Health Disparities and Children in Immigrant Families: A Research Agenda

Department of Pediatrics, School of Medicine, Stanford University, Lucile Packard Children's Hospital, 770 Welch Rd, Suite 100, Palo Alto, CA 94304, USA.
PEDIATRICS (Impact Factor: 5.47). 11/2009; 124 Suppl 3(Supplement):S187-95. DOI: 10.1542/peds.2009-1100F
Source: PubMed


Children in immigrant families now comprise 1 in 5 children in the United States. Eighty percent of them are US citizens, and 53% live in mixed-citizenship families. Their families are among the poorest, least educated, least insured, and least able to access health care. Nonetheless, these children demonstrate better-than-expected health status, a finding termed "the immigrant paradox" and one suggesting that cultural health behaviors among immigrant families might be protective in some areas of health. In this article the strength of the immigrant paradox, the effect of acculturation on health, and the relationships of acculturation, enculturation, language, and literacy skills to health disparities are reviewed. The current public policy issues that affect the health disparities of children of immigrant families are presented, and a research agenda for improving our knowledge about children in immigrant families to develop effective interventions and public policies that will reduce their health disparities is set forth.

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    • "Some parents fear that enrolling children in programs will affect future chances at regularization, including family sponsorship or naturalization. The variability in the public charge assessment—in which applicants for permanent residency status must prove they will not be primarily dependent on the government—has led some families to avoid obtaining services for their children (Mendoza, 2009; Park, 2011). The potential for variable eligibility to occur among siblings is associated with lower access to care for all and ultimately reduced household resources (Hagan et al., 2003; Hudson, 2009). "
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    ABSTRACT: There are approximately 2.3 million mixed-status families in the United States, containing varied combinations of citizens, permanent legal residents, undocumented immigrants, and individuals in legal limbo. These families offer an opportunity to examine the functioning of the contemporary state and its penetration at the household level. For many Latino youth, experiences are framed not only by their own but other family members’ legal status. This article reports on health care seeking experiences of mixed-status families in the Lower Rio Grande Valley of South Texas and the impact of the recent health care reform (Affordable Care Act). We utilized qualitative ethnographic methods including 55 semistructured interviews with mixed- status families and 43 interviews with health care providers, caseworkers, and public health officials. Results indicate that changes accompanying the reform directly and indirectly affect mixed-status households’ ability to access care. We describe strategies in times of illness, including those unique to border communities. We conclude that, for successful implementation of policies associated with health care reform, broader issues related to immigration status must be addressed, especially anxieties regarding future chances of regularization. These uniquely affect mixed-status families, create a ripple effect on all household members, and result in unintended consequences for U.S. citizen children. Implications point to the need for a pathway to citizenship for parents as a basic step in improving well-being of children.
    American Behavioral Scientist 09/2014; 58(14). DOI:10.1177/0002764214550290 · 0.69 Impact Factor
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    • "In some international contexts, not having health insurance may also be considered an important health related problem (Flores et al., 2005; Javier et al., 2009; Schwebel & Brezausek, 2009). Traditionally, all these conditions can increase health disparities (Jolly & Reeves, 2005; McKay et al., 2003; Mendoza, 2009). "
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    ABSTRACT: Immigrants and ethnic minorities have been identified as vulnerable groups in health, in general, and in what concerns therapeutic non-adherence (TA) in particular; i.e., (not)following health-care providers’ therapeutic recommendations. The general aim of this paper is presenting a literature review of immigrants’/ethnic minorities’ TA determinants. We will start by highlighting the reasons as to why immigrants’/ethnic minorities’ therapeutic (non)adherence should be a topic of concern. Then, we will present a review of the main determinants of immigrants’/ethnic minorities’ TA, at different levels of analysis (e.g., broad structural level, social and community networks; material and social conditions) and emphasize that non-adherence among immigrants/ethnic minorities is mostly non-intentional, seeing as how it is associated with issues such as: low socio-economic conditions, language barriers and cultural mismatches. Finally, we will highlight the role of health-care providers in tackling this health-related problem and reflect about the importance of promoting development and training of health-care providers’ multicultural abilities.
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    • ", 2005 ; Abraido - Lanza et al . , 2006 ; Mendoza , 2009 ) . In addition , this risk pattern is consistent with the results of a study based on the Florida Birth Defects Registry , which dem - onstrated that the risk of gastroschisis was reduced in the offspring of foreign born women versus US born women ( aOR50 . "
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    ABSTRACT: Unlabelled: Studies indicate that gastroschisis is associated with maternal age, ethnicity, and acculturation. This analysis was conducted to further define the associations between gastroschisis and parental Hispanic ethnicity and acculturation, and to determine whether such associations vary by maternal age. Methods: This study was based on data from mothers of 753 gastroschisis cases and 6,496 control infants in the National Birth Defects Prevention Study. The relationships between gastroschisis and both parental Hispanic ethnicity and acculturation, within maternal age strata (<20 versus ≥20 years at conception), were assessed using logistic regression and principal component analyses. Results: The risk of gastroschisis in offspring of women <20 years old was not significantly associated with parental Hispanic ethnicity or acculturation. Among mothers ≥20 years old, US-born non-Hispanic white parents had a lower risk of gastroschisis in offspring as compared to either US-born Hispanic (odds ratios [ORs] ranging from 0.55 to 0.60) or English-speaking Hispanic (ORs ranging from 0.58 to 0.65) parents. Further, compared with US born Hispanic women ≥20 years, the risk of gastroschisis was lower for Hispanic women who had lived in the US <5 years (OR=0.35, 95% confidence interval [CI]: 0.17, 0.74) or who migrated to the US at ≥20 years (OR=0.47, 95% CI: 0.25, 0.88). Conclusion: These results provide further evidence that gastroschisis risk is associated with ethnicity and some aspects of acculturation. Additionally, these associations were limited to the offspring of women who are ≥20 at the time of conception.
    Birth Defects Research Part A Clinical and Molecular Teratology 08/2013; 97(8). DOI:10.1002/bdra.23140 · 2.09 Impact Factor
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