. As he neared his safe house, he cut the back lights to avoid being followed.

Moving people each night requires a delicate dance: First, he strikes a deal with a low-ranking Iranian border guard to allow a certain number of migrants to cross. Then, he tells other smugglers to bring migrants from their hotel to a safe house in the desert and coordinates with his business partner to meet the group on the other side of the border. Once the sun sets, he and others drive for hours, scoping the area for Taliban patrols and - once the route is clear - take the migrants from the safe house to the border.

" We don't have a home, our home is our car, all night driving near to the border - one day my wife will kick me out of home," S. said, erupting in laughter.

Crossing the border is just the first hurdle that Afghans must overcome. Since the takeover, both Pakistan and Iran have stepped up deportations, warning that their fragile economies cannot handle an influx of migrants and refugees.

In the last five months of 2021, more than 500,000 who entered these countries illegally were either deported or voluntarily returned to Afghanistan, likely fearing deportation, according to the U.N.'s International Organization for Migration.

Sitting on the ragged blue carpet of one hotel was Negar, 35, who goes by only one name. She had climbed over the border wall into Iran with her six children two nights before desperate to start a new life in Iran. For months, she had stretched out her family's meager savings, buying little more than bread and firewood to survive. When that cash ran out, she sold her only goat to make the journey here.

But once she touched Iranian soil, a pack of border guards descended on the group of migrants and fired shots into the pre-dawn darkness. Lying on the ground, Negar called out to her children and had a horrifying realization: Her two youngest sons were missing.

After two agonizing days, smugglers in Iran found her sons and sent them back to her in Zaranj. But shaken by losing them, she was at a loss over whether to attempt to cross again.

"I'm worried," she said. "What if I can never make it to Iran?"

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Over a Million Flee as Afghanistan's Economy Collapses

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Thousands of Afghans are trying to sneak into Iran and Pakistan each day, as incomes have dried up and life-threatening hunger has become widespread. Just a few hundred yards away from the Iranian border, the migrants hunch down in a ditch around midnight, waiting to receive the green light from their handlers to move forward, near Zaranj, Afghanistan, in November.

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In Exit West, Saeed and Nadia rely on their cell phones to communicate as the civil war physically separates them. Through text messages, their relationship grows closer. Their cell phones serve as a means of connection, but they also allow Saeed and Nadia to distract themselves from the world—and eventually each other.

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Mobile phones are ubiquitous. Stand in line at any grocery store or sit in any hospital waiting room, and you see people staring at their phones, presumably catching up on news or work or just relieving their boredom.

This seems innocuous enough. But could being on our phones affect our ability to connect with the people around us? A new study aimed to answer that question.

Researcher Kostadin Kushlev and his colleagues asked pairs of college students, who were strangers to each other, to come into a small lab waiting room-either with or without their phones. They were given no other instructions, but were told the researchers were running a bit late and they needed to wait. While waiting, their faces were secretly videotaped. Afterwards, the students reported how they felt and how much they interacted with the other participant, if at all.

Independent coders studied videotapes of the faces of pairs who interacted, measuring how often they smiled, how genuine the smiles were, and how much of the time they spent smiling during their wait. The results? People with phones exhibited fewer smiles overall (and fewer genuine smiles), and spent 30 percent less of the time smiling than people who didn't have their phones with them, signaling less interest in connecting with others.

"Smiling is a really powerful social lubricant. When somebody smiles at you, that indicates approachability," says Kushlev. "Our research suggests that phones might actually be impeding this very important approach-related behavior that serves to create new social ties."

What a smile does

Why would people smile less when they have their phones?

Kushlev isn't sure, but his prior research has found that people with phones find their interactions less enjoyable and less meaningful. The same may have been true in this situation, though the participants didn't report feeling significantly worse off after their waiting period was over-maybe not a surprise, given that the wait was only 10 minutes. Still, smiling is an unbiased, measurable indicator of happiness, perhaps more reliable than filling out a survey.

Besides indicating happiness, a smile also communicates to others that you're interested in them and trustworthy. So, if phones make us smile less when we're out and about in public, it could thwart our ability to form "weak ties"-connections with neighbors, colleagues, and other non-intimates in our community-that have been shown to have a profound effect on our health and happiness.

"Phones might actually have an effect on well-being because we know that interacting, even with strangers, and just having random interactions improves our well-being and makes us feel more connected," says Kushlev.

Though his experiment was designed only to analyze smiling in pairs, Kushlev and his colleagues also noted that thirty-two participants with phones didn't interact at all in the waiting room-while only six people without phones didn't interact. That lends credence to the hypothesis that there's something about having a phone with you that impedes connection with strangers overall.

This is not the first study to find that phones have pernicious impact on social interactions.

Indeed, some past research has shown that phones interfere with social conversation and our capacity to engage in activities requiring cognitive focus, which could affect our motivation to engage. Kushlev believes that looking down at our phones could be what explains these results, because looking down sends a signal of disinterest and stalls conversations. Or, he says, it could be that cell phone use drains our cognitive capacity so that we're less able to follow conversations or to interpret others' social signals.

How phones are changing our relationships

Does this mean we should eschew our phones whenever we're out and about? Maybe not, says Kushlev.

"There's lots of research that shows phones can help people meet basic psychological needs, maybe make you feel competent, and that can be good for well-being," he says. In his study, he argues, people might have chosen to talk to a friend or to read an article that could have made them happier, if they'd known how long they'd be waiting.

He's not advocating that phones are bad or social impediments, in general. In fact, he says, they can sometimes help us form and improve social ties, like when we use dating apps like Tinder to meet people or when we use them to connect with family who are far away. But he does think that pulling out your phone in public can often be a cop-out, done to avoid any potential awkwardness that can occur in socializing with strangers.

"It's this intermittent use of cell phones that can be a problem-where you look at your phone, the conversation doesn't go anywhere, and you're sending a signal that there are more important things to do than to talk to someone else," he says.

Instead of relying on your phone to distract you from discomfort, he suggests turning off notifications or using apps that determine what messages you see when you're out in public. That way, you don't miss out on what's going on around you or on making new connections. You can still use cell phones wisely, he argues, if you better understand their upsides and downsides and take steps to manage them better.

"The point isn't that phones are ruining our lives," he says. "The point is that phones are changing the ways that humans have met and created relationships and formed new social bonds throughout evolution. And that's important to know."

Greater Good wants to know: Do you think this article will influence your opinions or behavior?

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How Phones Compromise Our Ability to Connect

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Mobile phones are ubiquitous. Stand in line at any grocery store or sit in any hospital waiting room, and you see people staring at their phones, presumably catching up on news or work or just relieving their boredom. This seems innocuous enough. But could being on our phones affect our ability to connect with the people around us?

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Young adults face lots of trauma from immigration, especially latino adolescents. PTSD and more can develop.

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Abstract

Using data from a stratified random sample of 281 foreign-born adolescents and their parents, this study provides data on migration-related trauma exposures and examines how the migration process influences the risk of experiencing trauma and developing Post-Traumatic Stress Disorder (PTSD). We find that 29% of foreign-born adolescents and 34% of foreign-born parents experienced trauma during the migration process. Among those that experienced trauma, 9% of adolescents and 21% of their parents were at risk for PTSD. Pre-migration poverty combined with clandestine entry into the US increased the risk of trauma and the subsequent development of PTSD symptoms. Post-migration experiences of discrimination and neighborhood disorder further exacerbated this risk, while social support and familism mitigated it. Our results emphasize the importance of understanding how factors prior to, during, and after migration combine to influence the health of immigrants.

Keywords: immigrant, Latino, Hispanic, PTSD, trauma, health, acculturation

Approximately 37 million immigrant adults and 3 million immigrant children (ages 0-17) live in the United States ( US Census 2010). Over half (53%) are Hispanic of Latin American or Caribbean origin ( Acosta & Partirica de la Cruz, 2011). Before, during, and after migration to the US many of these Latino immigrants are at risk for experiencing trauma and developing symptoms of Post-Traumatic Stress Disorder (PTSD). These traumatic experiences can have severe and long-term impacts not only on the mental health of immigrants but also on their adjustment to life in the US ( Makley and Falcone, 2010). Trauma can led to difficulties at work for adults and difficulties at school among children ( Eisenman, et al., 2008; Kataoka, et al., 2009; MacMillan, 2001; Porche, et al., 2011).

According to the American Psychiatric Association (APA), trauma is defined as having experienced, witnessed or been confronted with an event that involves actual or threatened death or serious injury, or threat to the physical integrity of oneself or others ( APA, 2000). Common checklists of trauma experiences include questions about whether individuals have either experienced or witnessed a life-threatening accident; fire, flood, or a natural disaster; combat or war; rape or sexual molestation; childhood abuse or neglect; or someone being badly injured or killed ( Kessler, et al., 1995; Copeland et al., 2007). Symptoms of PTSD can include re-experiencing the event; avoiding thoughts, feelings or experiences associated with the event; and increased arousal, such as difficulty sleeping, irritability, and hyper-vigilance ( APA, 2000).

First recognized as a syndrome suffered by war veterans, most PTSD research among immigrants focuses on refugees from war-torn areas ( Bronstein and Montgomery, 2011; Johnson and Thompson, 2008; Lustig, et al., 2004). These studies report rates of PTSD between 19-54% among refugee children, rates well above prevalence rates of 2-9% in studies of the general population. Among adult refugees in community-based samples, rates vary between 14-19%. Traumatic exposures for refugee populations typically include combat experience and war or terror victimization (e.g., forced separation from family, torture, and having a friend or family member killed).

Immigrants who are not classified as refugees, especially those with low socioeconomic status and those who migrate to a country without authorization, can experience some of the same traumas experienced by refugees. Yet few scholars have investigated the prevalence of traumatic experiences or PTSD in a community-based sample of Latino immigrant adults and their children. Evidence suggests that the majority of men (61%) and women (51%) in the US experience at least one potentially traumatic event in their lifetimes ( Kessler, et al., 1995). Potentially traumatic events are prevalent among children as well. In one large longitudinal study of children, 68% reported experiencing a potentially traumatic event by the age of 16 ( Copeland et al., 2007). Both of these studies focus on a primarily white, non-Latino population and neither indicates that Spanish-speaking individuals were included in their samples.

The only US-based population study of Latino adults (ages 18+) found that approximately 16% experienced any anxiety-related disorder and 4% experienced PTSD within their lifetimes, but these prevalence rates differed significantly by Hispanic background or country of origin ( Alegria, et al., 2008; Alegria, et al., 2007). Other studies of Latino populations based primarily on convenience samples from health care facilities have found much higher rates of PTSD (18-38%), especially among those exposed to natural disasters, war and political violence, life-threatening illnesses, or sexual abuse ( Cervantes, et al., 1989; Eisenman, et al., 2003; Heilemann, Kury, and Lee, 2005; Santa-Maria and Cornille, 2007; Steel, Chey, and Silove, 2010; Yule, 2001). Additionally, some studies suggest that Hispanics and immigrants develop PTSD at much higher rates than US-born whites or African Americans ( Marshall, Schell, and Miles, 2009; Pole, Gone, and Kulkarni, 2008); whereas others find just the opposite ( Heilemann, Kury, and Lee, 2005; Alegria, et al., 2007, 2008; Roberts et al., 2011).

US-based studies of PTSD among children have found rates of 3-8% in adolescents and young adults ( De Bellis and Van Dillen, 2005; Yule, 2001). One study of immigrant children (ages 8-15) from Los Angeles found that 32% reported clinically-significant levels of PTSD symptoms ( Jaycox, et al., 2002). But others find lower rates and suggest that foreign-born Latino youth are less at risk of PTSD than US-born Latino youth ( Flores, et al,. 2010; Kataoka, et al., 2009). None of these studies specifically explores how the migration process influences trauma exposure and the development of PTSD.

