Cardiovascular Disease Among Children of Immigrants: Implication for Family Poverty Status and Immigrant Generation

Background/Purposes:

Children diagnosed with cardiovascular disease have a lifelong likelihood of comorbidities, repeated surgical interventions, and lifelong need of health services. Failure of timely diagnosis commonly results in death in some cases. Although negative outcomes are associated with children’s cardiac problems in general, a lack of knowledge prevents in-depth understanding of the prevalence of cardiovascular disease among children of immigrants, the fastest-growing population in the US. Furthermore, it is unknown whether the prevalence of cardiac disease differs by family poverty status, which is an important factor of health among children of immigrants. To this end, this study examines whether the rates of cardiovascular disease differ between children of immigrants and children of US-born parents and their relationship with immigrant generation and poverty.

Methods:

Using the National Health Interview Survey (NHIS) 2010-2018 and multivariate logistic regression models, we analyze the rates of cardiac problems among children of immigrants compared to children of US-born parents. We then separate the children sample by immigrant generation and family poverty status to compare the rates of cardiac problems. Post-hoc analysis is run to test the differences in the outcomes between first-generation and second-generation children. The final sample includes 86,879 children aged 0-17.

Results:

Controlling for multiple covariates, this study finds that children of immigrants have lower odds of having heart diseases (OR=0.56; CI=0.44-0.70) than children of US-born parents. Children of immigrants living under poverty (OR=0.54, CI=0.42-0.70) and above poverty (OR=0.59, CI=0.35-0.99) had significantly lower odds of having heart problems. Our additional analyses show that the odds of having cardiac problems were significantly lower among second-generation children (OR=0.55, CI=0.43-0.70) compared to children of US-born parents in the full sample. Among children living under poverty, second-generation children (OR=0.54, CI=0.31-0.94) had 46% lower odds of having cardiac diseases compared to children of US-born parents. Although the rates of cardiac disease among first-generation children were lower compared to children of US-born parents regardless of family poverty status, the results were not significant.

Conclusion/Implication:

Using a nationally representative children sample, this study finds that children of immigrants are protected from cardiovascular diseases compared to children of US-born parents regardless of family poverty status. Also, this study demonstrated that second-generation children had a lower risk of having cardiovascular disease compared to children of US-born parents irrespective of family socio-economic status. Our findings support a notion of immigrant health paradox that children of immigrants tend to be healthier compared to children of US-born parents, even when they are socially and economically disadvantaged. Alternatively, the findings may result from reduced chances to visit specialists among immigrant families for diagnosis, thus underreporting their conditions. Under CHIPRA and ACA, immigrant families may still forego professional screening due to unfamiliarity with the US health policy, limited access to health care services, and a lack of health insurance. These findings inform health policy and program development by raising awareness of education on cardiac diseases and significance of timely detection of cardio-vascular diseases among immigrant families.