Addressing the Social Determinants of Mental Health Among Latinx and Asian Immigrant Children

Background and Purpose:

There is a dearth of research examining the social determinants of mental health (SDOMH) among Latinx and Asian children in the United States, especially examining the differences between US-born and immigrant children. Studies in other countries have shown mixed results, with some showing no significant differences while others showing that immigrant children have better mental health. Given the plethora of studies on the mental health of adult immigrants but minimal studies on the mental health of immigrant children, this study investigates the difference in mental health problems of immigrant and US-born children. In addition, it explored the role of various social structural factors within the SDOMH framework that may have an impact on mental health conditions among children.

Methods:

Data were from the 2020-2021 National Survey of Children’s Health (NSCH), a nationally representative parent-proxy survey of children in the United States. Parents (N=93,669) completed self-reported surveys and indicated elements like income, employment, education, healthcare access, food insecurity, neighborhood safety, and adverse childhood experiences (ACEs) that fit into the social determinants of health (SDOH) framework. Immigration status was based on whether the child was born in the United States or not. This study focused on children, 6 to 17 years of age, from the Latinx (N=8,277) and Asian (N=3,427) groups who account for most of the immigrants. A couple of multiple logistic regression analyses were conducted to examine the difference in the impact of social determinants on mental health between Latinx and Asians.

Results:

In general, US-born children reported having a higher prevalence of having any type of mental health problems (14.5% vs. 11.7%; χ2=8.655, p=.003). While there were no significant differences in the mental health problems of US-born and immigrant children in the Latinx group (17.2% vs. 14.7%; χ2=2.794, p=.095), Asian immigrant children had significantly higher rates of mental health problems compared to U.S. born (9.3% vs. 6.4%; χ2=8.111, p=.004). Multiple logistic regression showed that Adequate Health Care and ACEs were consistently powerful factors associated with having mental or behavioral problems. Factors that were verified in literature as strong factors of mental health outcomes (e.g. job security, food security, neighborhood factors) were reported not to have associations with mental health problems in both groups regardless of the place of birth. Living in a supportive neighborhood (Exp(B)=.472, p=.024) and discrimination (Exp(B)=3.063, p=.002) were significant in foreign-born Asian children, while the impacts were not reported in US-born Asian Children.

Conclusions and implications:

This study found racial differences in the mental health of immigrant children (6-17 years of age), indicating that assumptions about the mental health of all immigrant populations cannot be made. Discrimination was a significant factor, but many social determinants included in our model did not show up to be significant. As hate crimes targeting individuals from Asian and Latinx backgrounds have been on the rise in recent years, increased efforts to gain a deeper understanding of the social determinants, such as discrimination and social inclusion, that contribute to the mental health of immigrant children.