Given the growth of Latino immigrant populations in the US ( Acosta & Partirica de la Cruz, 2011), it is essential to understand how the migration process shapes their health and adjustment. Migration to the US is a dynamic process which begins in immigrants' home countries (pre-migration), extends through the time spent in transit to a new destination (during migration) and continues upon their arrival in receiving countries (post-migration; Perreira and Ornelas, 2011). Yet the vast majority of previous research on the immigrants and their children focuses only on post-migration factors that influence immigrants' well-being. Few studies have documented how the migration process (before, during, and after settlement in a new country) contributes to mental health among Latino immigrant parents and their children ( Cervantes, et al., 2012; Ornelas and Perreira, 2011; Potochnick and Perreira, 2010; Santa-Maria and Cornille, 2007).

Examining migration as a process unfolding over time and within families, this study provides prevalence data on the exposure of immigrant adolescents and their parents to trauma before, during, and (for parents) after migration. In addition, this study examines risk and protective factors at each stage of the migration process that influence the development of PTSD symptoms. We conclude with a discussion of strategies to reduce traumatic exposures among immigrant children and their caregivers and mitigate their risk for developing PTSD.

Our framework for this analysis stems from segmented assimilation theory and developmental theories which emphasize the role of contexts on the well-being of immigrants ( Portes and Rumbaut, 2001; Rumbaut, 1991; Garcia-Coll and Magnuson, 1997). Segmented assimilation theory suggests that both the contexts of exit and reception influence the mental health of immigrant parents and their children. Critical factors include immigrants' socioeconomic status in their country of origin, their motivations for leaving, the safety of their journey, and the social context into which they arrive ( Portes and Rumbaut, 2001; Rumbaut 1991). Developmental theories posit that the consequences of migration for children will vary by their age as well as the socio-cultural, neighborhood, and family resources available to them ( Garcia-Coll and Magnuson, 1997; Lusting et al., 2004). Moreover, experiences at one stage of migration can influence experiences at another stage of migration ( Perreira and Ornelas, 2011). Thus, the risk of experiencing trauma and developing PTSD can accumulate throughout the migration process. provides a conceptual overview of these relationships.

Pre-migration Experiences

A variety of factors influence parent's decisions to migrate and to bring their children to the US ( Massey and Espinosa, 1997). Among these, economic hardships in their home countries and previous experiences with migration to the US can critically shape their migration and settlement experiences. For children who immigrate, a protracted separation from parents who have immigrated earlier can add to the hardships experienced before and during migration and can result in family conflict when children are re-united with their parents in the US ( Suarez-Orozco, Tadorova, and Louie, 2002).

Many immigrants who have lived in poverty prior to their migration to the US have endured years of chronic stress and have been exposed to war and political violence ( Eisenman, et al., 2003; Infante, et al., 2011). With limited educations and income, these impoverished immigrants have few legal avenues for migrating to the US and often enter clandestinely, without authorization ( Donato and Armenta, 2011; Riosmena and Massey, 2012). They are consequently at increased risk for exposure to trauma and the development of PTSD.

While chronic poverty prior to migration can potentially increase the challenges of migration and settlement, previous visits to the US may facilitate migration and settlement. Immigrants learn through experience how best to navigate the migration process, avoid problems, and find work and resources to assist with their settlement (Massey, Durand, and Malone, 2002). At the same time, each additional migration can lead to new trauma exposures and increase the risk of developing PTSD, especially for those entering without authorization.

Historically, males have undertaken the risk of migration while leaving their wives and children behind. In recent decades though, women have increasingly migrated alone or with their spouses while leaving their children in the care of friends or relatives ( Donato, 2010). Suarez-Orozco and colleagues (2002, 2006) have estimated that almost one-third of foreign-born children stay in their countries of origin with a relative before re-uniting with their parents in the US. Scholars typically expect parent-child separation to increase the stress of migration and the risk of developing PTSD after exposure to trauma ( Masten and Narayan, 2012; Santa-Maria and Cornille, 2007). This may be especially true in the absence of an alternative caregiver with whom the child can form an emotional bond ( Masten and Narayan, 2012). Among refugee populations, forced family separation and the death of primary caregivers result in the presence of unaccompanied children who display high levels of psychological distress ( Bronstein and Montgomery, 2011; Ludwig et al., 2004).

In non-refugee immigrant populations, parents may choose to migrate first and bring their children to the US at a later date (and older age) as a protective strategy. These children are not left alone or with strangers but are typically left with extended family with whom they already have social and psychological attachments ( Suarez-Orozco, Tadorova, and Louie, 2002). This sequential family migration strategy allows parents to migrate safely, adjust to life in the US, and save money to help bring their children to the US through either legal or safer modes of entry without authorization. Previous studies provide some evidence of a link between family separations and depression among immigrant children ( Suarez-Orozco, Tadorova, and Louie, 2002). However, no clear links between family separation and anxiety or anxiety-related disorders such as PTSD have been established among non-refugee immigrant populations.

Migration Experiences

After deciding to migrate to the US, immigrant parents and their children must next decide how best to migrate. Although the vast majority of immigrants (approx. 80%) enter the US with legal authorization on family, work, refugee, student or tourist visas, many Mexicans and other Central Americans have limited access to these visas and enter more frequently without authorization ( Donato and Armenta, 2011). Even those who enter with legal authorization may sometimes overstay their visas and join the ranks of the unauthorized population living in the US. As a result, the majority (approx. 70%) of the unauthorized immigrant population is of Mexican or other Central American origin ( Infante, et al., 2011).

Entry to the US without legal authorization can involve arduous journeys with exposure to extreme physical hardships as well as violence ( DeLuca, McEwen, and Keim, 2010; Infante, et al., 2011; Rasmussen, et al., 2007). Consequently, those who enter without authorization may be at substantial risk of trauma and the development of PTSD. Children immigrating at younger ages are particularly vulnerable to victimization during the migration journey (Cavazos-Rehg, Zayas, and Spitznagel, 2007; DeLuca, et al., 2010) and can have fewer social resources to promote their resilience and forestall the development of mental health problems such as PTSD ( Alegria, et al,. 2007; Vega, et al., 2004). Alternatively, young children may also be protected from developing PTSD after a traumatic exposure by lack of awareness due to cognitive immaturity ( Masten and Narayan 2012). For these reasons, we expect young children to be at greater risk of trauma but potentially lower risk of developing frequent PTSD symptoms. Adults can also mitigate the risk of trauma during migration for themselves and their children by traveling as part of a larger family unit that can both offer protection from potential assailants and buffer family members from the effects of stress. Thus, we expect that children and their parents who migrate as a family unit will be less at risk for trauma and PTSD.

Post-migration Experiences

Upon entering the US, immigrants can be exposed to several additional hardships which both increase the likelihood that they will experience trauma and that trauma will result in subclinical or clinical levels of PTSD symptoms. In particular, research shows that immigrants with distinctive phenotypical characteristics or religious practices experience high rates of racial-ethnic discrimination in the US and elsewhere ( Suarez-Orozco and Qin, 2006). Moreover, perceived racial-ethnic discrimination acts as a social stressor making some immigrants and ethnic minorities in the US feel threatened and powerless and as a biological stressor promoting biochemical changes that increase the risk of poor physical and mental health outcomes ( Flores, et al., 2010). Thus, some scholars argue that racial-ethnic discrimination is not only stressful but potentially traumatizing ( Bryant-Davis and Ocampo, 2005).

As an economically disadvantaged group, Latino immigrants in the US also find themselves segregated into more impoverished and high crime neighborhoods and schools where additional exposures to violence and discrimination can occur ( Charles, 2006; Oropesa, 2012; Orfield and Lee, 2005). These exposures can directly increase the risk for PTSD ( Jaycox, et al., 2002; Kataoka, et al. 2009). Moreover, experiences of discrimination and neighborhood disorder marginalize immigrants and can keep them from accessing sources of institutional support in their communities which could alleviate the stresses of migration and settlement ( Fortuna, 2008; Garcia-Coll, et al,. 1996; Pole, et al., 2008).

In contrast to discrimination and neighborhood disorder, the presence of strong family and social support systems typically protect parents and their children from exposure to trauma after migration and the development of PTSD ( Masten and Narayan, 2012; Pole, et al., 2005). Household caregiving responsibilities and strict parental controls can leave immigrant children with little time or opportunity to engage in risky behaviors ( Suarez-Orozco and Qin, 2006) and imbue them with a sense of family obligation which motivates them to stay out of trouble ( Fuligni and Pendersen, 2002). Additionally, family and social support systems can buffer immigrants from stress and promote resiliency across the life course. Thus, previous research consistently finds positive associations between familism (i.e. a strong connection and loyalty to family), social support, and mental health ( Kuperminic, et al., 2009; Alegria, et al., 2007).

Finally, one of the most heavily researched aspects of the post-migration experience - acculturation - has an ambiguous theoretical influence on mental and physical health ( Finch, et al., 2009). Measured in a variety of ways (immigrant generation, years in the US, language usage, and scales measuring adaptation to US socio-cultural norms) acculturation cannot be expected to have a causal influence on exposure to trauma prior to or during migration. However, it may influence how immigrants deal with these stressful events and thus their risk for PTSD symptoms after migration. Years in the US can signal increased time since exposure to trauma for those exposed prior to or during migration; English language skills can provide a greater capacity to access health services and other institutional resources in the US; and adaptation to US socio-cultural norms can indicate a greater ease with navigating US social systems. Alternatively, time in the US can signal more cumulative exposure to post-migration discrimination and neighborhood disorder and the loss of Spanish-language skills can signal the weakening of protective ethno-cultural ties and diminished access to ethnocentric resources. Overall, too few studies with mixed results have considered the relationship between acculturation and PTSD to be conclusive ( Escobar, et al., 1983; Heilman, Kury, and Lee, 2005; Marshall and Orlando, 2002; Ortega and Rosensheck, 2000).

METHODS

Study Design

We used data from the Latino Adolescent Migration, Health, and Adaptation Project (LAMHA), a population-based study of 281 foreign-born Latino youth (ages 12-18) and their primary caregivers (ages 25-60) in North Carolina. Between 2004-2006, LAMHA data were collected through a stratified-random, cluster sample of foreign-born Latino youth enrolled in high school or middle school (for details see Potochnick and Perreira, 2010). Parents and children could complete the survey in either Spanish or English. Due to low-literacy levels in the population, the parent survey was interviewer-administrated while the youth survey was interviewer-assisted (i.e. interviewers were available to answer questions if needed).

Sample

The sample reflects the background of first-generation immigrant youth and their caregivers living in North Carolina, one of the top 10 new immigrant receiving states in the United States ( Fortuny, 2010). For the most part, youth participants had only recently immigrated to the US -- 65% had lived in the US for 5 years or fewer and 15% had moved to the US before their 6 th birthday. The majority had emigrated from Mexico (78%) and spoke primarily Spanish at home (58%). Their primary caregivers were mostly biological mothers (76%) in their mid-thirties to early forties who had lived in the US for more than 5 years (74%). Primary caregivers other than biological mothers included fathers (14%) and other relatives (10%) such as an aunt or grandparent. We refer to all primary caregivers as parents throughout the remainder of this analysis. Most parents lived with a spouse or partner (73%) and neither they nor their partner had completed high school (67%). Most parents were also employed (74%) and living below the 2006 Federal Poverty Level (54%). Though poor, with an annual family income of $27,205, 50% of parents remitted an average of $240 per month to family in their home countries.

