Using the 2007 National Survey of Children's Health (N = 91,532), we studied the relationship between the joint effects of immigrant family type (foreign-born children, US-born children/one foreign-born parent, US-born children/both foreign-born parents, and US-born children/US-born parents) and race/ethnicity on various health measures (parent-reported physical and dental health, obesity/overweight, breast-feeding, school absence, injury, and chronic condition). We used weighted logistic regression to examine the independent effects of the 12-level joint variable on various health status measures while controlling for confounding factors. Overall, nearly one-third of families with both foreign-born parents were poor, and one-quarter of the parents in these households did not complete high school. Compared with non-Hispanic White US-born children, multivariable analyses indicate that all Hispanic children have higher odds of obesity, poor physical and dental health, with Hispanic foreign-born children 7 times as likely to report poor/fair physical health. Most children of immigrant parents were more likely to have been breast-fed and less likely to miss school more than 11 days. Child age and household poverty status were independently associated with most of the health status measures. Combined race/ethnicity and immigrant family type categories have heterogeneous associations with each health outcome measure examined. Culturally competent interventions and policies should be developed to serve these expanding communities. 1. Introduction Children from US immigrant families, who are defined as individuals under the age of 18 in families with at least one foreign-born parent, comprised nearly one-quarter of all US children in 2010 [1]. In USA, immigrant families have been differentiated by the following types: those with foreign-born children, US-born children with both foreign-born parents, and US-born children with one foreign-born parent. Many of these children live in households with low incomes, have parents with low education levels and limited English proficiency, interact less often with their parents, and use less health care benefits than children of natives [2]. Immigrant families are driving rapid population increases and growing racial and ethnic diversity in local communities and school districts across the country [3]. This significant demographic shift presents a unique set of social and economic challenges for access to health care, oral health, and health promotion outcomes. Differential health care access and use have been found in
References
[1]
E. M. Grieco, Y. D. Acosta, G. P. de la Cruz, et al., “The Foreign-Born Population in the United States: 2010,” American Community Survey Reports, ACS-19. May 2012.
[2]
R. Capps, M. E. Fix, O. S. T. Jason, J. Reardon-Anderson, and J. S. Passel, The Health and Well-Being of Young Children of Immigrants, The Urban Institute, 2005.
[3]
M. Mather, Children in Immigrant Families Chart New Path. Reports on America, Population Reference Bureau, 2009.
[4]
S. M. Yu, Z. J. Huang, and M. D. Kogan, “State-level health care access and use among children in US immigrant families,” American Journal of Public Health, vol. 98, no. 11, pp. 1996–2003, 2008.
[5]
L. A. Blewett, P. J. Johnson, and A. L. Mach, “Immigrant children's access to health care: differences by global region of birth,” Journal of Health Care for the Poor and Underserved, vol. 21, supplement 2, pp. 13–31, 2010.
[6]
B. D. Gushulak, K. Pottie, J. Hatcher Roberts, S. Torres, and M. DesMeules, “Migration and health in Canada: health in the global village,” CMAJ, vol. 183, no. 12, pp. E952–E958, 2011.
[7]
T. A. LaVeist, D. J. Gaskin, and P. Richard, The Economic Burden of Health Inequalities in the United States, Joint Center for Economic and Political Studies, 2009.
[8]
S. M. Yu, Z. J. Huang, R. H. Schwalberg, and M. D. Kogan, “Parental awareness of health and community resources among immigrant families,” Maternal and Child Health Journal, vol. 9, no. 1, pp. 27–34, 2005.
[9]
S. M. Yu, Z. J. Huang, R. H. Schwalberg, and R. M. Nyman, “Parental english proficiency and children's health services access,” American Journal of Public Health, vol. 96, no. 8, pp. 1449–1455, 2006.
[10]
S. M. Yu and G. K. Singh, “Household language use and health care access, unmet need, and family impact among CSHCN,” Pediatrics, vol. 124, no. 4, pp. S414–S419, 2009.
[11]
S. M. Yu and G. K. Singh, “High parenting aggravation among US immigrant families,” American Journal of Public Health, vol. 102, no. 11, pp. 2102–2108, 2012.
[12]
S. M. Yu, Z. J. Huang, and G. K. Singh, “Health status and health services access and utilization among Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese children in California,” American Journal of Public Health, vol. 100, no. 5, pp. 823–830, 2010.
[13]
F. S. Mendoza, “Health disparities and children in immigrant families: a research agenda,” Pediatrics, vol. 124, no. 3, pp. S187–S195, 2009.
[14]
A. Duggan, J. Jarvis, D. C. Derauf, C. A. Aligne, and J. Kaczorowski, “The essential role of research in community pediatrics,” Pediatrics, vol. 115, supplement 4, pp. 1095–1100, 2005.
[15]
A. J. Starmer, J. C. Duby, K. M. Slaw, A. Edwards, and L. K. Leslie, “Pediatrics in the year 2020 and beyond: preparing for plausible futures,” Pediatrics, vol. 126, no. 5, pp. 971–981, 2010.
