Predictors of Childcare Use and State Subsidy Uptake Among Immigrant Caregivers of Young Children on the US-Mexico Border

Background and purpose: Immigrant families navigate complex considerations when making childcare decisions, including affordability, transportation, language accessibility, cultural preferences, and concerns related to immigration status. While quality childcare supports child development, school readiness, and parental wellbeing, immigrant families often prefer parental or culturally/linguistically concordant care options that align with their values and needs. New Mexico offers expansive childcare subsidies through multiple funding sources, though knowledge gaps and enrollment challenges persist. This study examines childcare utilization determinants among immigrant families in New Mexico's borderlands, where progressive state policies contrast with federal immigration enforcement.

Methods: Using a community-based participatory research approach, we surveyed 227 immigrant caregivers of children under age 8 in Doña Ana County, New Mexico, a U.S.-Mexico border region with high child poverty rates. Guided by Andersen's Behavioral Model, the survey assessed factors defined as predisposing (demographics, help-seeking attitudes, childhood trauma), enabling (employment, resource mobilization skills, public assistance use), and need domains (mental health, immigration stress, housing insecurity). Bilingual/bicultural interviewers administered surveys in participants' preferred language. Bivariate and multivariate logistic regression analyses identified predictors of childcare subsidy receipt and service utilization.

Results: The sample (82.4% female, mean age 35.67 years) of caregiver participants had lived in the US for an average of 15.48 years, with only 19.8% speaking English well. Among participants, 32.6% received state childcare subsidies and 34.4% used childcare services. Multivariate analyses revealed that positive attitudes toward help-seeking (OR=1.18, 95% CI=[1.10, 1.29]) and higher use of public assistance (OR=1.48, 95% CI=[1.02, 2.19]) significantly increased the odds of receiving childcare subsidies. For childcare service utilization, domain-specific models showed statistical significance for number of children, childhood trauma, housing insecurity, and employment status, though in the full model, only help-seeking attitudes and public assistance use remained significant predictors.

Conclusions and implications: Mental health help-seeking attitudes significantly predicted both state childcare subsidy use and formal childcare services participation, suggesting either that openness to external support extends across service domains or that childcare engagement positively influences perspectives on seeking professional assistance. Successful navigation of public assistance programs strongly correlated with childcare service utilization, highlighting how childcare centers may function as resource brokers connecting families to broader support networks. Use of formal childcare was associated with having more children, trauma history, and housing insecurity, potentially indicating that families with greater needs appropriately seek external supports. These findings emphasize childcare's crucial role in holistically addressing immigrant families' multidimensional needs. The implications suggest a multi-pronged approach to improving childcare resource access: (1) culturally responsive outreach addressing help-seeking attitudes; (2) streamlined connections between public assistance and childcare services; (3) positioning childcare centers as less threatening entry points to service systems; and (4) developing multicultural competencies among staff. Future research should examine Spanish-language provider availability, childcare preferences and service quality, and structural barriers affecting immigrant families' childcare decisions in borderland communities.