After deleting observations with missing data on the independent variables (N adolescent=12, N parent=22), the analytic sample for models of any traumatic experience was 269 for adolescents and 259 for caregivers. No data were missing on the dependent variables. After deleting observations with missing data on the dependent (N adolescent=4, N parent=0) and independent variables (N adolescent=7, N parent=13), the analytic sample for models of PTSD symptoms was 270 for adolescents and 268 for parents. Based on observed variables, all missing data were at random and on independent variables, such as parent's age or years of parent-child separation, which could not be imputed.

Measures

We derived all measures utilized in this study from either adolescent interviews or parent interviews. Surveys of both adolescents and their parents included questions on their immigration histories, family relationships, school and community experiences, socioeconomic backgrounds, and health. All measures included in the LAMHA surveys had been previously evaluated for use with Latino and Spanish-speaking populations. Several were adapted from the Children of Immigrant Longitudinal Survey (CILS; Portes and Rumbaut 2001). For all scales used in this analysis, we report internal reliability measures and reference validation studies for each scale.

Traumatic experiences

This study focused on migration-related traumas experienced directly by participants. Respondents were asked about traumatic experiences in three separate sets of questions at three different points during their interview. Interviewers asked adult and adolescent respondents if they had experienced several types of events: (1) in the year prior to moving to the US, (2) during their journey to the US, and (3) ever in their lifetimes (prior to migration, during migration, or after migration). Respondents were prompted about specific types of events such as natural disasters, the arrest of a family member, the murder of a family member, crime, terrorism, war, and serious injury or illness. At each of these three times when respondents were prompted to share their experiences, they were also prompted through an open-ended question to share additional details and other types of traumatic experiences. Respondents mentioned other experiences such as domestic violence, assault, rape, and severe illness or injury (e.g., dehydration and hunger) in response to these open-ended questions. In accordance with the DSM-IV definition of trauma, responses to all open-ended questions were coded as traumatic events when they involved "actual or threatened death or serious injury, or threat to the physical integrity of oneself or others" ( APA, 2000:427). Because it focuses on trauma directly experienced by respondents and associated with their migration experiences, our measure of trauma is more restrictive than measures focusing on life-time trauma that has either been experienced directly or witnessed ( Kessler et al, 1995; Copeland et al., 2007).

PTSD symptoms

Adolescents completed the Trauma Symptom Checklist for Children -Abbreviated version (TSCC-A), a 44-item checklist that yields six clinical scales - Anxiety, Anger, Depression, Disassociation, and Post-Traumatic Stress ( Briere, 1996). Item responses ranged from never (=0) to almost all the time (=3). Relying on only the 10-item post-traumatic stress scale, we followed standard protocol and classified adolescents as at risk for sub- or clinical PTSD if they had a T-score of 60 or greater. Raw scores ranged from 0 to 30 and are converted into standard T-scores (mean=50, SD=10) based on population norms which vary by gender and age. Internal consistency in our sample was good (α=.85).

Adult caregivers completed the 17-item Modified PTSD Symptom Scale (MPSS-SR; Falsetti, et al., 1993). The MPSS-SR can be used to assess both frequency and severity of symptoms. In addition, a PTSD diagnosis meeting the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) classification can be assigned if after experiencing trauma at least one re-experiencing symptom, three avoidance symptoms, and two arousal symptoms are endorsed ( APA, 2000). Assessed over the past 2 weeks on a scale ranging from not at all (=0) to 5 or more times per week (=4), MPSS-SR frequency scores are equivalent to scores generated from the PTSD Symptom Scale ( Foa, et al., 1993). Scores range from 0 to 51 and a frequency of 15 or greater is considered clinically significant in a community-based sample. The MPSS-SR demonstrated good overall consistency in our sample (α=.91). Following the guidelines for use of this scale, we classified adults as at risk for PTSD if the met either the frequency score threshold or the DSM-IV criteria ( APA, 2000).

Pre-migration factors

We considered three pre-migration factors. Following guidelines for measuring poverty in Mexico (CONEVAL 2010), we classified parents and children as living in extreme poverty prior to migration (1=yes, 0=no) if they reported that their homes abroad had dirt floors and lacked indoor plumbing. We also considered whether or not the child or parent had previously traveled to the US (1=yes, 0=no). Lastly, in models focused on adolescents, we considered whether the child had been separated from his/her primary caregiver for at least one year prior to migration.

Migration factors

For both parents and children, we determined whether they had entered the US without authorization (1=yes, 0=no) and whether they had migrated with a family member (1=yes, 0=no). To determine whether they had entered without authorization, we used data from parents on their and their child's place of birth, US citizenship, and the type of visas they and their child utilized to enter the country. Individuals indicating that they were not US citizens and who utilized no visa to enter the country were classified as having entered the US without authorization. In models focused on adolescents, we also included an indicator variable for migrating to the US at age 6 or less, a time of potentially low vulnerability to mental health problems. Ninety-five percent of youth who migrated to the US at age 6 or less were also accompanied by a family member.

Post-migration Factors

We assessed the effects of two groups of post-migration factors - acculturation and social environment. Acculturation was measured by years in the US, 4-items on language usage from the Short Acculturation Scale for Hispanics (SASH; Marin, et al., 1987), and the 10-item Psychological Acculturation Scale (PAS; Tropp et al., 1999). For both the SASH and PAS, items are answered on a 5-point Likert scale ranging from 1 (= Spanish only/Latinos only) to 5 (= Anglos only/English only). Items were then averaged to create scores ranging from 1 to 5 (α=.77 in our adult sample; α=.77 in our youth sample). Responses to language questions were highly skewed in our sample. Therefore, after scoring the SASH, we created an indicator variable (1=yes, 0=no) for being Spanish language dominant when the child had a score of less than two or when the parent had a score of 1.

Unlike the SASH, the PAS contained no questions on language usage. Instead, it focused exclusively on social contacts and cultural understanding. In our sample, internal consistency was high among adults (α=.88) and youth (α=.91). Among adults, correlations with the SASH score and years in the US were .54 and .17 (p < .05), respectively. Among youth, correlations with the SASH score and years in the US were .26 and .42 (p < .05), respectively.

In our evaluation of the post-migration social environment, we assessed two potential stressors - discrimination and living in an unsafe neighborhood. For both adolescents and parents, we identified whether they had "ever been discriminated against in the US" because of their race/ethnicity (1=yes, 0=no). We asked parents (but not youth) if any of the following were not a problem (=0), a minor problem (=1), or a major problem (=2) in their neighborhood: little respect for rules, laws, and authority; assaults and muggings; delinquency or gangs; or drug use or drug dealing out in the open ( Oropesa, 2012; Portes and Rumbaut 2001). We then identified a neighborhood as unsafe (1=yes, 0=no) if they indicated that any of these issues was at least a minor problem.

We also assessed four potential buffers from stress- social support, familism, parent living with a partner, and church attendance. We measured adolescent social support using the 8-item social support scale included in the School Success Profile ( Bowen, Rose, and Bowen, 2005). Affirmative responses were counted to create a scale ranging from 0 to 8 (=high support) with an internal consistency of .91 in our sample. We measured parents' social support using the 12-item Interpersonal Support Evaluation List (ISEL; Cohen, et al., 1985). After reverse coding six items, items were summed to create a scale ranging from 0 to 36 (= high support) with an internal consistency of .76 in our sample. For both parents and adolescents, we utilize Gil and Vega's (1996) 7-item familism scale (α adults=.87; α youth=.91). Each item is evaluated on a 5-point Likert scale and items are averaged to create a score ranging from 1 to 5 (= high familism). Parents reported whether they were living with a spouse or partner (1=yes, 0=no). Both parents and adolescents reported whether they attended church once per week or more (1= yes, 0=no). Social support was modestly correlated with familism, among both parents (r =.13, p < .05) and adolescents (r =.15, p <.05). Because the PAS emphasizes socio-cultural contact, it was also modestly correlated with social support among adolescents (r =.12, p <.05).

Demographic controls

In all models we controlled for sex (female=1), age, and whether at least one parent had completed high school (yes=1).

Comorbid Conditions

We assessed depression and anxiety which frequently co-occur with PTSD. Among adolescents, scores of 20 or greater on the Children's Depression Inventory (CDI, α=.85,; Kovacs 1992) and scores of 56 or more on the 10-item Multidimensional Anxiety Scale for Children (MASC-10, α=.72; March, et al. 1997) indicate clinically significant symptoms of depression and anxiety, respectively. Among adults, scores of 16 or greater on the Center for Epidemiological Studies -Depression (CES-D, α=.72) scale indicate clinically significant symptoms ( Radloff, 1977). Data on anxiety were not available for adults.

Analytic Approach

We began by estimating the prevalence of traumatic experiences that occurred among immigrant youth and their caregivers prior to migration, during migration, and, for parents only, post-migration. We then estimated unadjusted (available upon request) and adjusted logit models to identify what pre-migration, migration, and post-migration factors are associated with reports of exposure to any trauma. Analyses were conducted separately for youth and their parents. Next, we evaluated the prevalence of PTSD using the MPSS-SR for caregivers and the TSCC-A for youth, their co-occurrence, and their co-morbidities with depression and anxiety. Finally, we estimated unadjusted (available upon request) and adjusted negative binomial regressions (NGB) to identify the strength of associations between traumatic experiences, pre-migration, migration, and post-migration factors and raw PTSD scores among youth and zero inflated NGB regressions among parents. NGB regressions account for the fact that symptom frequencies have a binomial distribution with over dispersion ( Cameron and Trivedi, 1998). Zero-inflated models adjust for the large number of PTSD scores equal to zero among parents (89%; Greene, 2003). In parent models, PTSD scores can equal zero because the MPSS-SR is only completed by those adults reporting a traumatic experience and scores are set to zero for all others. NGB regressions are most easily interpreted by exponentiating the coefficient to obtain the multiplicative effect of each variable. In these models, a coefficient on x of exp(β)=1.3 would indicate that x is associated with a 30% increase in PTSD symptom frequency; whereas a coefficient of exp(β)=.7 indicates that x is associated with a 30% decrease in symptom frequency.

In additional analyses, we also estimated the risk of having PTSD (rather than symptoms of PTSD) using exact logit models for rare events ( King and Ryan 2002; Meehta and Patel 1995). Results from exact logits were fully consistent with results from logit models of any trauma experience and NGB regressions of PTSD symptoms. Thus, we do not include them here.

For more parsimony, variables of interest which were never significant in either unadjusted or adjusted models and not necessary to control for confounding were dropped from all final models. For example, post-migration social support was not included in models of pre-migration and migration-related trauma among adolescents. But these factors are considered in models of trauma among parents.

RESULTS

Migration Experiences

shows the distributions of pre-migration, migration, and post-migration characteristics in our samples of adolescents and their caregivers. Most children (68%) had been separated from their parents for at least one year prior to immigrating to the US but few (7%) had lived in extreme poverty. Though some children (15%) and their parents (23%) had visited the US prior to their most recent migration, most children (74%) and parents (69%) in our sample entered the US without authorization and were not legal permanent residents or US citizen. Most children (89%) and parents (68%) had also traveled to the US accompanied by another adult family member. Those who did not travel to the US together with a family member, migrated with a stranger or migrated alone. Once in the US, all children in this sample were reunited with their parents (90%) or other relative such as an aunt or grandparent (10%).

Table 1

Because most parents and their children had lived in the US for fewer than 10 years, neither they (mean PAS score=1.7) nor their children (mean PAS score=2.1) reported high levels of psycho-social acculturation. In contrast, most children (71%) but few parents (36%) spoke, read, or thought in English at least as much as Spanish. After moving to the US, some youth and their parents reported experiencing discrimination (38% and 32%, respectively). Nearly, one-fifth of parents also reported that they and their children lived in unsafe neighborhoods with crime, gang, and drug problems. Helping buffer them against these stressors, both parents and youth reported high levels of social support and familism. In addition, 73% of parents lived with a spouse or partner and attended church weekly (42%).

