Reversing Paradoxes in Immigrant Children's Well-Being? Caregiver Challenges in Meeting Children's Basic Needs
Trends in the health of children of immigrants have been described as a paradox given patterns of morbidity and mortality that are at odds with what would be expected given the group’s socioeconomic profile. Health paradoxes have been observed for indicators such as infant low birth weight and infant mortality among children of Latino immigrants when compared to children of U.S. born Latinos and whites. However, these initial health advantages appear to erode into childhood. Declines have been attributed to hardships such as food insecurity and limited access to health and social programs. However, few population-based studies have examined how immigrant parents fare in their ability to address their children’s basic needs during childhood. This study examined whether a health paradox exists among immigrant caregivers in reported ability to address a child’s basic needs for sufficient food, medical care, and safe supervision when compared to other race/nativity groups.
Data was drawn from a random, general population telephone survey of parents/guardians of children at least 12 years of age in 50 California cities. The 30 minute survey was conducted in English and Spanish and administered using computer assisted telephone interview procedures. Participants included 2,259 respondents with complete data for the variables under study (88.1%) and included immigrant Latinos (12.5%), U.S. born Latinos (15.5%) and U.S. born whites (71.9%). Parental ability to address a child’s basic needs for sufficient food, medical care, and safe supervision was assessed using the Multidimensional Neglectful Behavior Scale (MNBS). Caregiver covariates included gender, age, marital status, education, depression/anxiety, drinking patterns, and social support. Child covariates included gender and age. Proper estimates for weighted sample characteristics were generated using Stata 11’s survey facility. Hypotheses of statistical equivalence for proportions and means were tested using adjusted Wald tests. Adjusted logistic regression was used in models stratified by household income to examine the relationship of race/nativity to MNBS measures. Models were adjusted for clustering by city to account for the potential correlation of responses in cities with multiple participants.
Despite the presence of several protective factors, immigrant Latino caregivers of low household income had significantly greater odds of reporting chronic inability to provide sufficient food (OR 12.08), medical care (OR 7.91), and safe supervision (OR 7.43) for their children when compared to whites in models adjusted for covariates. These effects were attenuated in comparisons to U.S. born Latinos and immigrant caregivers with higher household incomes. Among higher income households, disparities in ability to provide medical care by race/nativity disappeared.
Unlike paradoxical trends observed in infant health, immigrant parents of low income face significant challenges in addressing their children’s basic needs when compared to similarly socioeconomically positioned race/nativity groups and immigrants with greater resources. Punitive immigration policies are likely to compound the developmental risks that may be present among children of immigrants in low-income households. The degree to which children of immigrants in low-income households achieve their potential as adults may partly depend on social investments made in their well-being. Implications for policy and practice are discussed.