Longitudinal Trajectories of Food Insecurity Among Children of Immigrants

Attention-Deficit Hyperactivity Disorder among children of immigrants: immigrant generation and family poverty

OBJECTIVES

Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most common disorders diagnosed among children in the US. However, little knowledge is available about ADHD prevalence among children of immigrants, the fastest-growing population in the US. This study seeks to examine ADHD rates among children of immigrants in different generations compared to children of US-born parents and their association with family poverty.

DESIGN

The sample includes 83,362 children aged 0-17 from the National Health Interview Survey (NHIS) 2010-2018 data. Multivariate logistic regression model is used to estimate prevalence of ADHD among children of immigrants compared to children of US-born parents. We then compare ADHD rates among the children sample in different immigrant generations. For all analyses, we examine ADHD occurrence separately for children in families living below the poverty threshold and those at or above the poverty threshold.

RESULTS

The odds of having ADHD were significantly lower among children of immigrants compared to children of US-born parents. Both first-generation children and second-generation children of immigrants had significantly lower odds of having ADHD than children of US-born parents. Post hoc tests find that first-generation children had lower odds of having ADHD compared to second-generation children. Likewise, additional analyses showed that children of immigrants, first-generation children in particular, were less likely to have ADHD compared to children of US-born parents, in both lower- and higher-income families.

CONCLUSION

Using a nationally representative sample of children, we find that the likelihood of having ADHD increases with higher generations, detecting differences in ADHD prevalence by immigration generation. Importantly, first-generation children had a significantly lower risk of having ADHD conditions compared to second-generation children and children of US-born parents, regardless of family socio-economic status. Public health policy and program development would gain from a clear comprehension of the shielding attributes of ADHD among immigrant families.

Factors associated with food insecurity among Latinx/Hispanics in the U.S.: evidence from the Fragile Families & Childhood Wellbeing Study

OBJECTIVE

U.S. Latinx/Hispanic families experience higher food insecurity rates than the general population. Few studies have examined factors that contribute to food insecurity among the Latinx/Hispanic population, and none have done so using a national dataset. Drawing from the ecological theory of human development framework, this study explores the following research questions: What micro-, meso-, and exo/macro-system factors are related to adult and child food insecurity? How do these factors compare for Latinx/Hispanic, Black, and White mothers?

DESIGN

This study uses data from the Fragile Families and Child Wellbeing Study (FFCWS), a national survey that follows a birth cohort of mostly unwed parents and their children over a 15-year period. The sample was limited to Hispanic (both foreign-born and native-born), non-Hispanic Black mothers, and non-Hispanic White mothers. This yielded a final sample size of 2,636 for all mothers and 665 for Latinx/Hispanic mothers.

RESULTS

While micro-level factors were influential for food insecurity, they alone could not explain the variation. Social support, a meso-level factor, remained a consistently significant predictor for both adult and child food insecurity, regardless of race/ethnicity. There were also several key differences in predictors across racial/ethnic groups. Being Spanish speaking and mother's health status were only significant for Latinx/Hispanic mothers, and neighborhood support was not significant for Latinx/Hispanic mothers.

CONCLUSIONS

Drawing from ecological theory, our study explores the micro-, meso-, and exo-/macro-level variables that influence food insecurity. Findings suggest that access to social support is crucial for disadvantaged families avoiding food insecurity, despite race/ethnicity. Still, factors predicting food insecurity may be racialized and should be recognized as such.

The 2016 Presidential Election, the Public Charge Rule, and Food and Nutrition Assistance Among Immigrant Households

Objectives. To investigate whether the 2016 US presidential election and the subsequent leak of a proposed change to the public charge rule reduced immigrant families' participation in food and nutrition assistance programs. Methods. We used nationally representative data on n = 57 808 households in the United States from the 2015-2018 Current Population Survey-Food Security Supplement. We implemented difference-in-difference-in-difference analyses to investigate whether the election and proposed rule change produced decreases in immigrant families' participation in food and nutrition assistance programs and whether such decreases varied according to state policy generosity toward immigrants. Results. Findings indicate significant and large decreases in Supplemental Nutrition Assistance Program, School Breakfast Program, and National School Lunch Program participation among immigrants in moderately generous states but no changes to receipt of food assistance from nongovernmental sources or to household food insecurity. Conclusions. Both anti-immigrant rhetoric and the perceived threat of policy enactment can be enough to produce chilling effects that have potentially serious implications for the health of immigrant households and thus the health of the nation. (Am J Public Health. 2022;112(12):1738-1746. https://doi.org/10.2105/AJPH.2022.307011).

Food insecurity among immigrants and refugees of diverse origins living in metropolitan Atlanta: the roles of acculturation and social connectedness