Prevalence of Traumatic Events, PTSD symptoms, and Co-morbid Conditions

In 50% of the immigrant families we interviewed either a parent or child reported experiencing trauma (). In 13% of families, both the parent and child reported experiencing trauma. Overall, 29% of youth had had a traumatic experience either in the year prior to immigrating or during their migration to the US. Among youth, 9% had been victims of a natural disaster, had had a family member arrested or killed prior to immigrating to the US, or reported escaping war or persecution in their home countries. In addition, 23% had been robbed, physically attacked, or accidentally injured; or had become ill during their migration journey.

Table 2

Many more caregivers than youth characterized their migration experience as "very stressful" (47% vs. 22%). Several (11%) had been a victim of a natural disaster, had had a family member arrested or killed, or had experienced war or terrorism in the year prior to immigrating to the US. Additionally, 11% had been robbed, physically attacked, or accidentally injured, or had become ill during their migration journey. At the time that we interviewed them, 17% of parents reported having been a victim of crime or violence during their lifetimes; 13% reported living through a natural disaster; and 7% reported experiencing a war or act of terrorism. Overall, 34% of parents had had at least one traumatic migration-related experience in their lifetimes.

Although high percentages of youth and their parents reported traumatic experiences, they did not report frequent traumatic symptoms (). On average, youth had an average raw PTSD score of 5.2 and only 4% of the sample had sub- or clinical frequencies of PTSD symptoms. Among those adolescents who experienced trauma, the prevalence of sub- or clinical PTSD symptoms was significantly higher than those who had not experienced trauma (9% vs. 2%, p<.05). Moreover, frequencies of sub- or clinical PTSD symptoms co-occurred with parents' PTSD. Fourteen percent of the youth at risk for PTSD also had parents at risk for PTSD; whereas only 7% of youth at low risk for PTSD had parents with PTSD. Youth at risk for PTSD also had higher rates of depression (28% vs. 5%, p<.05) and anxiety (67% vs. 29%, p<.05) than those at lower risk of PTSD.

Only parents who reported a trauma completed survey items about PTSD symptoms. Among these parents (n=89), 52% reported experiencing at least one of 17 symptoms of PTSD a few times a week or almost every day; and a substantial percentage (21%) were considered at risk for PTSD (). Like their adolescent children, parents at risk for PTSD also reported higher rates of depression than those not at risk (81% vs. 9 %, p<.01).

Associations with Traumatic Events

For both adolescents and parents, we found that extreme poverty and entry without authorization were strongly associated with one another and with the likelihood of experiencing trauma (). All youth and 98% of parents exposed to extreme poverty prior to migration entered the US without authorization. Compared to those not exposed to extreme poverty, youth exposed to extreme poverty prior to migration had a 4.4 higher odds of experiencing trauma. Compared to those who entered the US with authorization, parents who entered the US without authorization had a 3.1 higher odds of experiencing trauma. Experiences of discrimination and exposure to unsafe neighborhoods with crime, gang, and drug problems further added to parents' risk of experiencing trauma.

Table 3

For children, factors associated with a lower risk of potentially traumatic experiences included higher levels of psychological acculturation, time in the US, older age at migration, and a delayed migration where the child migrated to the US one or more years after their parent. Those factors protecting immigrant parents from potentially traumatic experiences included the presence of a spouse or partner in the household and strong social support systems.

Associations with PTSD Symptoms

As expected, the experience of a potentially traumatic event was associated with an increased risk of PTSD for both immigrant adolescents and their parents (). In unadjusted models, adolescents who reported any traumatic experience had PTSD symptom scores an average of 31% (1.5 points at the mean) higher than those who reported no trauma. Among parents, trauma experienced prior to migration was associated with an increase of PTSD symptom scores by 160% (i.e. 2.9 points at the mean). After adjusting for other covariates, the influence of traumatic events on PTSD symptom scores declined only slightly to exp(β)=1.29 for adolescents and increased slightly to exp(β)=2.71 for their parents.

Table 4

In addition to being associated with traumatic experiences, the frequency of PTSD symptoms in adolescents was associated with other migration and post-migration factors (). Among youth, a lower age at migration and familism were protective and negatively associated with PTSD symptoms. In contrast, ever experiencing discrimination and living in unsafe neighborhoods were associated with an increased risk of PTSD symptoms. Among parents, the frequency of PTSD symptoms was positively associated with poverty prior to migration, previous migration experiences, and female gender. Living with a spouse or partner familism, acculturation (language, psychological or years in the US), discrimination, and living in an unsafe neighborhood were never associated with PTSD symptoms among parents and were ultimately excluded to improve the parsimony of our models.

DISCUSSION

This study is one of the first to comprehensively examine the influence of stressors at various stages of migration on the well-being of immigrant families, and thus represents an important contribution to the literature. Five key results emerge from this research.

First, we found that 34% of Latino immigrant parents and 29% of Latino immigrant adolescents experienced trauma. Among those who experience trauma, 21% of parents and 9% of adolescents are at risk for PTSD. Studies of primarily non-immigrant and non-Hispanic white populations in the US report that as many as 51% of women and 61 % of men and 68% of adolescents in the US have experienced a potentially traumatic event during their lifetimes ( Kessler et al., 1995; Copeland et al., 2007). A large portion of these are life-threatening accidents, including traffic accidents, (14-25%), witnessing someone badly injured or killed (14-36%), and in the case of children, hearing about a traumatic event (21%). These are not the types of directly experienced migration-related traumas captured by this study. Nevertheless, the risk of PTSD among those who reported a potentially traumatic event was quite similar in our Latino immigrant sample to the rates of PTSD in these previous studies. Approximately, 20% of women and 3% of adolescents exposed to trauma developed PTSD ( Kessler et al., 1995; Copeland et al., 2007). In other words, most individuals experiencing potentially traumatic events do not develop PTSD. The same is true of immigrants. They are resilient and many survive potentially traumatic events without developing PTSD.

Second, we show that factors that contributed to immigrants' resilience included social support among parents as well as acculturation, time in the US, and familism among children. This has become a nearly ubiquitous finding in the research on mental health among immigrants ( Cook, et al., 2009; Perreira and Ornelas, 2011; Kuperminc, et al., 2009). High levels of familism create a safe, nurturing environment for the development of children where they can rely on the protective guidance and emotional support of their parents. Similarly, parents can rely on instrumental and emotional support of their spouses and extended family networks.

Third, our research adds to the wealth of evidence that the context of exit profoundly shapes the health consequences of migration ( Portes and Rumbaut 2001; Rumbaut 1991). Most importantly, we show that poverty prior to migration together with entry to the US without authorization were strongly associated with the likelihood of exposures to trauma in both adolescent children and their parents. These findings are not surprising given the dangerous conditions under which many Mexican and Central American immigrants migrate to the US. Those beginning the journey under conditions of financial hardship may also have fewer resources for ensuring a safer trip. Those who migrate to improve their economic situation may continue to struggle with financial hardship after arriving in the US, especially if they are working to send home remittances or pay off debts incurred during migration ( Negi, 2011).

Fourth, in contrast to the literature on unaccompanied refugee children ( Bronstein and Montgomery, 2011; Ludwig et al., 2004), we find a negative-association between parent-child separation and the likelihood of experiencing a potentially traumatic event. We find a positive association between young age at migration and trauma experiences. In our sample, forced family separations did not occur. Family separations were voluntary and children separated from their parents prior to migration lived with other family members such as a grandparent. At the time that we interviewed them, all children and parents had been re-united with their families. Our results support the hypothesis that parent-child separation reflects a strategy of delayed migration where the parent migrates first and the child follows at a later date and older age. This strategy allows parents to gather the resources needed to ensure a safer passage and reduce the likelihood that their child will experience a potentially traumatic event.

Lastly, our research contributes to understanding how the context of reception influences the health consequences of migration ( Portes and Rumbaut 2001; Rumbaut 1991). Both discrimination and neighborhood disorder contributed to the risk of post-migration trauma and the development of PTSD symptoms. These findings are consistent with previous research on the harmful effects of both discrimination and neighborhood disorder on the mental health of both adolescent and adult Latinos ( Cook, et al., 2009; Potochnick and Perreira, 2010).

Though our sample of immigrants is primarily Mexican, we expect that similar results would be found among other groups of immigrants characterized by low SES relative to the US population and immigrants who move from countries where they have experienced natural disasters, war, or political violence. Additionally, we expect similar results for other populations who migrate to the US without legal status. Migration-related traumas are likely a common experience not only for refugees but also for many other immigrant populations.

By exclusively focusing on Latino immigrants and asking detailed questions about the full migration process, the Latino Adolescent, Migration, and Adaptation (LAMHA) study provided a unique opportunity to examine how factors before, during, and after migration influence mental health outcomes such as PTSD. At the same time, this study is based on a relatively small, cross-sectional sample with limited power to detect weaker associations and analyze potential modifying effects. Additionally, all retrospective studies of trauma are subject to recall bias and memories of traumatic experiences can sometimes be suppressed or forgotten ( Maughan and Rutter, 1997; Raphael, Cloitre, and Dohrenwend, 1991). Those who experience PTSD may also be those most likely to recall trauma, a problem making it difficult to disentangle causal relations in a cross-sectional study. Given the sensitive nature of the topic, respondents may also have chosen not to share some of their experiences with interviewers. We aimed to reduce recall and reporting bias by inquiring about respondents' experiences at different stages of the migration process and at different points in the interview as interviewers built rapport with respondents.

Finally, data collection for this study took place before the increase in immigration enforcement activities within the interior of the United States. These enforcement activities included Department of Homeland Security (DHS) worksite enforcement actions between 2006-2008, the authorization local law enforcement officers to question noncitizens about their immigration status, and the authorization of local law enforcement officers to detain noncitizens with immigration violations for up to 48 hours ( Capps et al., 2007; Chaundry et al., 2010). Each of these activities has resulted in the arrest, detention, and deportation of immigrant parents, mostly fathers, with both foreign-born and US-born children ( Wessler, 2012). Such arrests, detentions, and deportations result in the forced and potentially traumatic separation of parents from children ( Chaundry et al., 2010; Dreby, 2012; Hagan, Eschbach, Capps 2008). Though the participants in this study did not experience deportations and forced separation, future work should identify and evaluate the consequences of these experiences.

To build upon this analysis and others, future research on the health of immigrant populations and their children must collect more comprehensive and longitudinal data about the migration process and settlement experiences of immigrants. We cannot fully understand the role of migration in health and development without considering how experiences prior to and during migration shape the context of settlement in the US.

Trauma occurs frequently in the lives of immigrant youth and their parents. More than anything else, extreme economic hardship, limited legal means for authorized entry to the US for poorer Mexicans and other Central Americans, and discrimination within the US increase the risk of trauma. These traumatic experiences can result in the development of acute and chronic mental health problems including PTSD, generalized anxiety, and depression. The consequences of poor mental health to parents and their children can be severe and include lower academic achievement among children, reduced employment opportunities and lost wages among parents, and stressful family relations ( Eisenman, et al., 2008; Kataoka, et al., 2009; MacMillan, 2001; Porche, et al., 2011). Thus, immigration policy reforms promoting safe and legal migrations and efforts to reduce discrimination and improve the settlement experiences of immigrants can promote their civic engagement in their local communities as well as their health and ability to contribute to the US economy.

Acknowledgments

The LAMHA Project was funded by a grant from the William T. Grant Foundation and directed by Krista M. Perreira and Mimi V. Chapman. This research was also supported by grant, 5 R24 HD050924, Carolina Population Center, awarded to the Carolina Population Center at The University of North Carolina at Chapel Hill by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Persons interested in obtaining LAMHA restricted use data should see http://www.cpc.unc.edu/projects/lamha for further information. The authors would also like to express their appreciation to Paula Gildner for her management of the data collection process; Stephanie Potochnick for her assistance with data cleaning; and all the schools, immigrant families, and adolescents who participated in our research project

Contributor Information

Krista M. Perreira, Department of Public Policy, University of North Carolina, Chapel Hill.

