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Date: Sept. 9, 1998
Contacts: Dan Quinn, Media Relations Officer
Kristen Nye, Media Relations Assistant
(202) 334-2138; e-mail <>


Health of Immigrant Children Worsens After Living in U.S.;
Better Data Needed to Guide Policy Decisions

WASHINGTON -- Children in immigrant families are as healthy or healthier than children in U.S.-born families, but for reasons that are poorly understood, their health deteriorates with assimilation into American life, according to parental surveys and other data analyzed in a new report from the National Research Council and the Institute of Medicine. At the same time, these children 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 may face an increased risk of specific medical problems, including drug-resistant tuberculosis.

Much 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 public policies may have on this important sector of the U.S. population. Specifically, the report calls on the federal government to fund a new longitudinal survey to measure the development, assimilation, and adjustment of children in immigrant families over an extended period of time. Today's children offer a preview of the nation's future, when their productivity, health, and civic participation will be crucial to the nation as the baby-boom generation approaches retirement, the report says.

"Very 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 committee chair Evan Charney, professor of pediatrics, University of Massachusetts Medical School, Worcester. "It is critical that we understand the factors that affect these children's health and make informed policy decisions based on that knowledge."

To provide a clearer picture, new data collection should focus on measuring the personal, family, neighborhood, and historical events that can affect a child's well-being over years and decades, the report says. 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.

A Growing Population

Fourteen million children in the United States -- one of every five people under age 18 -- are immigrants or have parents who are immigrants. Three-quarters of these children have been U.S. citizens all their lives, and one-quarter came to the United States from elsewhere. 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. The majority 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. Children of migrant workers are exposed to pesticides, and children of Mexican families may be exposed to more lead than children with U.S.-born parents, the report says. In addition, compared with the children of U.S.-born parents, children in immigrant families are less likely to have health insurance or a regular provider of health care, and are less likely to have visited a doctor in the previous year. Specifically, 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 says.

Whatever health advantages immigrant families enjoy recede over time, and the health of some immigrant groups declines, the report says. By the third and later generations, for example, rates of adolescent risk-related behaviors -- such as violence, illegal drug use, or unprotected sexual intercourse -- approach or exceed those of white adolescents with U.S.-born parents. The reasons for this decline are unknown.

Lower Use of Public Assistance

Children in immigrant families experience, on average, a somewhat higher poverty rate than do the children of U.S.-born parents. However, compared with children in similar socioeconomic and demographic circumstances, those in immigrant families are actually less likely to live in families receiving public assistance. Welfare reform restricted many of the benefits that immigrants receive, and shifted much of the authority for determining who is eligible for public assistance from the federal government to the states. These policy changes were made without full debate in Congress about their potential effects on children in immigrant families, the report notes.

The committee expressed concern over the fact that, unlike any other group of children in the United States, many of those in immigrant families arriving in the United States after Aug. 22, 1996, are no longer eligible for Medicaid, the new State Child Health Insurance Program, food stamps, or Supplemental Security Income for their first five years in this country.

Diversity Among Immigrants

Most immigrants today come to the United States from Latin America and Asia, and their socioeconomic status varies greatly depending on country of origin. Of particular concern are children from 12 countries that account for half of the children in immigrant families in the United States -- the former Soviet Union, Cambodia, Laos, Thailand, Vietnam, El Salvador, Guatemala, Nicaragua, Haiti, Honduras, the Dominican Republic, and Mexico. A 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.

Insights gained from long-term surveys of immigrant children would improve knowledge of the development of all children, while making research on immigration and childhood development more widely available, and encouraging interdisciplinary research and collaboration, the report says. 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. Key national data-collection systems should include country of birth and citizenship status, and parents' country of birth. The need to monitor the circumstances of children in immigrant families should be a prominent consideration in the development of new surveys.

A committee roster follows. The study was funded by the U.S. Department of Health and Human Services, the National Institute for Child Health and Human Development, the U.S. Department of Education, the Carnegie Corporation of New York, the W.T. Grant Foundation, the Rockefeller Foundation, and the California Wellness Foundation.

The committee is part of the Board on Children, Youth, and Families, a joint activity of the National Research Council -- the operating arm of the National Academies of Sciences and Engineering -- and the Institute of Medicine. They are private, non-profit organizations that provide advice on science, technology, and health under a congressional charter granted to the National Academy of Sciences.

Read the full text of From Generation to Generation: The Health and Well-Being of Children in Immigrant Familiesfor free on the Web, as well as more than 1,800 other publications from the National Academies. Printed copies are available for purchase from the National Academy Press Web siteor at the mailing address in the letterhead; tel. (202) 334-3313 or 1-800-624-6242. Reporters may obtain a pre-publication copy from the Office of News and Public Information at the letterhead address (contacts listed above).

National research council
Institute of medicine
Board on Children, Youth, and Families

Committee on the Health and Adjustment of Immigrant Children and Families

Evan Charney, M.D.* (chair)
Professor, Department of Pediatrics
University of Massachusetts Medical Center and School

Kathleen Gainor Andreoli, D.S.N.*
Vice President for Nursing Affairs, and
John L. and Helen Kellogg Dean, College of Nursing
Rush University, and
Professor of Nursing
Rush-Presbyterian-St. Luke's Medical Center

E. Richard Brown, Ph.D.
Director, UCLA Center for Health Policy Research, and
Professor, School of Public Health
University of California
Los Angeles

Donald J. Cohen, M.D.*
Professor of Child Psychiatry, Pediatrics, and Psychology, and
Director, Child Study Center, School of Medicine
Yale University
New Haven, Conn.

Janet Currie, Ph.D.
Professor, Department of Economics
University of California
Los Angeles

Mary Lou de Leon Siantz, Ph.D.
Professor of Nursing, Department of Family and Child Nursing
College of Nursing
University of Washington

Michael Fix, J.D.
Director, Program on Immigrant Policy Studies
The Urban Institute
Washington, D.C.

Bill Ong Hing, J.D.
Associate Professor, School of Law
Stanford University

Arthur Kleinman, M.D.
Maude and Lillian Presley Professor of Medical Anthropology; Professor of Psychiatry; and Chair, Department of Social Medicine
Harvard Medical School
Harvard University
Cambridge, Mass.

Alan M. Kraut, Ph.D.
Professor, Department of History
American University
Washington, D.C.

Nancy S. Landale, Ph.D.
Associate Professor, Department of Sociology
Pennsylvania State University
State College

Antonio McDaniel, Ph.D.
Associate Professor of Sociology, and
Research Associate, Population Studies Center
University of Pennsylvania

Fernando S. Mendoza, M.D., M.P.H.
Chief, Division of General Pediatrics, and Associate Dean of Student Affairs
Stanford University School of Medicine, and
Associate Professor of Pediatrics
Lucile Salter Packard Children's Hospital
Palo Alto, Calif.

Victor Nee, Ph.D.
Goldwin Smith Professor of Sociology, and
Chair, Department of Sociology
Cornell University
Ithaca, N.Y.

David R. Smith, M.D.
President, Health Sciences Center
Texas Tech University

Alex Stepick, Ph.D.
Professor of Anthropology and Sociology, and
Director, Immigration and Ethnicity Institute
Florida International University

Sylvia F. Villarreal, M.D.
Clinical Professor of Pediatrics
University of California, San Francisco, and
Chief of Staff
San Francisco General Hospital


Donald J. Hernandez, Ph.D.
Study Director
* Member, Institute of Medicine