Primary Care, Access, and Special PopulationThe Relationship of Immigrant Status With Access, Utilization, and Health Status for Children With Asthma
Section snippets
Data Source
This study used data from the California Health Interview Survey (CHIS),20 a population-based random-digit, dialing, telephone health survey of California civilian households. Data were obtained from the 2001 and 2003 surveys, which conducted interviews during November 2000 through September 2001, and August 2003 through February 2004, respectively. Interviews were conducted in 6 languages: English, Spanish, Chinese, Vietnamese, Korean, and Khmer (Cambodian). The CHIS used stratified sampling
Results
Sociodemographic characteristics of our sample are presented in Table 2 by immigrant family status. The major differences between children with asthma in immigrant families compared with those in nonimmigrant families were that these children were more likely to be Latino or Asian, have parents with less education, live in poverty, and be uninsured or lack continuous insurance in the past year. They were also less likely to live in a single-parent household, more likely to have a parent who was
Discussion
Our study had 3 main findings. First, children in immigrant families with physician-diagnosed asthma had decreased access and utilization compared with children in nonimmigrant families. Second, both bivariate and multivariate analyses revealed that the relationship of immigrant status with health measures was complex. Finally, multivariate analyses suggested that decreased access and utilization were associated with poverty status and lack of insurance, whereas limitation in function and poor
Conclusions
Our study found that children with asthma in immigrant families experienced reduced access and utilization compared with their nonimmigrant counterparts, in part related to poverty and insurance status. The association of these findings with health measures was complex and may reflect differences in symptom awareness, perceptions of health, and access to health care. Caution should be used in generalizing the immigrant paradox to immigrant children with asthma, particularly as health policies
Acknowledgments
Support for this work comes in part from the Ambulatory Pediatric Association Young Investigator's Grant Program and fellowship funding from the Children's Health Initiative Pediatric Research Grant (Lucile Packard Foundation for Children's Health) and The William Randolph Hearst Foundation (Dr Javier received all 3 grants). The authors thank Maureen Lahiff, PhD, for statistical consultation and programming support.
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2015, Advances in PediatricsCitation Excerpt :Compared with children with asthma in nonimmigrant families, children with asthma in immigrant families are more likely to report access barriers, such as lacking a usual source of care or reporting delays in medical care. They are also less likely to report asthma symptoms and utilization of an emergency room in the past year, yet more likely to report fair or poor perceived health status [68]. Although these data support the immigrant paradox, because they are based on parental reports, like many self-reported surveys, the results might be significantly influenced by the lack of health care access to identify the child’s condition.
Neighborhood context and the Hispanic health paradox: Differential effects of immigrant density on children's wheezing by poverty, nativity and medical history
2014, Health and PlaceCitation Excerpt :Asthma, the leading chronic disease during childhood in the industrialized world (Shankardass et al., 2007), is a condition for which a HHP has been noted. Studies have shown that US-born Hispanic children have higher rates of asthma than Hispanic children born outside the US (Eldeirawi et al., 2005; Holguin et al., 2005), which is notable since immigrants not only tend to be economically deprived, but also experience healthcare access barriers, legal residency challenges and English-language limitations (Holguin et al., 2005; Javier et al., 2007). Research over the past decade indicates that the HHP may be shaped in part by the protective effects of living in co-ethnic neighborhoods (Browning and Cagney, 2003; Cagney et al., 2005, 2007; Wen et al., 2003; Landy et al., 2012; Peak and Weeks, 2002).
Parental limited english proficiency and health outcomes for children with special health care needs: A systematic review
2014, Academic PediatricsCitation Excerpt :Two studies, 1 of children with systemic lupus erythematosis28 and 1 of children with asthma,29 found no relationship between parental LEP and objective health measures including risk of developing lupus nephritis (based on pathologic or laboratory criteria) and asthma diagnosis (based on spirometry), respectively. Two larger studies of children with asthma and 1 study of children with diabetes, however, revealed that LEP parents reported worse health status and quality of life for their children than EP parents.30–32 Twelve studies assessed relationships between parental LEP and health care access (Table 3).
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2013, Early Human DevelopmentCitation Excerpt :Finally, the exact cause of the reduced rate of rehospitalizations for children of immigrant mothers is uncertain. This may be due to the “healthy immigrant phenomenon” but may also have been caused by reduced utilization of health care services due to linguistic and cultural barriers [28]. We did not have information on the immigration status of the families and outwards migration may have impeded record linkage.
Vision Loss in Children from Immigrant and Nonimmigrant Households: Evidence from the National Survey of Children’s Health 2018–2020
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