India Ornelas, Department of Health Services, University of Washington, Seattle.

References

Falsetti SA, et al. The Modified PTSD Symptom Scale: A Brief Self-Report Measure of Posttraumatic Stress Disorder. Behavioral Assessment Review. 1993 Jun;:161-162. [Google Scholar]

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Infante C, et al. Violence Committed Against Migrants in Transit: Experiences on the Northern Mexican Border. [Accessed April 15, 2012];Journal of Immigrant and Minority Health. 2011 doi: 10.1007/S10903-011-9489-Y. [[PubMed] [CrossRef] Google Scholar]

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Painful Passages: Traumatic Experiences and Post-Traumatic Stress among Immigrant Latino Adolescents and their Primary Caregivers

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Using data from a stratified random sample of 281 foreign-born adolescents and their parents, this study provides data on migration-related trauma exposures and examines how the migration process influences the risk of experiencing trauma and developing Post-Traumatic Stress Disorder (PTSD). We find that 29% of foreign-born adolescents and 34% of foreign-born parents experienced trauma during the migration process.

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Reminds me of the concept of doors leading to mysterious places in the novel. Much like the mass immigration of Vietnamese people escaping during the Vietnam War, they too didn’t know where they would be in the next month, if they’d be alive, or if they would still even have their family. It shows a lot that, despite this mystery, people find freedom and stability to be so important that they take this risk.

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I Was A Boat Person: Vietnamese Refugees Look Back

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Not every monster in your closet is evil.

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Door Analysis: Throughout the novel, doors are mentioned repeatedly. These doors are more than simply an escape; they represent, as this article explores, modern technology. This article relates modern technology to the doors.

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Exit West, written by Mohsin Hamid, imagines a world in which waves of refugees from all over the world flee their home countries in search of safety. The story centers around Nadia and Saeed, whose journey and relationship the reader follows as the two grow together, leave their home country, and eventually grow apart. Yet Exit West has another layer of complexity: the refugees flee through magical doors that pop up and lead to everywhere from London to California and back again. This magical technology plays many roles in the novel, most obviously by eliminating the journey that refugees face and focusing on their lives after migration instead. However, these doors also play a crucial role in human connection and the relationship between central characters in the story. Similarly to cell phones, which are also emphasized throughout the novel, the doors are able to both connect and distance people; bring them together and tear them apart. Hamid uses magical doors as a large-scale physical metaphor for cell phones: the doors, like phones, have completely altered the characters' everyday lives and they offer the opportunity to connect to the outside world in ways previously unimaginable, yet they simultaneously distance characters from one another. These doors, when viewed as a metaphor, illuminate the large-scale effects that technology has on human connection, for better or for worse.

In the words of Eva Menger, "new inventions are created every day, but only a small percentage of them significantly change the way of human life," (Menger 5). Adam Greenfield, in his piece "Radical Technology," asserts that cellphones have indeed "altered the texture of everyday life," (Greenfield). In Exit West, the life-changing effects of cellphones are clearly present throughout the narrative. Nadia and Saeed are "always in possession of their phones" when they first meet and are able to be "present without presence" in each other's lives through these devices, thus helping their relationship come to fruition (Hamid 39-40). When the cell service disappears in their city, Nadia and Saeed "and countless others [feel] marooned and alone and much more afraid," (57). On an everyday scale, Nadia uses her cell phone as a form of escapism: "It kept her company on long evenings, as it did countless young people in the city...she rode it far out into the world...She watched bombs falling, women exercising, men copulating, clouds gathering, waves tugging at the sand..." (41). In doing so, Nadia essentially separates herself from the dangerous and politically unstable world that she physically resides in and is able to access the rest of the world - wherever she chooses - and immerse herself in it.

The magical doors similarly change the way of human life. When many people in Nadia and Saeed's city feel alone and afraid to leave their homes, utterly devoid of cell service and thus devoid of both human connection and connection to the outside world, rumors of magical doors "that could take you elsewhere, often to places far away, far removed from this death trap of a country" begin to circulate (72). These are the ultimate and most literal form of escapism, yet on a much larger and more significant scale. This thus magnifies the serious effects that phones can have. Cellphone addiction can leave humans "dazed and sick" - a disorientation associated with the doors as well - and glued to their screens, which can distance humans from one another mentally (40). Greenfield notes how cellphones "increasingly dominate social space wherever we gather...we're both here and somewhere else at the same time, joined to everything at once yet never fully anywhere at all," (Greenfield). The magical doors physically, rather than mentally, distance humans from one another.

The most prominent example of this is when Saeed leaves his father via a magical door. Saeed "desperately" wants to leave his city, and Nadia is "possibly even more feverishly keen to depart," (94). Saeed recognizes what he is giving up with this journey - his family and friends - and is deeply saddened. Similarly to his cell phone use, Saeed is happily willing to utilize the new technology but recognizes the strong effects it can have. Nadia, meanwhile, is "more comfortable with all varieties of movement in her life than was Saeed," (94). She embraces the use of the doors with few worries. Just as Nadia's phone allows her to mentally escape the reality of the dangerous city she lives in, the door physically lets her escape the city.

Saeed's father, on the other hand, rejects the magical doors completely when Nadia and Saeed beg him to accompany them in escaping the city. His father recognizes this magical technology and its benefits but is unwilling to actually use it himself. He is attached to the things that he has known his whole life: his home city, family, and way of life. He knows that passing through a door will leave him completely disconnected from his buried wife and remaining family, and thus he refuses. This rejection of new technology by Saeed's father strongly mirrors how different generation approach and use technology differently, especially cellphones. While the vast majority of the younger generations have fully embraced cellphones - and are addicted to them, using them for approximately four hours a day, on average - the older generations generally use them significantly less often, if at all (Hymas). Hamid does not pass judgement on whether Nadia and Saeed, who have grown up with technology and are excited to use the doors, are too trusting of the doors or whether Saeed's father, to whom this technology is new and unknown, is too cautious; Hamid simply acknowledges that the effect technology has on us is omnipresent and even omnipotent.

However, the doors - and phones - do not just disconnect people; they often bring people together as well. Just as the constant possession of cell phones allows Nadia and Saeed's relationship to initially blossom, the doors mirror this by bringing people together who, in another world, would never have met face to face. Both Nadia and Saeed themselves encounter other romantic partners through the doors. Nadia falls in look with "the head cook from the cooperative, a handsome woman with strong arms," while "Saeed and the preacher's daughter likewise drew close," in the town of Marin, which the two migrated to through their third door (218-219). Exit West presents other relationships that are able to form through the technology of the magical doors as well. Near the end of the novel, Hamid gives the reader an interlude to the story in which a "wrinkled man" and an "elderly man" meet one another through a door of their own, visiting one another every day and eventually falling in love (175). Hamid describes the new world brought forth by the doors: "For many, adjustment to this new world was difficult indeed, but for some it was unexpectedly pleasant," (173). These technologies radically change how we live but are neither all good nor all bad.

The magical doors alter society on a larger scale as well, changing how people create communities and work together to create change. Cellphones have provided global access to global information, especially information that was previously unavailable, and through which people are able to educate themselves regarding how other cultures and areas of the world live. Furthermore, those in war zones or dangerous areas who are need of help are often able to more easily publicize their situations. Revolutions can be brought to light through this technology, whether from a GoFundMe page on someone's social media or a full-blown social movement such as the Western Cape Anti-Eviction movement in South Africa, which specifically utilize "the mobile phone for democratic activism," (Chiumbu 194).

Just as phones start revolutions, doors start revolutions as well. When Nadia and Saeed enter Mykonos, Hamid writes: "In this group, everyone was foreign, and so, in a sense, no one was," (106). Later, a woman in California recognizes that everyone is a type of migrant, thinking, "We are all migrants through time," (209). The huge number of refugees constantly moving from one place to another revolutionizes both how they are viewed and how they are treated by much of the public. The overwhelming use of the magical doors brings to light the actual need of many of migrants to escape their dangerous home countries and raises global awareness. Although nativists, groups of people who violently push back against the migrants, exist and cause harm, many others sympathize with the travelers. The movement of people through these doors bring forth "volunteers delivering food and medicine...aid agencies at work...and the government had not banned them from operating," (137). Even governments act consciously - after an initial attempt at removing the migrants in London, they pull back. Hamid writes: "Perhaps they had grasped that the doors could not be closed, and new doors would continue to open...and too many native parents would not after have been able to look their children in the eye, to speak with head held high of what their generation had done..." (166). The act of deporting refugees or migrants - arguably comparable to those who are labeled as 'illegal' immigrants - when they are unsafe in their home country and have nowhere to flee is immoral, and the mass migration made possible by the doors revolutionizes their treatment on a large scale.

The magical doors in Exit West bring us face to face with the serious consequences that technology has on humanity. In many ways, the doors and their effects closely mirror cellphones and their effects. What phones do mentally, the doors often do physically and thus amplify the gravity of their impacts. Hamid does not pass a clear judgement on these effects, presenting us with both the best and the worst that technology can bring to humanity. While phones and doors often bring people together, they just as often tear people apart. They can change ways of life, spread information, and even start revolutions, yet simultaneously leave us addicted and disconnected from reality. Regardless of whether the benefits outweigh the dangers, Exit West raises awareness of how we use technology in our lives.

Works Cited

Chiumbu, Sarah Helen. Exploring Mobile Phone Practices in Social Movements in South Africa - the Western Cape Anti-Eviction Campaign. 2012. Semantic Scholar, doi: 10.1080/14725843.2012.657863.

Greenfield, Adam. "Smartphone: The Networking of the Self." Radical Technologies: The Design of Everyday Life, Verso, 2017.

Hamid, Mohsin. Exit West. Penguin Random House, 2017.

Hymas, Charles. "A Decade of Smartphones: We Now Spend an Entire Day Every Week Online." The Telegraph, 2 Aug. 2018. www.telegraph.co.uk, https://www.telegraph.co.uk/news/2018/08/01/decade-smartphones-now-spend-entire-day-every-week-online/.

Menger, Eva. "'What It Feels like to Be an Other': Imaginations of Displacement in Contemporary Speculative Fiction." Studies in Arts and Humanities Journal; Dublin, vol. 4, no. 2, 2018, pp. 61-78.

Stanley Johnston on August 12, 2019:

Interesting essay on imaginative, clever book.

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Magical technology plays a key role in Exit West, written by Mohsin Hamid. Often mirroring the role of cell phones, magical doors pop up throughout the world and transport people from one place to another. This article analyzes the use of these doors in the novel.

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“But maybe we, in another life
Could fall in love, have it all
And chase our daydreams
But here we are, sat across
From one another on an empty train
Getting lost in thought”

Emphasizes the theme of lost liberty/freedom in the novel. It’s clear that Saeed and Nadia have accepted their reality of living separate lives after moving to California- the lyrics create the feeling that everything has gone so poorly that someone should just wait for “another life,” the current life essentially given up on.

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Throughout the novel, Saeed and Nadia face slight trauma after moving from their war-torn city. For their rest of their lives, they may spend time hearing loud noises and thinking they are something they aren't, and so much more. This is one link that delves into trauma.

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Understanding Immigrant Trauma > The Immigrant Learning Center

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Learn about immigrants’ unique mental health challenges and how they can be addressed. Access research on trauma, acculturative stress and more.

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California is a place to follow your dreams; a place where "everyone is a star." In chapter 10, we see just that: Saeed and Nadia are discovering internal truths about themselves, changing overtime and developing a new sense of life.