[16]
L. Kruse, C. E. Denk, L. Feldman-Winter, and F. M. Rotondo, “Longitudinal patterns of breastfeeding initiation,” Maternal and Child Health Journal, vol. 10, no. 1, pp. 13–18, 2006.
[17]
G. K. Singh, M. D. Kogan, and D. L. Dee, “Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the United States, 2003,” Pediatrics, vol. 119, no. 1, pp. S38–S46, 2007.
[18]
J. L. Kornosky, J. D. Peck, A. M. Sweeney, P. L. Adelson, and S. L. Schantz, “Reproductive characteristics of Southeast Asian immigrants before and after migration,” Journal of Immigrant and Minority Health, vol. 10, no. 2, pp. 135–143, 2008.
[19]
S. Ghaemi-Ahmadi, “Attitudes toward breast-feeding and infant feeding among Iranian, Afghan, and Southeast Asian immigrant women in the United States: implications for health and nutrition education,” Journal of the American Dietetic Association, vol. 92, no. 3, pp. 354–355, 1992.
[20]
G. K. Singh, M. D. Kogan, and S. M. Yu, “Disparities in obesity and overweight prevalence among us immigrant children and adolescents by generational status,” Journal of Community Health, vol. 34, no. 4, pp. 271–281, 2009.
[21]
G. K. Singh, M. Siahpush, R. A. Hiatt, and L. R. Timsina, “Dramatic increases in obesity and overweight prevalence and body mass index among ethnic-immigrant and social class Groups in the United States, 1976–2008,” Journal of Community Health, vol. 36, no. 1, pp. 94–110, 2011.
[22]
G. K. Singh, M. D. Kogan, P. C. Van Dyck, and M. Siahpush, “Racial/ethnic, socioeconomic, and behavioral determinants of childhood and adolescent obesity in the United States: analyzing independent and joint associations,” Annals of Epidemiology, vol. 18, no. 9, pp. 682–695, 2008.
[23]
G. K. Singh, S. M. Yu, M. Siahpush, and M. D. Kogan, “High levels of physical inactivity and sedentary behaviors among US immigrant children and adolescents,” Archives of Pediatrics and Adolescent Medicine, vol. 162, no. 8, pp. 756–763, 2008.
[24]
G. K. Singh and S. M. Yu, “The impact of ethnic-immigrant status and obesity-related risk factors on behavioral problems among US children and adolescents,” Scientifica, vol. 2012, Article ID 648152, 14 pages, 2012.
[25]
M.-R. Watson, A. M. Horowitz, I. Garcia, and M. T. Canto, “Caries conditions among 2-5-year-old immigrant Latino children related to parents' oral health knowledge, opinions and practices,” Community Dentistry and Oral Epidemiology, vol. 27, no. 1, pp. 8–15, 1999.
[26]
S. M. Yu, H. A. Bellamy, M. D. Kogan, J. L. Dunbar, R. H. Schwalberg, and M. A. Schuster, “Factors that influence receipt of recommended preventive pediatric health and dental care,” Pediatrics, vol. 110, no. 6, p. e73, 2002.
[27]
G. G. Dela Cruz, R. G. Rozier, and G. Slade, “Dental screening and referral of young children by pediatric primary care providers,” Pediatrics, vol. 114, no. 5, pp. e642–e652, 2004.
[28]
National Center for Health Statistics, The National Survey of Children's Health (NSCH), 2007: The Public Use Data File and Documentation, US Department of Health and Human Services, Hyattsville, Md, USA, 2009, http://www.cdc.gov/nchs/about/major/slaits/nsch07.htm.
[29]
K. S. O'Connor, K. S. Brooks, K. L. Nysse-Carris, B. J. Skalland, E. T. Sipulski, and D. M. Costanzo, “Design and operation of the Survey of Adult Transition and Health, 2007,” Vital and Health Statistics, no. 52, pp. 1–85, 2011.
[30]
Health Resources and Services Administration, The Health and Well-Being of Children: A Portrait of States and the Nation. The National Survey of Children's Health 2007, US Department of Health and Human Services, Rockville, Md, USA, 2009.
[31]
R. M. Friedberg, “You can't take it with you? Immigrant assimilation and the portability of human capital,” Journal of Labor Economics, vol. 18, no. 2, pp. 221–251, 2000.
[32]
RTI International, SUDAAN 10.0 User's Guide, Research Triangle Park, NC, USA, 2008.
[33]
S. J. Blumberg and J. V. Luke, “Reevaluating the need for concern regarding noncoverage bias in landline surveys,” American Journal of Public Health, vol. 99, no. 10, pp. 1806–1810, 2009.
[34]
S. Lee, J. M. Brick, E. R. Brown, and D. Grant, “Growing cell-phone population and noncoverage bias in traditional random digit dial telephone health surveys,” Health Services Research, vol. 45, no. 4, pp. 1121–1139, 2010.
