Research Supplement for Immigrant Families and Children's Health

移民家庭和儿童健康研究补充

• 批准号: 10541788
• 负责人: Jens Hainmueller
• 金额: $ 9.7万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-25 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10541788
• 关键词: Address; Affect; Age; Agreement; Award; Birth Records; Caring; Censuses; Child; Child Health; Child Mental Health; Child Welfare; Child health care; Childhood; Communities; Complex; Computerized Medical Record; Costs and Benefits; Country; County; Data; Data Set; Data Sources; Databases; Decision Making; Eligibility Determination; Face; Family; Family health status; Federal Government; Foundations; Generations; Geographic Locations; Goals; Government; Health; Health Personnel; Health Policy; Health Professional; Health Services Accessibility; Healthcare; Household; Immigrant; Immigrant family; Immigration; Infant Health; Information Systems; Intervention; Laws; Link; Maternal Health; Measures; Medicaid; Medical; Mental Health; Mothers; Natural experiment; Outcome; Parents; Pathway interactions; Personal Satisfaction; Policies; Population; Population Group; Prenatal care; Primary Health Care; Process; Public Health; Public Policy; Quasi-experiment; Regulation; Research; Research Design; Research Personnel; Resource Allocation; Resources; Risk; Risk Factors; Role; Sampling; Science; Services; Shapes; Statutes and Laws; System; Techniques; Time; United States; Woman; Workplace; data centers; data resource; evidence base; federal policy; health care availability; health data; health disparity; health service use; hospital utilization; improved; innovation; insight; intergenerational; novel; parent project; programs; response; social determinants; social health determinants

Project Summary of R01-MD01384 One in four children in the United States lives in an immigrant family, and at least one in twenty lives in a mixed-immigration status family. While several studies have demonstrated the importance of a family’s immigration status as a social determinant of child health – few have analyzed the role of immigration policy in shaping child health outcomes. Previous analyses have been challenging because of the limited availability of nationwide data sets containing the requisite measures of immigration status, and the use of insufficiently-rigorous analytic techniques that are unable to go beyond statistical association. Our interdisciplinary group has shown its capacity to overcome these issues in a recent study using state Medicaid data and innovative analytic techniques to examine the impact of immigration policy on infant, child, and maternal health. In our parent award, our overarching goal is to extend this capacity nationwide by using Medicaid data to assess the impact of public policy on health care access, health- service utilization, and health outcomes for US-born children of first-generation immigrant parents. We are working to fulfill the following aims. Aim 1: to build a national, longitudinal, linked Medicaid data set to examine the effect of immigration policies on children’s health. Aim 2: using this national database, examine the impact of national immigration policy on child health (e.g., mental health) and health care use (e.g., primary-care access, hospital utilization). Aim 3: examine state and local immigration policies to determine the differential impact of various policies on immigrant parents and their US-born children. We use eligibility requirements for Medicaid to identify immigrant mothers and their US born children, and then use probabilistic matching (via household billing identification systems and birth records) to link family units. To conduct the analyses in Aims 2-3, we will use causal inference research designs (such as difference-in-difference) to explore the impact of external public policy changes – taking advantage of “natural experiments” in policy implementation over time and across geographic areas. This includes federal and state immigration policies (e.g., immigration laws, regulations that include or exclude immigrants from particular services), state and local immigration actions (e.g., workplace-level and community-level enforcement), and federal and state health policies (e.g., federal Medicaid legislation, regulation or guidance specific to prenatal care, pediatric care) that may differentially impact first generation immigrant parents and their US-born children. We hypothesize that these policies will have important intergenerational impacts on the health and wellbeing of US-born children of immigrants. Answering these specific aims is essential to inform decision-making by policymakers, public health leaders, and medical professionals who are committed to addressing health disparities and improving health trajectories for children in immigrant families, one of the most rapidly growing child population groups.

R01-MD01384项目概要 在美国，四分之一的儿童生活在移民家庭，至少二十分之一的儿童生活在移民家庭。 混合移民身份家庭。虽然一些研究已经证明了家庭的重要性 移民身份作为儿童健康的社会决定因素——很少有人分析移民的作用 塑造儿童健康结果的政策。由于限制，之前的分析一直具有挑战性 包含移民身份必要措施的全国数据集的可用性，以及使用 分析技术不够严格​​，无法超越统计关联。我们的 跨学科小组在最近的一项利用状态的研究中显示了克服这些问题的能力 医疗补助数据和创新分析技术来检查移民政策对婴儿、 儿童和孕产妇健康。在我们的家长奖中，我们的首要目标是扩展这种能力 通过使用医疗补助数据在全国范围内评估公共政策对医疗保健获取、健康- 第一代移民父母在美国出生的孩子的服务利用和健康结果。我们是 努力实现以下目标。目标 1：建立一个全国性的、纵向的、相互关联的医疗补助数据集 研究移民政策对儿童健康的影响。目标 2：使用这个国家数据库， 研究国家移民政策对儿童健康（例如心理健康）和医疗保健的影响 使用（例如初级保健服务、医院使用）。目标 3：审查州和地方移民政策 确定各种政策对移民父母及其在美国出生的孩子的不同影响。我们 使用医疗补助的资格要求来识别移民母亲及其在美国出生的孩子，以及 然后使用概率匹配（通过家庭账单识别系统和出生记录）来链接 家庭单位。为了进行目标 2-3 中的分析，我们将使用因果推理研究设计（例如 差异中的差异）探索外部公共政策变化的影响——利用 随着时间的推移和跨地理区域的政策实施的“自然实验”。这包括 联邦和州移民政策（例如，移民法、包含或排除的法规） 来自特定服务的移民）、州和地方移民行动（例如， 工作场所层面和社区层面的执法）以及联邦和州卫生政策（例如联邦 针对产前护理、儿科护理的医疗补助立法、法规或指南）可能会有所不同 影响第一代移民父母及其在美国出生的孩子。我们假设这些政策 将对美国出生儿童的健康和福祉产生重要的代际影响 移民。回答这些具体目标对于决策者、公众的决策至关重要 致力于解决健康差距和问题的卫生领导者和医疗专业人员 改善移民家庭儿童的健康轨迹，这是成长最快的儿童之一 人口群体。