Little is known about the prevalence and correlates of food insecurity among immigrants and refugees. Acculturation and social connectedness may influence food insecurity (lack of access at all times to enough food for an active, healthy life) by affecting a person's ability to access and use governmental and charitable food assistance programs, as well as other community-based or informal food-related resources. We explored associations of acculturation and social connectedness with food insecurity among diverse immigrants and refugees living in metropolitan Atlanta, a major destination for these populations in recent years. From 2017 to 2018, we surveyed 162 adults attending health fairs or programs hosted by two community-based organizations serving immigrants and refugees. Food insecurity within the past year was assessed using the American Academy of Pediatrics' two-item questionnaire. Acculturation indicators included heritage culture and American acculturation scores (Vancouver Acculturation Index), English fluency, heritage language fluency, and percentage of lifetime in the USA. Social connectedness was operationalized using measures of religious attendance and social isolation. We conducted a multivariable logistic regression controlling for age, sex, education, household income, employment status, and household size. In the sample, 51.9% identified as Vietnamese, 16.0% Hispanic, 15.4% Burmese, 14.8% Bhutanese or Nepali, and 1.8% other. The average age was 39.10 (standard deviation [SD] =13.83), 34.0% were male, 73.8% had below a Bachelor's degree, and 49.7% were unemployed. Average scores for American acculturation (mean [M] = 3.26, SD = 1.05, range 1-5) were lower than heritage acculturation (M = 4.34, SD = 0.68, range 1-5). Additionally, 43.4% were fluent in English. Average percentage of life in the USA was 40.59% (SD = 33.48). Regarding social connectedness, 55.9% regularly attended religious services. Average social isolation scores were 3.93 (SD = 1.34, range 3-9). Overall, past-year food insecurity was reported by 17.3% (34.6% in Hispanics, 24.0% in Burmese, 13.1% in Vietnamese, and 8.3% in Bhutanese or Nepali). In adjusted models, food insecurity was associated with English fluency (adjusted odds ratio [aOR] = 0.36, p = .03) and social isolation (aOR = 2.29, p < .001) but not other measures of acculturation or religious attendance. Limited English proficiency may make it more difficult to navigate or use governmental and charitable food assistance programs. Social isolation may hinder individuals from obtaining information about food assistance programs, receiving aid for services navigation, and sharing or borrowing food from family, friends, and neighbors. Interventions should seek to improve access to English language and literacy services, enhance the linguistic and cultural competency of service providers, and build social connectedness among immigrants and refugees.

Policies to reduce food insecurity: An ethical imperative

A quarter of U.S. households receive food assistance, yet more than 11% still experience food insecurity annually. We argue that an expansion-oriented approach to food and nutrition assistance policy is an ethical imperative. Drawing on values from the Capability Approach and Social Empathy Model and supported by empirical evidence, we propose an ethical framework characterized by four principles that can be used to assess and inform the development of just food policies. We argue that policies should (1) embrace compassion, (2) create opportunity, (3) consider essential needs, and (4) promote knowledge and empathy. In an applied case, we evaluate current SNAP policy in terms of those principles and offer recommendations to promote justice in the design and implementation of SNAP and other food policies.

The Role of Parents' Nativity in Shaping Differential Risks of Food Insecurity Among US First Graders

Objectives Food insecurity remains a problem in the US, especially for children in immigrant families. We developed a novel measure of parental nativity and incorporated school effects to advance knowledge from prior studies. Methods Using hierarchical logistic models and data from the Early Childhood Longitudinal Study-2011 Kindergarten Cohort, we examined how parental nativity and race/ethnicity, and school characteristics influence household food insecurity among a nationally representative sample of US first-graders in 2012. Results After adjusting for potential confounders, children without any US-born parents had a higher likelihood of household food insecurity than children with two US-born parents or one foreign-born/one US-born parent. Attending a Title 1 school was associated with food insecurity independent of household socioeconomic status. Conclusions for Practice Results suggest that providers should take special care to screen for food insecurity among children with only immigrant parents and that Title 1 schools have a potentially important role to play in reducing food insecurity.

Food Insecurity Among Hispanic/Latino Youth: Who Is at Risk and What Are the Health Correlates?

PURPOSE

We examined the correlates and health implications of household food insecurity among Hispanic/Latino youth (aged 8-16 years), a high food insecurity-risk population.

METHODS

Using the Hispanic Community Children's Health/Study of Latino Youth (n = 1,362) and bivariate and multivariate analyses, we examined the correlates of household and child food insecurity and very low food security. We assessed the influence of four sets of risk/protective factors-child demographic, acculturation, socioeconomic, and family/social support. We then examined associations between food insecurity and four health indicators-body mass index, diet quality, depression, and anxiety-and used modification effects to assess whether these associations differed by sex, age, household income, parent nativity, and acculturative stress levels.

RESULTS

We found high rates of food insecurity: 42% of Hispanic/Latino youth experienced household food insecurity and 33% child food insecurity. Moreover, 10% lived in a very low food secure household. Compared with their food secure peers, Hispanic/Latino youth in food insecure households experienced greater parent/child acculturative and economic stress and weakened family support systems. Associations of food insecurity with health outcomes varied by sex, age, household income, parent nativity, and child acculturative stress levels.

CONCLUSIONS

Food insecurity is highly prevalent among Hispanic/Latino youth and has detrimental health implications, especially for girls, older youth, and youth experiencing acculturative stress. Reducing food insecurity and improving health among Hispanic/Latino youth will likely require comprehensive policies that address their multiple migration, familial, and economic stressors.

Injuries Among School-aged Children of Immigrants

In response to a dearth of research on injuries among children of immigrants, this study examined child injury rates by immigrant generation. We used generalized estimating equations and nationally representative data to estimate injury risk for school-aged children of immigrants of different generations compared to children of native, US-born parents. After controlling for multiple other factors including socioeconomic status, citizenship, and children's general health, both 1st and 2nd generation school-aged children had significantly lower odds of having injuries compared to children of natives. Additional analyses also found lower odds of injuries among 1st and 2nd generation children relative to children of natives that persisted in both lower- and higher-income families. The findings suggest that 1st and 2nd generation immigrant families possess factors that protect children from injury independent of socioeconomic status. Policy and program development would benefit from a clearer understanding of these protective factors.