Seizures are linked to irregular brain development and brain destruction among children. Although negative outcomes are associated with children’s seizures, a lack of knowledge prevents in-depth understanding of seizure prevalence among children of immigrants, the fastest-growing population in the US. This is a crucial omission as children of immigrants may experience underdiagnoses of seizures, due to the lack of financial resources. Despite intervention initiated by CHIPRA and ACA, few studies have examined seizure rates among children of immigrants in the new policy era. Furthermore, it is unknown whether seizure prevalence differs by poverty status, which is an important factor in the health of children of immigrants. Therefore, this study examines whether seizure prevalence differs between children of immigrants and children of US-born parents and their relationship with poverty
This study utilizes data from the National Health Interview Survey (NHIS) 2010-2018 to reflect seizure prevalence in the context of CHIPRA and ACA. Using a multivariate logistic regression model, this study analyzes rates of seizures among children of immigrants compared to children of US-born parents. This study also separates the children sample by immigrant generation and family poverty status to compare seizure occurrence. A post-hoc analysis is run to test for differences in the outcomes between first-generation and second-generation children. The final sample includes 86,886 children aged 0-17.
Controlling for multiple covariates, this study finds that children of immigrants have lower odds of reporting seizure prevalence (OR=0.633) than children of US-born parents. Both first-generation (OR=0.503) and second-generation (OR=0.673) children were less likely to report seizures compared to children of US-born parents. Children of immigrants living under poverty (OR=0.554) and above poverty (OR=0.667) were also less likely to experience a seizure in both adjusted and unadjusted models. Our post hoc tests found no significant differences in seizure rates between first- and second-generation children, regardless of family poverty status.
Conclusions and Implications:
Based on the nationally representative children sample, the study finds that both first- and second-generation children of immigrants are protected from seizures compared to children of US-born parents in both unadjusted and adjusted results. Our findings support a notion of immigrant health paradox that children of immigrants with less exposure to the US culture tend to be healthier compared to children of US-born parents. Alternatively, the findings may result from a lack of visits to professional health care providers, among immigrant families for diagnosis; therefore, making children appear healthier than they are. The findings may also reflect a result of stigma related to cultural beliefs attached to a seizure condition and the need for health education among immigrant families. Although CHIPRA and ACA have expanded benefits, health care resources may still be underutilized by immigrant families until assimilation increases familiarity with the US health care system. These findings inform policy and program development by raising awareness of available public health care resources and maximizing the potential of ACA and CHIPRA for children of immigrants.