Parental immigration status is associated with children's health care utilization: findings from the 2003 new immigrant survey of US legal permanent residents

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From: Maternal and Child Health Journal(Vol. 17, Issue 10)
Publisher: Springer
Document Type: Report
Length: 5,291 words
Lexile Measure: 1500L

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Our objective was to examine the association between parental immigration status and child health and health care utilization. Using data from a national sample of immigrant adults who had recently become legal permanent residents (LPR), children (n = 2,170) were categorized according to their parents' immigration status prior to LPR: legalized, mixed-status, refugee, temporary resident, or undocumented. Logistic regression with generalized estimating equations was used to compare child health and health care utilization by parental immigration status over the prior 12 months. Nearly all children in the sample were reported to be in good to excellent health. Children whose parents had been undocumented were least likely to have had an illness that was reported to have required medical attention (5.4 %). Children whose parents had been either undocumented or temporary residents were most likely to have a delayed preventive annual exam (18.2 and 18.7 %, respectively). Delayed dental care was most common among children whose parents had come to the US as refugees (29.1 %). Differences in the preventive annual exam remained significant after adjusting for socioeconomic characteristics. Parental immigration status before LPR was not associated with large differences in reported child health status. Parental immigration status before LPR was associated with the use of preventive annual exams and dental services. However, no group of children was consistently disadvantaged with respect to all measures.

Keywords Emigrants and immigrants * Dental care * Pediatric * Primary health care * Pediatric * Health care disparities * Pediatric

Background

Nearly one quarter of children in the United States have at least one foreign-born parent [1], and this cohort represents the fastest growing group of American children [2]. These families, for simplicity described as "immigrant families," are highly diverse in national origin, socioeconomic status, and educational background. Additionally, they are diverse in their immigration experience, and include different subgroups of documented migrants (e.g. refugees and temporary migrants) as well as undocumented migrants.

Our understanding of the health status and other health issues among children in immigrant families remains limited. Previous studies have reported that children in undocumented families are more likely to be uninsured, in poor health, and lack a usual source of care relative to children in documented immigrant or non-immigrant families [3-5].

Another study found that children in refugee families may be more likely than children in non-refugee immigrant families to obtain dental care [6]. This pattern of disparities has been attributed to language, economic, and cultural barriers, but the importance of parental immigration status has not been adequately studied. For example, undocumented parents may be fearful of discovery by authorities and this may discourage them from accessing pediatric care [7]. In contrast, individuals from other immigrant subgroups, such as refugees, may be more likely to seek health care, perhaps because of engagement with case management services that promote access to care.

Available research is scant and largely limited to data from California. While this research advances the literature significantly, these analyses may not be nationally representative, due to state-specific policies. Furthermore,...

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Gale Document Number: GALE|A353320917