Nativity as a Determinant of Health Disparities Among Children

Abstract

Nativity is not often considered in the study of health disparities. We conducted a cross-sectional, parent-reported survey of demographics, socioeconomic characteristics, healthcare access, and health conditions in New York City schoolchildren (n = 9029). US-born children with US-born parents (US/US) had higher socioeconomic status, better access to healthcare, and reported higher rates of disease diagnoses compared to US-born children with immigrant parents and to immigrant children. Dental cavities were the only condition in which US/US children reported lower prevalence. US/US children had the best healthcare access, most favorable parent-reported health status and highest rate of satisfaction with healthcare. The magnitude of racial/ethnic disparities varied based on nativity of the children being compared. Factors such as the healthy immigrant effect and differential diagnosis rates may explain the results. In conclusion, nativity influences disease burdens and should be considered in health disparities studies.

Individual and Neighborhood Factors Associated with Undiagnosed Asthma in a Large Cohort of Urban Adolescents

“…It is possible that the burdens related to immigration and language barriers are more prevalent in Latino communities than African-American/Black communities in NYC. This is relevant because children of immigrant caregivers, non-Englishspeaking caregivers, and undocumented caregivers are more likely to suffer from undiagnosed chronic illnesses, including asthma [38][39][40]. Our finding supports the argument that the ICE index can be a useful tool in measuring geographic risk factors in public health research [30].…”

Breaking Down the Boxes—Time to Reshape Demographic Data—Reply

“…We agree that there are potential benefits of deepening granularity within different cultural diasporas. We similarly agree that nativity and country of origin are additional aspects of identity that are not regularly collected, yet have been shown to have significant associations with reported health …”

Association of Maternal Nativity Status and Race/Ethnicity on Emergency Department Utilization Among Children in Vulnerable Families

“…The lack of association for regular checkups and routine place of care we found is contradictory to studies that have noted that immigrants' children have lower odds of having a doctor's visit in the past year and of having a place for routine care. 7,8,34 A potential explanation for our different findings is that our sample of mothers had a long duration of US residency (at year 9, median duration of residence was 17 years [interquartile range, 13-23 years]) and thus were more likely to mirror health care access behaviors of US-born mothers. This reasoning might not apply to ED use behavior because an immigrant mother might be comfortable bringing her child to a primary care provider at a facility with whom she has already built a relationship but not trusting enough to bring the child to unfamiliar providers in alternate settings such as an ED.…”