WASHINGTON, D.C. - Children in immigrant families are as healthy or healthier than children in U.S.-born families, but their health worsens as they integrate into American life, according to a new report from the National Research Council and the Institute of Medicine (IOM).
"Their health deteriorates as they assimilate into American life and by the second and third generations, it comes to resemble that of other U.S.-born children and adolescents," said Evan Charney, MD, chair of the committee that drafted the report.
The reasons for this are not clear. However, these children, who number around 14 million people, are more likely than children with U.S.-born parents to live in poverty, and less likely to have health insurance or receive regular medical care. Some also face an increased risk of specific medical problems, particularly infectious diseases like drug-resistant tuberculosis, the report said.
Charney said that better information is needed to guide policy decisions that affect the health of immigrant children, especially to track the effects that welfare reform and other recent public policies may have on this segment of America. "Why should we care about children of immigrants? The first reason is that collectively they represent the future of the United States. Fourteen million childrenone of every five people under age 18are immigrants or have parents who are immigrants," said Charney, professor of pediatrics, University of Massachusetts Medical School, Worcester.
Today's children offer a preview of the nation's future, when their productivity, health and civic participation will be crucial as the baby-boom generation approaches retirement, the report said. "Little effort has been made to track the health and well-being of immigrant children, despite some far-reaching changes in the public benefits they receive," said Charney. "It is critical that we understand the factors that affect these children's health and make informed policy decisions based on that knowledge."
The report calls on the federal government to fund a longitudinal survey to measure the development, assimilation and adjustment of children in immigrant families. New data should focus on measuring the personal, family, neighborhood and historical events that can affect a child's well being over time, the report said. These data should allow researchers to discern differences among children of various immigrant groups as well as make comparisons between them and African American, Asian, Hispanic and white children of U.S.-born parents. The government also should study the effects of welfare reform on immigrant children and adolescents.
The committee also recommended a series of improvements in the way data are gathered and information on children is disseminated by state and federal officials. Essential national data-collection systems should include country of birth and citizenship status, to monitor the circumstances of children in immigrant families should be a prominent consideration in the development of new surveys.
Three-quarters of the children of immigrant families have been U.S. citizens all their lives. Since 1990, the number of children and adolescents in immigrant families has risen seven times faster than the number of those with U.S.-born families. Most of these children are concentrated in California, New York, Texas, Florida, Illinois and New Jersey.
Drawing on census data, parental surveys and other information, the committee determined that children in immigrant families experience fewer short- and long-term health problems and fewer accidents and injuries than do children with U.S.-born parents. There are fewer low-birthweight babies and infant deaths in immigrant families, and adolescents reportedly have fewer mental health problems and are less likely to engage in risky behaviors. These findings are unexpected because these families are more likely to live in poverty.
Some children, however, face health problems associated with their countries of origin, including drug-resistant tuberculosis, intestinal parasites, hepatitis B and malaria. "Without proper medical care, these conditions can worsen and, in some cases, affect the health of large numbers of people," Charney said.
Children of migrant workers are exposed to pesticides, and children of Mexican families may be exposed to more lead than other children, the report said. Children in immigrant families are also less likely to have health insurance or a regular health care provider, and are less likely to have seen a doctor in the previous year. Immigrant children and adolescents are three times as likely to lack health insurance; and second-generation children and adolescents are twice as likely to lack it, the report said.
Whatever health advantages immigrant families enjoy recede over time, and the health of some immigrant groups declines, the report said. By the third and later generations, for example, rates of adolescent risk-related behaviorssuch as violence, illegal drug use, or unprotected sexual intercourseapproach or exceed those of white adolescents with U.S.-born parents. The reasons for this decline are unknown.
Most immigrants today come to the United States from Latin America and Asia, and socioeconomic status varies depending on their country of origin. Of particular concern are children from 12 countries that account for half of the children in immigrant families: the former Soviet Union, Cambodia, Laos, Thailand, Vietnam, El Salvador, Guatemala, Nicaragua, Haiti, Honduras, the Dominican Republic and Mexico. One-quarter of the children in families who emigrated from these countries live in poverty, are more likely to have parents with little formal education, and are more likely to live in overcrowded conditions. Despite this, they are less likely to receive public assistant than children of U.S.-born parents in similar socioeconomic and demographic circumstances.
Welfare reform restricted many of the benefits that immigrants receive; unlike any other group of children in the United States, many immigrants arriving in the United States after Aug. 22, 1996, are no longer eligible for Medicaid, the new federal Children's Health Insurance Program, food stamps or Supplemental Security Income for their first five years in this country. This is unfortunate, Charney said. "Medicaid offsets immigrant children's lower rates of health insurance coverage, and greatly increases the probability that a child will receive health care services," he explained. "We also found that having a connection or relationship with a source of care, often public hospitals or community clinics, similarly increases the probability that a child will visit a doctor at some point in a year."
For your information:
- Pre-publication copies of From Generation to Generation: The Health and Well-Being of Children in Immigrant Families are available from the National Academy Press; (202) 334-3313 or 1-800-624-6242. Cost is $52.95 (prepaid) plus shipping charges of $4.00 for the first copy and $.50 for each additional copy.
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