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Published on Jan 18, 2021

Updated on Nov 25, 2021

We all want to travel to places which offer all sorts of happiness in their own unique way.

A trip to California will definitely be worth your time. The state as a lot to offer that gives it the title as the Golden state.

California is a western state of the US that is known for its success in agriculture. The state constitutes acres of farmland and 45% of the global tree population. It is also a famous tourist state. Hollywood, the Golden Gate Bridge, Disneyland, Yosemite National Park, Alcatraz and Angel Island are few tourist destinations among many. These California quotes will encourage you to travel to the state at the earliest. But before you go, you must read this article to know fantastic sayings about California.

You may also like Patriotic quotes and Inspiring Quotes about America.

Popular Quotes About California

The golden state of California inspires many people every year with its charm. Even singers mention it in their songs. The Red Hot Chili Peppers had numerous songs inspired by California. Read below to find out some of the popular California quotes and California Instagram captions.

1. "You could travel the world, but nothing comes close to the golden coast."

- Katy Perry, 'California Girls'

2. "I just found out her ghost left town, the Queen of California is stepping down."

- John Mayer, 'Queen of California'

3. "In Los Angeles, everyone is a star."

- Denzel Washington

4. "My heart cried out for you, California."

- Joni Mitchell, 'California'

5. "She stood there bright as the sun on that California coast."

- Bob Seger, 'Hollywood Nights'

6. "You haven't lived until you've died in California."

- Mort Sahl

7. "Things are tough all over, cupcake, an' it rains on the just an' the unjust alike...except in California."

- Alan Moore

8. "I suddenly realized I was in California. Warm, palmy air - air you can kiss - and palms."

- Jack Keroua

9. "The light was different here in California."

- Heidi Freeston

10. "Everything is just better in California - the wine, the food, fruits and vegetables, the comforts of living. Even the instrumentalists are generous and curious. Everything is wonderful."

- Beth Anderson

11. "In California gold was what God was in the rest of the country: everything, everywhere."

- Claire Vaye Watkins

12. "California was almost entirely a dream, a dream vague but deep in the minds of westering people."

- Bernard DeVoto

13. "To capture a California sunset in South Pasadena is to hold an angel's wings with bated breath."

- Ace Antonio Hall

14. "I'm a Texas girl, with a California soul."

- Crystal Woods

15. "When I came to California, it was the mecca of the world. Every young person on the planet wanted to be here."

- Joni Mitchell

16. "There are so many different challenges California has; it's the greatest state in the greatest country in the world."

- Arnold Schwarzenegger

17. "I love driving; driving along the California coastline is the best drive in the world."

- Al Jardine

18. "We only have two kinds of weather in California, magnificent and unusual."

- James M Cain

19. "Living in California adds ten years to a man's life. And those extra ten years I'd like to spend in New York."

- Harry Ruby

20. "Best way to live in California is to be from somewhere else."

- Cormac McCarthy

21. "I am a California girl, born and raised, so flip-flops and cutoff shorts are my go-to look."

- Meghan Markle

22. "In California, we have some of the strongest consumer protection laws in the country. While it is easy to conceive of innovation and regulation as mutually exclusive, California is proof that we can do both. We can innovate responsibly."

- Kamala Harris

23. "I'm your biggest fan, California, I'm coming home"

- Joni Mitchell, 'California'

24. "Why don't you go on west to California? There's work there, and it never gets cold. Why, you can reach out anywhere and pick an orange. Why, there's always some kind of crop to work in. Why don't you go there?"

- John Steinbeck, 'The Grapes of Wrath'

25. "California, where the spring comes in the fall and the fall comes in the summer and the summer comes in the winter and the winter never comes at all."

- Inez Haynes Irwin

26. "Made up my mind to make a new start, going to California with an aching in my heart."

- Led Zeppelin, 'Going to California'

27. "California: bordering always on the Pacific and sometimes on the ridiculous. So, why do I live here? Because the sun goes down a block from my house."

- George Carlin

28. "Dean's California - wild, sweaty, important, the land of lonely and exiled and eccentric lovers come to forgather like birds, and the land where everybody somehow looked like broken-down, handsome, decadent movie actors."

- Jack Kerouac, ' On the Road'

29. "Nature. That's the one thing that tips the balance in terms of living here in California. Within minutes, I can be in a desert, at the ocean, in a park, and that's the most nourishing food for my soul."

- Lara Pulver

30. "This is the California that men dreamed of years ago, this is the pacific that Balboa looked at from the peak of Darien, this is the face of the earth as the creator intended it to look."

- Henry Miller

31. "I just realized some things make me happier, and the good weather in California makes me happier."

- Bianca Balti

32. "California, still a magical vanity fair."

- Eileen Granfors

33. "California is where you get to start over."

- Tracy Chevalier

34. "I think California has the best energy."

- Kevin Gates

35. "If they can't do it in California, it can't be done anywhere."

- Taylor Caldwell

36. "There is science, logic, reason; there is thought verified by experience. And then there is California."

- Edward Abbey

37. "California deserves whatever it gets. Californians invented the concept of life-style. This alone warrants their doom."

- Don Delillo

38. "Whether they're for good or bad, all trends in the United States start in California."

- Steve Schmidt

39. "I'm a California girl, even if I try and cover it up with leather."

- Gigi Hadid

40. "I was trying to pay the bills with poems, and it was easy to memorize my poems, because I'd be riding my bike in California trying to memorize them before going on stage at a poetry lounge."

- Omari Hardwick

41. "Whatever starts in California unfortunately has an inclination to spread."

- Jimmy Carter

42. "I love California, I practically grew up in Phoenix."

- Dan Quayle

43. "The mornings along the coast where the fog and mist meet with the salty spray of the seas is one of my favourite smells. I love the smell in the evergreen forest just after it rains - The Redwood Forest in California has the coast, too, so you have the best of everything!"

- Paul Walker

44. "Every time I come, I'm still amazed at the breadth California has. Big Sur, Yosemite, the desert... I love it."

- Theo James

45. "The apparent ease of California life is an illusion, and those who believe the illusion real live here in only the most temporary way."

- Joan Didion

46. "I'm not really a Hollywood person. Not that I don't like L.A., but I'm just a Northern California guy."

- Clint Eastwood

47. "The two girls grew up at the edge of the ocean and knew it was paradise, and better than Eden, which was only a garden."

― Eve Babitz, 'Sex and Rage: Advice to Young Ladies Eager for a Good Time: A Novel'

48. "God will break California from the surface of the continent like someone breaking off a piece of chocolate. It will become its own floating paradise of underweight movie stars and dot-commers, like a fat-free Atlantis with superfast Wi-Fi."

― Laura Ruby, 'Bad Apple'

Travel Quotes About California

These California quotes are worthy of Instagram captions. Quotes about California can't be complete without talking about the incredible beaches, travel, exploring, and more. One cannot resist posting pictures there. Here are some California quotes that you can use as California Instagram captions for your followers. You can also find cute California beach quotes here. Feed your wanderlust with these quotes and Instagram captions.

49. "It's the easiest thing in the world to get to California-you just aim yourself west and start walking."

-Rae Carson

50. "When California was wild, it was the floweriest part of the continent."

- John Muir

51. "Life in California is beautiful."

- Oscar Nunez

52. "California is always in my mind."

- David Hockney

53. "I love California. It definitely represents wild freedom."

- Jenny O.

54. "I like to go for a little drive up the California coast."

- Colin Farrell

55. "All creative people should be required to leave California for three months every year."

- Gloria Swanson

56. "Not all clouds fit over the ocean. Rain finds the lemon tree but rarely in California."

- Emily Vizzo

57. "Do Re Mi California is a garden of Eden, a paradise to live in or see, But believe it or not, you won't find it so hot If you ain't got the do re mi."

-Woody Guthrie

58. "California is an unbelievable state."

- Drew Barrymore

59. "The attraction and superiority of California are in its days. It has better days, and more of them, than any other country."

- Ralph Waldo Emerson

60. "There's nothing wrong with Southern California that a rise in the ocean level wouldn't cure."

- Ross MacDonald

61. "All scenery in California requires distance to give it charm."

- Mark Twain

62. "When a tree takes a notion to grow in California, nothing in Heaven or on earth will stop it."

- Lilian Leland

63. "California to me as a concept or as an idea always seems like endless optimism and endless opportunity - when people think of California they think of palm trees and blue skies and gorgeous sunsets and beaches and everything else."

- Mark Hoppus

64. "As one went to Europe to see the living past, one must visit Southern California to observe the future."

- Alison Lurie

65. "California is an Italy without its art."

- Oscar Wilde

66. "Everyone in California is from somewhere else."

- Wright Morris

67. "All of a sudden, I feel very old and very tired. Maybe when I get to California, the smog, brush fires, floods, and earthquakes will cheer me up."

- Erma Bombeck

68. "Everyone who comes to California brings a little of his own state with him. His own old state, regardless of where or when, is always lurking in the back of his memory for comparison with what he finds here."

- Max Miller

Serious Quotes About California

These California quotes will tell you some interesting facts about the state from a more real perspective. Take a look at these California quotes below!

69. "And you know something, because everything that I've gotten - my career, my money, my family; everything that I've gotten and achieved is because of California."

- Arnold Schwarzenegger

70. "California is one of the strongest states with one of the solidest economies but, at the same time, ignores the reality of its farmworkers."

- Diego Luna

71. "California is a queer place in a way, it has turned its back on the world, and looks into the void Pacific. It is absolutely selfish, very empty, but not false, and at least, not full of false effort."

- D. H. Lawrence

72. "California is going to be quite good for the Democrats. But the rest of the country is a draw."

- Stuart Rothenberg

73. "Southern California, where the American Dream came too true."

- Lawrence Ferlinghetti

74. "California can and does furnish the best bad things that are obtainable in America."

- Hinton R. Helper

75. "It was, of course, the discovery of gold that got California off to a flying start, and set in motion its chain-reaction, explosive, self-generating pattern of development."

- Carey McWilliams

76. "Californians tend to be outspoken. When the great migration began, the more timid people must have stayed home, and the bolder ones headed west."

- Shana Alexander

77. "California is a place of invention, a place of courage, a place of vision, a place of the future. People who made California what it is were willing to take risks, think outside convention and build."

- Nicolas Berggruen

78. "The biggest problem that we have is that California is being run now by special interests. All of the politicians are not anymore making the moves for the people, but for special interests and we have to stop that."

- Arnold Schwarzenegger

79. "California is our biggest economy. California is our biggest agricultural producer. So what happens here matters to every working American."

- Barack Obama

80. "California produces 40% of America's fresh fruits, vegetables and nuts - the kind you eat. We have had a bumper crop of the other variety, too."

- Ronald Reagan

Funny Quotes About California

California is a cheerful and joyful place to live in. So read the California quotes below to know the fun side of the Golden State by the people who know it too well. You will also be able to find Southern California quotes in here.

81. "California people are quitters. No offense. It's just you've got restlessness in your blood."

-Claire Vaye Watkins

82. "California is full of homesick people."

- Judy Van Der Veer

83. "I'd rather be in prison in California than free anywhere else."

- Inez Haynes Irwin

84. "Los Angeles? That's just a big parking lot where you buy a hamburger for the trip to San Francisco."

- John Lennon

85. "It's a scientific fact that if you stay in California you lose one point of your IQ every year."

- Truman Capote

86. "California, here we come. Right back where we started from."

- Phantom Planet, California

87. "I'm going back to Cali."

- LL Cool J, 'Going Back To Cali'

88. "California is a fine place to live - if you happen to be an orange."

- Fred Allen

89. "A large part of Canada heads for Florida, California, and Hawaii in the winter to get away from the snow."

- Margaret MacMillan

90. "I wouldn't live in California. All that sun makes you sterile."

