One in five children under the age of 6 in the United States is a child of immigrant parents, making children of immigrants the fastest growing child population in the United States. Although 93 percent of children of immigrants are U.S. citizens, Federal assistance programs meant to provide a safety net for poor families often do not reach these vulnerable children. Information is limited on how this difficulty in participating in food assistance programs affects the health and well-being of U.S. citizen infants and toddlers of immigrant parents.
The Children’s Sentinel Nutrition Assessment Program (C-SNAP) is an ongoing multi-site survey that investigates the associations between well-being and public assistance participation among young children under the age of 3. Since its inception in 1998, the C-SNAP study has been interviewing caregivers of infants and toddlers in emergency departments and ambulatory care practices in Boston, Little Rock, Baltimore, Los Angeles, Minneapolis, Washington DC, and Philadelphia.
This study investigated the associations between Federal food assistance participation and maternal and child well-being among immigrant households. Indicators of household and child food insecurity, child health, history of child hospitalizations since birth, maternal depression, and child development were used to measure well-being.
In the C-SNAP sample restricted to no receipt of private insurance (n=19,272), 7,216 children had immigrant parents. Caregivers were interviewed in English, Spanish, or Somali. Criteria for inclusion were mother’s recorded place of birth and no receipt of private insurance. All infants and toddlers included in the study were U.S. citizens.
Food insecurity was measured with the USDA’s 18-question survey module. Food insecurity was categorized at two levels: household food insecurity and child food insecurity. The caregiver’s report of the child’s overall health status was asked in standard form as used in the Third National Health and Nutrition Examination Survey. A three-item maternal depression screen was used to screen for maternal depression. The Parents’ Evaluation of Developmental Status (PEDS), a validated parent assessment of their child’s development, was asked of families with an infant of 4 months and older.
Bivariate associations between immigrant status and other categorical variables used chi-square tests, and t-tests were used for bivariate associations with continuous variables. Variables controlled in regression analyses included study site, low birth weight, whether or not child was breastfed, maternal race/ethnicity, and level of mothers’ education. In secondary analyses, the study also evaluated the impact of immigrant parents’ length of stay in the United States, as some States continue to require a minimum of 5 years of stay for legal immigrants to be eligible for food stamps and other forms of Federal assistance.
Demographic characteristics of immigrant caregivers differ substantially from the U.S.-born caregivers.
Study findings were further disaggregated by mother’s country of origin. Results demonstrate that households with Mexican-born mothers had almost three times the prevalence rate of food insecurity than households with U.S.-born mothers (46 versus 16 percent) and more than five times of the rate of child food insecurity (34 versus 6 percent). Mexican caregivers have the highest prevalence of food insecurity compared with other immigrant groups.
The odds of household food insecurity for all immigrant households were two times the odds of household food insecurity among households with U.S.-born mothers. The odds for food insecurity were even more pronounced for child food insecurity. Length of stay beyond 10 years significantly mitigated food insecurity, as the odds of household and child food insecurity decline drastically when compared with immigrants more newly arrived (within 5 years or fewer).
For children of immigrants, the odds of fair or poor health were 1.2 times greater than the odds of fair or poor health for children of U.S.-born parents. Compared with the odds among the Latino sample only, the odds of fair or poor health were significantly higher for children of Latino immigrants than for children of U.S.-born Latinos.
The odds of depression among all immigrant mothers were significantly less than the odds for depression among U.S.-born mothers, a;though the adjusted results for the Latino sample did not remain significant. Length of stay, after adjusting, showed significant association with increased odds of maternal depression for all immigrants considered together but not for the Latino immigrants considered separately.
Among all immigrants, the study was unable to demonstrate that improved child health, maternal depression, and hospitalizations were associated with receipt of food stamps or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
The increased risk for poor child health for immigrant Latinos, despite considerably higher rates of breastfeeding and lower rates of low birth weight, is a clear indication of the struggle of immigrant families to protect their children’s health in the United States. The high rates of food insecurity for all immigrants and the elevated risk of poor child health of young children should encourage decisionmakers to reassess current policies toward immigrants, both documented and undocumented. Poor health early in life can affect cognitive development and ultimately affect a child’s ability to function in school, succeed on the job market, and develop to their full potential.