Citation
Degboe, Arnold N. K. (2011). Adolescents in immigrant families: Disparities in health status and health care access and utilization.
Abstract
Immigration to the United States has increased significantly over the past three decades. As a result, immigrants now constitute about 12% of the total U.S. population. In the same way, the population of children in immigrant families in the United States (including immigrant children and U.S.-born children of adult immigrants) as also increased considerably. The proportion of children residing in a home with at least one foreign-born parent rose from 12.1% in 1990 to 18.1% in 2000 and 22% in 2007. Yet, the health and health behaviors of this fast-growing population of children in immigrant families remain insufficiently understood. Additional research is needed to adequately understand the psychological, physical, and emotional needs of children in immigrant families, identify the barriers to resources that they experience, and examine the underlying mechanisms through which various aspects of immigrant integration affect the physical and psychological well-being of immigrant children. This dissertation focuses on adolescents with one or more immigrant parents. The thesis consists of three studies that examine the disparities in physical and mental health status and health care access and utilization between adolescents and young adults in immigrant and non-immigrant families. In the first study, I examine the differences in the trajectories of self-reported physical health from age 12 to 32 among non-Hispanic Whites, non-Hispanic Blacks, Asians, and Hispanics in immigrant and non-immigrant families. Further, I assess the effect of assimilation on the self-reported health trajectories of adolescents and young adults age 12 to 32 with immigrant or non-immigrant parents from the four racial/ethnic backgrounds mentioned. The second study determines whether the trends in the receipt of routine physical exams from age 12 to 32 differ for those in immigrant and non-immigrant families. Also, the role of factors associated with health care access and utilization on the trajectories of routine physical examination is evaluated. Finally, the third study examines the immigrant generational differences in depressive symptoms among adolescents and notes how person, family, and neighborhood factors explain the association between depressive symptoms and generational status. In all the three studies, I analyze the National Longitudinal Study of Adolescent Health (Add Health) data using hierarchical or multilevel modeling techniques. The results of the first study are that an advantage in the trajectory of self-reported health exists for those in immigrant families from age 12 to 32 regardless of race/ethnicity and adjusting for socioeconomic characteristics, demographic factors, acculturation, and spatial assimilation does not fully explain the health advantage. The second study results show immigrant families are less likely to receive timely routine physical exams between the ages of 12 and 22 compared to those in non-immigrant families. However, from age 23 to 32 those in immigrant families are more likely to receive routine physical exam compared to those in non-immigrant families among Blacks, Asians, and Hispanics. High income, health insurance, having a usual source of health care, and a high parental education enhance the probability of routine physical exam over time. In the third study, first generation adolescents report higher average depressive symptoms than third generation adolescents while second generation adolescents do not differ significantly from third generation adolescents regarding average depressive symptoms reported. Also, greater proportions of first and second generation adolescents reside in neighborhoods characterized by high concentrate disadvantage, high immigrant concentration, and low residential stability. Results from the third study also indicate that person and family factors account for generation differences in depressive symptoms while neighborhood factors contribute substantially to racial/ethnic disparities in depressive symptoms among adolescents. Taken as a whole, the three studies in the dissertation have added to the existing knowledge on the health status and health care access and utilization of adolescents and young adults in immigrant families as well as the role of person, family, and neighborhood factors in shaping these health outcomes using a nationally representative longitudinal dataset and multi-level modeling approaches.
URL
https://etda.libraries.psu.edu/files/final_submissions/308Reference Type
Thesis/Dissertation
Book Title
Health Policy and Administration and Demography
Author(s)
Degboe, Arnold N. K.
Year Published
2011
Volume Number
Ph.D.
Publisher
Pennsylvania State University
Reference ID
7510