- Alan Alda

91. "In California the only way to look like you are getting older is to look like you are getting younger...if you can move your forehead over the age of forty, then people become very suspicious."

- Matt Haig

92. "A new study says that over half of all Californians are obese. In fact, half of Californians are really two-thirds of Californians."

- Jay Leno

93. "In California, they don't throw their garbage away - they make it into TV shows."

- Woody Allen

94. "In California everyone goes to a therapist, is a therapist, or is a therapist going to a therapist. "

- Truman Capote

95. "California is a place where they shoot too many pictures and not enough actors."

- Walter Winchell

96. "Santa Barbara is pleasant. It's heaven, but with a bit more traffic."

- Matt Haig

97. "California is where you can't run any farther without getting wet."

- Neil Morgan

98. "'Hey boys, come up here!' Lee's excited shout bounced from rock to rock down the gulch. 'I've got all of California right here in this pan!'"

- Phyllis Flanders Dorset, 'The New Eldorado'

99. "Ninety-five percent of all brussels sprouts come from California."

- Danny Meyer

100. "The men of California are thriftless, proud, and extravagant, and very much given to gaming; and the women have but little education, and a good deal of beauty, and their morality, of course, is none of the best."

- Richard Henry Dana Jr

101. "Californians try everything once."

- T. J. MacGregor

102. "Secretly, I think everyone who makes fun of California really does want to be in California."

- Zooey Deschanel

Northern California- San Francisco Quotes

Located in Northern California, San Francisco is a popular tourist city in the state. Here are some California quotes and sayings about this beautiful city.

103. "San Francisco is the only city I can think of that can survive all the things you people are doing to it and still look beautiful."

- Frank Lloyd Wright

104. "San Francisco is poetry. Even the hills rhyme."

- Pat Montandon

105. "If you're going to San Francisco, be sure to wear some flowers in your hair."

- Scott McKenzie, 'San Francisco'

106. "I'm just mad for San Francisco. It is like London and Paris stacked on top of each other."

- Twiggy

107. "I left my heart in San Francisco."

- Tony Bennett, 'I Left My Heart In San Francisco'

108. "San Francisco is 49 square miles surrounded by reality."

- Paul Kanter

109. "It's an odd thing, but anyone who disappears is said to be seen in San Francisco."

- Oscar Wilde

110. "You are fortunate to live here. If I were your President, I would levy a tax on you for living in San Francisco."

- Mikhail Gorbachev

111. "There may not be a Heaven, but there is San Francisco."

- Ashleigh Brilliant

112. "It seemed like a matter of minutes ...suddenly reached a height and saw stretched out ahead of us the fabulous white city of San Francisco on her eleven mystic hills with the blue Pacific and its advancing wall of potato-patch fog beyond, and smoke and goldenness in the late afternoon of time."

― Jack Kerouac, 'On the Road'

113. "Now there's a grown-up swinging town."

- Frank Sinatra

114. "Maybe in San Francisco it wouldn't feel like the universe was conspiring to keep me in a bubble."

- Heather Demetrios

115. "I've never been somewhere I belonged, but there are places where I think I could be happy. Like San Francisco. Well, do art museums count? Because I feel like I belong in them."

- Heather Demetrios

116. "San Francisco has only one drawback: 'tis hard to leave."

- Rudyard Kipling

Los Angeles Quotes

You will be familiar with Los Angeles or LA mostly if you are a Hollywood fan. The city is one of the famous places of this golden state. Read some of the California quotes and Instagram captions about this city.

117. "When I came to Los Angeles, it was the first time that I ever felt like I belonged somewhere."

- Jennifer Love Hewitt

118. "I love Los Angeles, it reinvents itself every two days."

- Billy Connolly

119. "Tip the world over on its side and everything loose will land in Los Angeles."

- Frank Lloyd Wright

120. "Darling, in LA, you decide who you are. Every neighborhood has its own culture and population. Once you find the right one for you, you're home. Los Angeles is a way of life."

-Cara Dee

121. "While I'm in L.A. I always make time for my favorite activity which is hiking. The trails in California are amazing, as they are always challenging, and I never get bored from all the beautiful scenery."

- Dylan Lauren

122. "Los Angeles has no seasons, so it's kind of hard to keep track of time here. The lines between spring, summer, fall, and winter all blur like my vision. I get stuck on repeat for different measures of eternity."

- Kris Kudd

123. "You got that special kind of sadness, you got that tragic set of charms that only comes from time spent in Los Angeles, makes me wanna wrap you in my arms."

- Dawes, 'Time Spent in Los Angeles'

124. "Los Angeles is 72 suburbs in search of a city."

- Dorothy Parker

125. "Los Angeles was the kind of place where everybody was from somewhere else and nobody really dropped anchor. It was a transient place. People drawn by the dream, people running from the nightmare. ....everybody in L.A. keeps a bag packed. Just in case."

― Michael Connelly, 'The Brass Verdict'

Here at Kidadl, we have carefully created lots of interesting family-friendly quotes for everyone to enjoy! If you liked our suggestions for California Quotes, then why not take a look at African American quotes or Alaska quotes

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120+ Best California Quotes About The Golden State

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Published on Jan 18, 2021 Updated on Nov 25, 2021 We all want to travel to places which offer all sorts of happiness in their own unique way. A trip to California will definitely be worth your time. The state as a lot to offer that gives it the title as the Golden state.

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The Migrant Mother. I think of the original photo taken during the Dust Bowl, and now there are millions of other migrant mothers stuck at the border. In Chapter 8, a mother reunites with a daughter she left in a Mexican border after returning from across the border. While this specific duo escape through a door together, many others in real life are not afforded the same luxury.

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Stuck at the border, migrant mothers confront a complex maze

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Spurred on by rumors and false hope, women who reach Juárez, Mexico, are “the new face of migration.”

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Ukraine faces a growing threat of invasion by Russia. The consequences would affect all of Europe, including the sudden influx of between “three and five million Ukrainian refugees” seeking shelter in nearby countries.

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Joe Biden talking about his first year as President said Russia is likely to invade Ukraine. (Photo ... [+]
Getty Images

President Biden warned in his year-end news conference that a war between Russia and Ukraine could break out at any moment. As White House press secretary Jen Psaki put it, we are witnessing an "extremely dangerous situation." Indeed, several developments suggest the invasion is imminent. Some Ukrainian government online platforms were the subject of a "mysterious" cyber attack shutting them down in recent days, and an unusual barrage of "analytical articles" focusing on the weakness of NATO and the American administration have littered the internet. Sweden moved hundreds of troops not long ago to its strategically important Gotland island - which lies in the Baltic Sea. And Denmark strengthened its military presence in the region a few days before that. In addition, American and Ukrainian officials have noted that Russia has been emptying out its embassy in Kyiv, the Ukrainian capital. While a plethora of Western articles discussing the crisis have appeared, one aspect of the conflict that has not been adequately considered is the likely exodus of refugees from Ukraine. In short, should a Russian invasion of Ukraine take place, what will be the impact of immigration on Western Europe and even North America?

Ukraine's Foreign Minister Oleksii Reznikov expressed concern about a possible exodus of refugees ... [+]
NurPhoto via Getty Images

A Quick Answer

The quick answer according to Oleksii Reznikov, Ukraine's Minister of Defense, is that, "A major war in Ukraine would plunge the whole of Europe into crisis. The sudden appearance of between three and five million Ukrainian refugees fleeing the Russian invasion would be just one of many major concerns facing European society." Confirming this view, a senior Western intelligence official said, "We could have a very large number of refugees, deaths could reasonably be expected to be high as would destruction within Ukraine."

Historical Context

These views make sense judging by the number of Ukrainians that were displaced by Russia's 2014 intrusion into the Donbas region of Ukraine. The war that erupted then in eastern Ukraine has left 14,000 dead, 30,000 injured and an estimated 1.5 million displaced. Fortunately for the West in 2014, Ukraine absorbed these displaced people inside its western territories so there was no exodus of immigrants and no burden of refugees to bear by the EU. This time it appears likely things will be different. Depending on the degree of the invasion, there may be no Ukrainian territories to absorb displaced persons.

Nuclear Concerns

Of course no one can predict how many people in Ukraine may head westward if an invasion takes place. But as Craig Hooper, a Forbes journalist put it in considering that nuclear power plants could be involved in the fight, "The threat is real. Ukraine is heavily dependent upon nuclear power, maintaining four nuclear power plants and stewardship of the shattered nuclear site at Chernobyl. In a major war, all 15 reactors at Ukraine's nuclear power facilities would be at risk, but even a desultory Russian incursion into eastern Ukraine is likely to expose at least six active reactors to the uncertainty of a ground combat environment." Were nuclear power plants hit, there can be little doubt the exodus would be massive. As one Canadian official speculated, considering that the Russian invasion into about 20 percent of Ukraine's geographic territory since 2014 has generated about 1.5 million displaced persons, by that measure, a larger Russian invasion could generate as many as 7 million Ukrainian refugees.

What Should The U.S. And Allies Do?

Whatever the scale of the Russian invasion, Seth G. Jones of the Center for Strategic and International Studies says that if deterrence fails, the U.S. and its partners should, "Offer humanitarian support to help Ukraine deal with refugees and internally displaced persons. This assistance may also need to be extended to NATO allies on Ukraine's borders for refugees fleeing westward." Indeed, depending on the scale of the attack and the number of those fleeing, the U.S. and allies like the U.K., Canada and Australia may need to consider special immigration programming to help deal with the humanitarian crisis.

Why Is There A Crisis?

At the heart of this crisis is a Budapest Accord reached shortly after the demise of the former Soviet Union. In that agreement signed in 1994, Ukraine agreed to surrender its nuclear arsenal based on explicit assurances made by Russia, the U.S. and the U.K. (as well as similar supplementary assurances made by France and China). The assurances were that Ukraine's territorial integrity and political independence would be respected and maintained. At the time Ukraine had the third-largest nuclear arsenal in the world, including 5,000 strategic and tactical nuclear warheads. In accordance with the agreements reached and the assurances given, Ukraine surrendered these weapons to Russia. Since then Russia has invaded Ukraine, first in Crimea in 2014, and thereafter in the Donbas region. Ukraine has sought membership in NATO as a way to defend itself, but Russia objects to NATO's presence there. This disagreement could erupt into a further war that would threaten to upend the lives of people in Ukraine leading to the possible exodus discussed earlier.

US Secretary of State Antony Blinken is holding meetings in Europe to avert war (Photo by Alex ... [+]
POOL/AFP via Getty Images

Blinken Trying To Avert War

While officials are clearly preparing for the worst, diplomatic talks are still in progress and U.S. Secretary of State Anthony Blinken is, along with others, working to avert the crisis. He is trying to shore up the support of key NATO partners before his final meetings in Geneva with the Russian Foreign Minister.

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A Russian Invasion Of Ukraine Could Flood Europe With Millions Of Refugees

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One consequence of a further war in Ukraine may be a refugee crisis. The size of the possible exodus is hard to predict but could reach the level where the U.S., and allies such as the U.K., Canada and Australia, may need to alter their immigration programs to help.

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"I will always love you
How I do
Let go of a prayer for you
Just a sweet word"

After leaving Mykonos, Nadia and Saeed begin to grow apart. Their love isn't necessarily fading, but it begins to morph into something else. The relationship between the two suffers from stress and disagreements on fundamental values.

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Chapters 6-7 touch on the influx of refugees into London and how Londoners are affected.

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Europe's refugee crisis has been described as the worst of its kind since World War II, at the end of which there were more than 40 million refugees in the region.

The crisis led to the creation of international laws and organizations that would become the foundation of the world's refugee response today.

In 1943, the U.N. established a branch to provide humanitarian aid to refugees liberated by Allied forces. It was soon replaced by the International Refugee Organization, which became the U.N. High Commissioner for Refugees in 1950.

