Assimilation and emerging health disparities among new generations of US children(Hamilton et al. 2011)

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Hamilton, Cardoso, Hummer, and Padilla focus on the relationship between assimilation and health disparities among new generations of children in the United States. In particular they look at four out of seven child health conditions that are found to increase throughout the generations of immigration. These four child health conditions are higher for Black and Hispanic children in the third generation of immigration. Various determinants are mentioned that explain the racial/ethnic disparities that continue but there is still a question regarding the generational pattern observed.
Children of immigrants comprise an increasing number of children in the United States. As a result of the conditions that these children often live in, they are at-risk for poorer health conditions compared to native born children. Due to the increase in the numbers of immigrant children in poor living conditions, there needs to be a focus on the overall health outcomes for these children (Mendoza, 2009). This article compares the health outcomes of immigrant children to native born children.
Looking at the research on immigrant children health, the literature shows that these children are of similar or better health at birth than native born White children. This phenomena gives way to the epidemiological paradox (when discussing Hispanic immigrants). There is less research on immigrant child health throughout childhood as opposed to at birth. As a result, there are issues related to data collection and measurement. These constraints have led to a focus on Mexican-American children which indicates continued poor health for these children as they continue throughout their lifespan. This article seeks to find out if these outcomes would be similar for other immigrant children groups.
When discussing models of assimilation in the literature, the authors introduce a health assimilation model which tests the classic assimilation model and the segmented assimilation model. This is done by providing evidence that the disappearing differences in immigrant health points to worse health in the temporal and generational context which refutes the classic assimilation model and supports the segmented assimilation model.
There is a discussion of risk factors (access to health care and socioeconomic status) and protective factors (social networks and health and healthy parental behavior) that impact the lives of immigrant children. There is a question of the length of time that maternal health behaviors impact children (Guendelman, 1998). The impact of risk and protective factors are extended to the neighborhood level. The idea of overall neighborhood health and its impact of immigrant child health also plays a role in health outcomes.
The dataset used was the 2007 National Survey of Children’s Health (NSCH) which is sole dataset which has a large enough sample to estimate common health conditions in US sub groups. The sample included 64,509 Hispanic, Asian, Black, and White children aged 3-17. The sample only included those with information on all outcome variables.
It was difficult to measure generation placement due to grandparent’s place of birth not being included in the available data. In areas where Asians were less than five percent of the state sample population, they were coded as “Other”. The seven common physical and developmental health measures include asthma, allergies, ear infections, headaches, learning disabilities, developmental issues, and overweight. Four measures of child socioeconomic status and family structure were also included. Measures of parent health, behaviors, and indicators of social support were also included.
Regarding the methods used, age-standardized distributions were presented for the seven health conditions applied to each race/ethnic group. A series of multivariate, logistic regression models were tested for the other measures including socioeconomic and family factors. Full regression results are presented for asthma while predicted marginal proportions
The results of the age-standardized percent distributions of the health conditions indicate a prevalence pattern of allergies, asthma, developmental problems, and learning disabilities among the second and third generation groups. Specifically, the proportion of children with allergies increases by more than 300% for Asian and African-American children. The prevalence for asthma was shown to increase among all race/ethnic groups and generations. The condition of overweight indicated a generational pattern for Black children only. Evidence of the epidemiological paradox was evident among Hispanic children compared to White children.
Overall each of the analyses showed that Hispanic and Black children were much more likely to be disadvantaged compared to White and Asian children.
Questions:
1. As a result of the findings of this research, do you think the definition of the epidemiological paradox needs to be expanded to include other immigrant groups?
2. What would you include in the explanation of the first and second generation health advantage?
3. What are your thoughts on the changing of identity between censuses over time and the impact on the reporting of child health?

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