Raising American Children: Determinants of Immigrant Parents' Health and Mental Health Service Use

Nearly 25% of the nation’s children are raised by immigrant parents, however, their parents’ immigration status varies and little is known about how different immigration status affects these immigrant parents’ well-being and service use. Given the majority (87.1%) of these children are US-born citizens, the distinct personal and structural challenges faced by their immigrant parents in accessing health and mental health care subject them to more risks and poorer health, which in turn affect their children and other citizens in the communities. This study fills the gap of knowledge by examining the impact of population characteristics, community and state factors on their health and mental health care among three groups of parents: US-born citizens, naturalized citizens, and Non-citizens.    

Methods:

Using data from National Latino and Asian American Survey (NLAAS) between 2002 and 2003, the final sample of 1,050 consists of 80.2% of Latino and 19.8% of Asian American parents aged 18-64 with at least one child. Dependent variables of “receipt of service use in the past 12 months" includes health services (ER use and clinic care) and mental health care (receipt of therapy and counseling). Chi-Square Test was conducted to examine if significant differences existed among these three groups. Hierarchical logistic regression models were used to examine the impact of multiple level of factors on the receipt of health and mental health care. The covariates include age at immigration, length of residence in the U.S., poverty level, employment, English proficiency, medical health coverage, health and mental health condition, social support, community cohesion and state percentage of immigrants.

Research findings showed significant variations across these three groups of parents in their service use, education, poverty status, receipt of state Medicaid, insurance coverage, social support, and community cohesion. Non-citizen parents had the lowest use of mental health care, but the most frequent use of emergency medical care; naturalized citizen parents had the most frequent routine clinic care and lowest emergency care. Overall non-citizens were the most disadvantaged given their higher poverty rate, lower social support, community cohesion, lower level of education and health insurance coverage. The majority of Asian parents were naturalized citizens compared with a larger group of Latino parents who were either US-born citizens or non-citizens. In spite of a larger group of people living in poverty for non-citizen parents, US-born parents were more likely to receive state Medicaid. In terms of service use for each group, for US-born parents, the receipt of state Medicaid programs was associated with their service use; for parents who were naturalized citizens, insurance coverage, English proficiency, age at immigration and state immigrant concentration were associated with their service use; for parents who were non-citizens, immigrant-related factors such as English proficiency and age at immigration and education appeared related to their service use.      

Implications:

This study enhances more understanding of the prevalence of the immigrant families’ characteristics and addresses the barriers immigrant parents with varying immigration status in accessing public services. Communities with immigrant families of different composition of immigration status should have differential responses to approach and serve this population given the differentiating factors related to their service use.