After the war, hundreds of thousands of Jews who survived the Holocaust were living in displaced-persons centers in Allied-occupied parts of Germany, Austria and Italy. They were transported to France, Belgium, and Greece.

In Eastern Europe, Germans either fled or were expelled from their home countries, writes Bernard Wasserstein, a University of Chicago history professor. Yugoslavia removed nearly all of its 500,000 Germans. Romania reduced its pre-war population of 780,000 by more than half. Czechoslovakia expelled 2.2. million Germans.

"At the peak period, in July 1946, 14,400 people a day were being dumped over the frontier" in Germany, Wasserstein writes. By 1950, 11.5 million Germans had left Eastern Europe.

Polish communities were also forced out. The Soviet Union expelled almost 2 million Poles, 500,000 Ukrainians and others from parts of the country it had annexed. Meanwhile, the Allied nations returned more than 2 million Soviet citizens to areas under Soviet control in exchange for citizens of Western countries.

Here's Wasserstein again, on where the refugees ended up:

By 1959 some 900,000 European refugees had been absorbed by west European countries. In addition, 461,000 had been accepted by the USA, and a further 523,000 by other countries. But many 'hard-core' refugees still remained in camps.

Fast-forward to 2014: 219,000 refugees crossed the Mediterranean into Europe, the U.N. says. So far this year, more than 300,000 people have made that journey, many of them from fleeing Syria and Libya to escape civil wars.

Last June, the U.N. reported that the global number of refugees, people seeking asylum, and people displaced within their own countries had, for the first time since the post-WWII era, exceeded 50 million people.

Hungary has closed the main train station in Budapest to migrants-many of them refugees-to prevent them from traveling through the European Union.

The move appears to be an attempt by the country, itself an EU member, to enforce the rules of the bloc, which requires that migrants be first processed in the EU country they enter. Hungary had earlier allowed the migrants to board trains without registering them or checking their paperwork.

Earlier today 3,650 migrants reached Vienna, and many of them boarded trains that would take them to Germany-which is expecting to take in 800,000 refugees this year.

Many of those coming to Europe are fleeing civil wars in Syria and Libya. Others are fleeing unrest in Africa, the Middle East and elsewhere. The flow of people has been described as the world's worst migrant crisis since World War II.

Hungary's decision to close off the Keleti station in Budapest to the migrants sparked protests. They chanted "Germany" and waved their train tickets, the BBC reported:

About 1,000 migrants congregated outside Keleti station, in the east of the city, as it was evacuated on Tuesday.

It was closed briefly and public announcements said no trains would be leaving.

But it soon reopened to non-migrant passengers, with lines of police preventing migrants from going through the main entrance.

The move came amid chaotic scenes after hundreds of migrants had tried to board services to Austria and Germany.

Some complained that they had paid hundreds of euros for tickets, and called for the station to be reopened so that they could continue their journey.

Many of the migrants have been waiting at Keleti station for days. Reporters said they are mainly Syrians, Afghans and Eritreans.

As we have been reporting, 107,500 migrants crossed into Europe last month. The U.N. estimates that the number of refugees and migrants crossing the Mediterranean this year exceeds 300,000.

EU officials will meet in Brussels on September 14 to discuss the crisis, which was exacerbated last week when the bodies of 71 refugees was discovered in an abandoned truck in Austria.

EU officials will meet for an emergency session in Brussels on September 14 as Europe tries to tackle the flow of people-many of them fleeing civil wars in Syria and Libya-into the region.

The announcement comes following last week's discovery in Austria of the bodies of 71 migrants in an abandoned truck, and after hundreds of people died when the boats carrying them capsized in the Mediterranean.

The Luxembourg EU presidency announced the September 14 meeting- which will bring together the bloc's justice and interior ministers-after a special request by Britain, France and Germany.

"The situation of migration phenomena outside and inside the European Union has recently taken unprecedented proportions," the Luxembourg EU presidency said in a statement. It added that the meeting will discuss "the return policy, international cooperation, and investigation and measures to prevent trafficking of migrants."

As we have previously noted, the world is in the midst of the worst refugee crisis since World War II. Migrants are trying to escape civil wars in Syria and Libya, and instability in other parts of the Middle East and Africa.

Many of them pay human traffickers large sums of money to take them to a Europe that is increasingly unable to cope with the flow. Just last month, 107,500 migrants crossed into Europe. The U.N. High Commissioner for Refugees estimates that the number of refugees and migrants crossing the Mediterranean this year exceeds 300,000.

Last week's discovery of the 71 bodies-among them children-put a human face on the issue. As my colleague Uri Friedman noted:

Embedded in ... [the] horrific news is a harrowing reality: The 71 migrants who perished en route to Austria were escaping a hell they must have considered far worse than the forbidding truck they crowded into.

The artist Banksy posted his own take on the EU's response the migrant crisis. It's not complimentary.

A great deal-even though the terms are often used interchangeably.

But the distinction becomes important because the world is witnessing the worst refugee crisis since World War II-one with sometimes-tragic consequences. Here's how the United Nations High Commissioner for Refugees defines refugees:

Refugees are persons fleeing armed conflict or persecution. ... Their situation is often so perilous and intolerable that they cross national borders to seek safety in nearby countries, and thus become internationally recognized as "refugees" with access to assistance from States, UNHCR, and other organizations. They are so recognized precisely because it is too dangerous for them to return home, and they need sanctuary elsewhere. These are people for whom denial of asylum has potentially deadly consequences.

Migrants, on the other hand, "choose to move not because of a direct threat of persecution or death, but mainly to improve their lives by finding work, or in some cases for education, family reunion, or other reasons." The UN agency continues:

Unlike refugees who cannot safely return home, migrants face no such impediment to return. If they choose to return home, they will continue to receive the protection of their government.

Countries grant refugees certain protections under their international treaty obligations. This is why some states are reluctant to grant those people who are fleeing unrest in their home countries refugee status. Here's more from the UN agency:

Politics has a way of intervening in such debates. Conflating refugees and migrants can have serious consequences for the lives and safety of refugees. Blurring the two terms takes attention away from the specific legal protections refugees require. It can undermine public support for refugees and the institution of asylum at a time when more refugees need such protection than ever before.

But who you are can sometimes dictate how you are perceived. Here's Karl Sharro, a London-based satirist and architect:

The Lexicon of Global Migration. (Thanks to @trillingual for coming up with the idea.) pic.twitter.com/PnHPFUoe19
- Karl Sharro (@KarlreMarks) May 20, 2015

This post was updated on August 28 at 9 a.m. ET
Here's what we know this morning about the bodies that were found in an abandoned truck in Austria on Thursday:

-- Officials now say there were 71 people in the truck, and that it's likely the Syrian migrants suffocated.

-- Three people were arrested in Hungary in connection with the discovery. One of them is reported to be the truck's owner; the other two the drivers.

Authorities say the truck left the Hungarian capital, Budapest, on Wednesday, and entered Austria later that night. Police discovered the bodies Thursday morning when they were called to look into an abandoned truck on the side of the highway.

The bodies were decomposing. Officials initially said the number of people inside was between 20 and 50. Today they said there were 71: 59 men, eight women, and four children.

Hans Peter Doskozil, the police chief in Burgenland province, said today a travel document that was found in the vehicle suggests the migrants were Syrian. He said preliminary analysis showed the refrigerated truck did not have ventilation, and the migrants probably suffocated. They were dead for between 1½ and two days, he said.

"We are talking about a Bulgarian-Hungarian human-trafficking operation," Doskozil said.

As we told you yesterday, the world is in the midst of the worst refugee crisis since World War II. Migrants are trying to escape civil wars in Syria and Libya, and instability in other parts of the Middle East and Africa.

Many of them pay human traffickers large sums of money to take them to a Europe that is increasingly unable to cope with the flow. Here's more from the Guardian:

The EU has found itself overwhelmed by the sheer scale of migration, with a record number of 107,500 migrants crossing the EU's border last month. Chaotic attempts by Macedonian police to hold back refugees last week failed. On Wednesday, the UN's refugee agency said it expected 3,000 people a day to enter Macedonia from Greece until at least the end of the year.

Berlin, backed by Austria, wants a new system of mandatory quotas for refugees across the EU despite the issue being rejected in acrimonious scenes by EU leaders at a summit in June. Germany expects 800,000 asylum applications this year. The EU has also proposed a common "safe countries of origin" list, which would see migrants from these nations swiftly deported.

With the EU's common border policy increasingly dysfunctional, member states are taking matters into their own hands. Hungary is building a new fence along its border with Serbia, though this week refugees got through with relative ease.

Separately, hundreds of migrants are believed to have died when the two boats that were carrying them sank yesterday off Libya.

Ibrahim al-Attoushi, an official with the Red Crescent, said 198 people had been rescued, 82 bodies had been recovered, and about 100 people are still missing. The BBC adds:

The UN says about 2,400 migrants have died trying to cross the Mediterranean to Europe so far this year.

More than 100,000 others have landed in Italy, whilst another 160,000 have crossed to Greece.

Melissa Fleming, a spokeswoman for the U.N. High Commissioner for Refugees, said at a press briefing in Geneva today that the number of refugees and migrants crossing the Mediterranean this year exceeds 300,000. She said almost 200,000 people have landed in Greece; 110,000 in Italy. In all of 2014, she said, around 219,000 people crossed the Mediterranean.

Austrian authorities say up to 50 migrants were found dead today in a truck abandoned on the side of the highway in the eastern part of the country.

The discovery coincided with a meeting in Vienna in which European leaders discussed the worst migrant crisis since World War II.

Hans Peter Doskozil, who heads the police department in Burgenland district, said the deaths occurred some time ago. He said the bodies were decomposing, and that there are at least 20 of them. The toll could rise to between 40 and 50, he said.

"We can make no concrete assumptions about the origin or cause [of death]," he said. "We can assume, however, that they are refugees."

Local media reported the refrigerated truck was abandoned Wednesday on the side of a highway between the towns of Neusiedl and Parndorf. It was discovered by a road worker who noticed a liquid dripping from the back . Police are looking for its driver.

The truck had Hungarian plate , and was previously owned by a Slovakian poultry company that said it sold the vehicle last year. Hungarian officials say the vehicle is now registered to a Romanian.

European officials said the discovery underscored the need for united action on dealing with the continent's refugee flow.

Angela Merkel, the German chancellor, who is attending the Vienna meeting, said she was "shaken by the awful news."

"This reminds us that we in Europe need to tackle the problem quickly and find solutions in the spirit of solidarity," she said.

Johannes Hahn, the EU's enlargement commissioner, tweeted:

"Discussing w.#ForeignMinisters common approach to tackle #migration crisis amidst breaking news on dead refugees1/2 pic.twitter.com/vuObSHyM55
- Johannes Hahn (@JHahnEU) August 27, 2015

"Just another terrible incident, illustrating the urgent need for quick and determined common action". 2/2
- Johannes Hahn (@JHahnEU) August 27, 2015

Last month, a record 107,500 migrants crossed into the EU. The crisis has been sparked by the civil wars in Libya and Syria, as well as unrest in the Middle East and Africa. The migrants are aided by smugglers who transport them into Europe often via trucks. European officials are deeply divided on how to tackle the issue.

Austria and Germany want quotas that would ensure the migrants are distributed among the bloc's 28 members states. But other European countries, notably the U.K., strongly oppose this plan.

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A Brief History of Europe's Last Refugee Crisis

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Europe's refugee crisis has been described as the worst of its kind since World War II, at the end of which there were more than 40 million refugees in the region. The crisis led to the creation of international laws and organizations that would become the foundation of the world's refugee response today.

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Shared themes with Exit West:
Familial Relationships, Nationalism, Religion, Mortality, Escape