Methods: We used data from the Mexico Inter-Census Survey 2015 collected between the 2010 and 2020 (household sample size = 1.6 million). We conducted descriptive analyses, ANOVA and chi-square tests to examine the demographic characteristic of USBMs versus MEXBMs and to examine differences across groups. We used logistic regression to predict the probability of having access to health coverage using eight variables: age, sex, nativity, living with biological parent, literacy, educational attainment, employment status, and state of residence.
Results: 54,309 minors among the 6.1 million households surveyed in Mexico in 2015 were born in the United States and are therefore U.S. citizens. The average age of youth was 8.8 years old. Male youth represented 51% of the sample. The top 5 receiving states where USBMs lived in 2015 were Baja California, Chihuahua, Tamaulipas, Jalisco, and Michoacán. Two of these states, Michoacán and Tamaulipas, are on the DO NOT TRAVEL advisory list of the U.S. State Department due to high crime and kidnapping. More than a third of USBMs do not live with either parent and live in families where the head of household is unemployed. Poverty in USBM households is reflected in the low rates of health insurance; 42.6% of USBMs do not have health insurance, while this rate is only 13.5% for MEXBMs (p<.05). Logistic regression results show that nativity is a significant predictor of health coverage, where USBMs are 4 times more likely to have no health coverage than MEXBMs (p<.05). Low educational attainment of the caregiver (OR=1.07) and child age (OR=1.02) significantly increased the odds of not having health coverage. Higher literacy, living with biological parent, and employed caregiver significantly predicted stronger odds of having health insurance. The effect of sex is not significant. USBMs in Michoacán are 2 times more likely not to have health coverage, followed by USBMs in Tamaulipas (1.8x), and Baja California (1.6x), compared to USBMs who live in other states.
Conclusions: USBMs are a vulnerable group because of their ongoing exposure to poverty and crime in receiving communities. In the U.S, 7% of citizen children of undocumented immigrants do not have health insurance. This similar population of children in Mexico are far more disadvantaged and experience significantly greater social and economic inequality—conditions that could lead to a lifetime of pervasive disadvantage. Citizen children are able to return to the U.S. and these early childhood disadvantages can lead to expensive health complications and early morbidity.