Abstract
We tested the hypothesis that children in New York City (NYC) with an immigrant parent were more likely to lack health insurance and report poorer parent-rated health compared to those of US-born parents in this serial, cross-sectional study using existing data from 2009 to 2017 among children age < 12 years in two NYC health surveys. Main outcomes were parent-reported responses for (1) child insurance coverage and (2) child general health status. In multivariable logistic regression models, we estimated likelihood of outcomes for children of immigrants compared to those of US-born parents, adjusting for child, parent, and household characteristics. We included 2,637 children in 2009 and 7,042 in 2017 in NYC. In 2017, children of immigrant parents were more likely to experience uninsurance than children of US-born parents [adjusted odds ratio (AOR) 2.36 (95% CI: 1.05–5.31)]. Compared to children of US-born parents, children with an immigrant parent were more likely to have a gap in insurance coverage in both 2009 (AOR 1.88; 95% CI: 1.08–3.27) and 2017 (AOR 1.60; 95% CI: 1.06–2.41). Although more children of immigrants had poor/fair health than those of US-born parents in both years, differences were not statistically significant after adjusting for covariates. Our findings among a sample of children eligible for health insurance suggest policies intended to expand child health care access did not equitably reach children of immigrants despite their eligibility for health insurance. Tailored interventions for children of immigrants are needed to mitigate disparities in health insurance coverage.
Abbreviations
- PPACA:
-
Patient Protection and Affordable Care Act
- NYC:
-
New York City
- HD4NYC:
-
Health Data for New York City
- NYC DOHMH:
-
New York City Department of Health and Mental Hygiene
- IRB:
-
Institutional Review Board
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Acknowledgments
Thank you to HD4NYC and BCE workgroups for their contribution. This study was conducted through the Birth and Childhood Equity Health Data for New York City (HD4NYC) Working Group. HD4NYC, funded by the Robert Wood Johnson Foundation and led by the New York Academy of Medicine and the New York City Department of Health and Mental Hygiene, is a multi-institutional research platform that seeks to advance health equity by producing actionable, policy-relevant research and promoting the careers of academic and applied public health researchers. Thank you to Dr. Jennifer Humensky who provided, conceptualized, and designed the study and provided critical revisions of the manuscript for important intellectual content. Thank you also to the survey respondents who took the time to provide meaningful information.
Funding
Robert Wood Johnson Foundation; K23DK115682 (PI: Woo Baidal). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.
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Drs. Rosenbaum and Li assisted with study design and provided critical revisions of the manuscript for important intellectual content. Ms. Brahmbhatt assisted with data analysis and revised the manuscript. Ms. Hernandez assisted with results interpretation and provided critical revisions of the manuscript for important intellectual content. Ms. Vachon carried out data analysis and assisted with drafting the initial manuscript. Dr. Woo Baidal conceptualized and designed the study and drafted the initial manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
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Jennifer Woo Baidal and Mary-Elizabeth Vachon contributed equally.
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Woo Baidal, J., Vachon, ME., Hernandez, A. et al. Health Disparities Among Children in Immigrant Households: New York City 2009 and 2017. J Immigrant Minority Health (2024). https://doi.org/10.1007/s10903-024-01588-4
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DOI: https://doi.org/10.1007/s10903-024-01588-4