Pediatric Injury Outcome Among School-Aged Children of Immigrant Families and Native-Born Families

Background and Purpose

Although one in five school-aged children are children of immigrants, little attention has been paid to immigrant children’s health outcomes, such as pediatric injury, a leading cause of childhood morbidity which deserves health policy interventions. A handful of studies have explored pediatric injury among young children of immigrant families finding a lower risk of injuries compared to children of U.S.- born parents; however, little information on injury is available on school-aged immigrant children. Furthermore, no studies have investigated the association between child injuries by different immigrant generations. This study is the first to compare child injury among school-aged children of first and second generation immigrant families and children of U.S.-born families.

Method

The study takes advantage of a panel of school-aged children in the Early Childhood Longitudinal Study, Kindergarten Class of 1998, using data from the 3^rd, 5^th, and 8^th grade, when information on injury is available. Families are coded as: 1) native, if both children and parents are U.S.-born 2) second-generation, if children are U.S.-born and parents are foreign-born, and 3) first generation, if both are foreign-born. The pediatric injury outcome is measured as a dichotomous response (1=yes and 0=no), converting responses for a question, “How many times has child seen a doctor or other medical professional or visited a clinic or emergency room for an injury?”  We run logistic multilevel models controlling for multiple potential confounders.

Results

We find that compared to children of U.S.-born families, children of both first and second generation immigrants were less likely to have injuries. First generation immigrant children had 0.45 times the odds of having an injury (p<.0001), and second generation children had 0.62 times the odds of having an injury (p<.0001) compared to children of native-born families. Controlling for insurance coverage and routine care source in the model did not change the patterns of results. Post hoc analyses showed that although first generation children had lower probability of having injuries compared to second generation children, this difference was not significant.

Conclusion

This study is the first to focus on school-aged immigrant children in investigating pediatric injury probability by different generations. Our finding suggests that school-aged immigrant children, particularly first generation, are significantly less prone to injuries compared to children of U.S.-born families over time, which is consistent with previous studies on younger immigrant children. This pattern was, however, not affected by health insurance coverage nor routine care, which has been significantly linked to pediatric injuries in previous studies of non-immigrant children. This could imply that ‘immigrant effects’ of health are strong enough to rule out previously identified predictors of child injury in the literature. Nonetheless, the finding shows the lessened immigrant health effects among the second generation immigrant children, which confirms the literature’s claim: the longer children live in the U.S., the higher propensity of injuries that they have. Policy makers, researchers, and social workers should consider this finding and turn to intervention programs that capture contributing factors of immigrant health effects and decrease pediatric injury propensity.