Early Childhood Health Among Latinos/as

在美国，拉美裔儿童是一个庞大且快速增长的人口群体，面临着经历 儿童早期的不良健康后果。拉丁裔/AS出生的婴儿有许多健康优势 包括较高的出生体重，但根据结果，这种健康悖论不会持续到儿童早期 例如一般健康状况和认知发展。最近拉丁裔/a人口的分散到 在北卡罗来纳州和内布拉斯加州等地，美国各地的“新”移民接收门户可能 进一步将拉丁裔儿童的健康置于危险之中。相对于更成熟的网关，新的 目的地对拉丁裔/a家庭构成挑战，因为同族和机构支持较少，较高 居住隔离的程度。此外，由于它们涵盖农村、郊区和城市位置， 新的目的地可能更有可能包括医疗保健选择供应较少的社区，如 儿科医生和非营利性社区诊所。因此，这个项目将解决地理上的 拉丁裔/a家庭分散到新的目的地与拉丁裔/a幼儿健康差距有关。 第一个具体目标是比较新的和现有的拉丁裔/a的医疗保健供应特点 使用美国人口普查局的人口数据和公开的社区数据的目的地 美国卫生与公众服务部和国家慈善中心提供的医疗保健 统计数字。对这些数据的分析将确定新目的地的医疗保健供应是否较低 比已建立的目的地更多选择。第二个具体目标是检查年轻人之间的健康差距。 拉丁裔/a和非拉丁裔/a非移民白人儿童横跨拉丁裔/a目的地，并确定 医疗保健供给特征对这些联系起到中介作用和/或调节作用。利用上的数据库 拉丁裔/a目的地和卫生保健供应与关于幼儿的受限使用地理编码数据合并 健康状况在国民健康访谈调查和国民健康与营养检查调查中的统计 分析将检查拉丁裔/a目的地和拉丁裔/a儿童早期健康之间的联系 差异，调解和缓和分析将确定这些联系是被解释还是 根据当地医疗保健供应情况而有所不同。这一目标将确定拉丁裔/a儿童早期健康的地点 差距最为明显，而卫生保健提供的资源可以解决这种不平等问题。这个 第三个目标将研究拉丁裔/a目的地、医疗保健供应和早期 儿童健康状况因拉丁裔/父母的民族血统和出生地而异。这一目标将进一步确定 在不同类型的地点，最需要关注的拉丁裔/a人口中的幼儿。 该项目将为关于种族/族裔健康差异和基于地点的健康决定因素的研究提供信息，以及 将通过确定幼儿所在地区的类型，对政策和实践产生影响 的拉丁美洲人/AS最有可能遭遇不利的健康后果。

The children of Latinos/as in the U.S. are a large and fast-growing demographic group at risk of experiencing adverse health outcomes in early childhood. Infants born to Latinos/as have a number of health advantages including higher birthweights, but this health paradox is not sustained into early childhood based on outcomes such as general health status and cognitive development. The recent dispersion of the Latino/a population to “new” immigrant-receiving gateways across the U.S. in places such as North Carolina and Nebraska could further place the health of young children of Latinos/as at risk. Relative to more established gateways, new destinations pose challenges to Latino/a families due to fewer co-ethnic and institutional supports and higher levels of residential segregation. Additionally, because they encompass rural, suburban, and urban locations, new destinations may be more likely to include communities with a lower supply of health care options such as pediatricians and non-profit community clinics. This project, therefore, will address how the geographic dispersion of Latino/a families to new destinations is associated with Latino/a early childhood health disparities. The first specific aim is to compare health care supply characteristics across new and established Latino/a destinations using demographic data from the U.S. Census Bureau and publicly available data on community health care supply from the U.S. Department of Health and Human Services and National Center for Charitable Statistics. Analyses of these data will determine whether new destinations have a lower supply of health care options than established destinations. The second specific aim is to examine health disparities between young Latino/a and non-Latino/a non-immigrant white children across Latino/a destinations and to determine whether health care supply characteristics mediate and/or moderate these associations. Utilizing a database on Latino/a destinations and health care supply merged with restricted-use geocoded data on early childhood health in the National Health Interview Survey and National Health and Nutrition Examination Survey, statistical analyses will examine associations between Latino/a destinations and Latino/a early childhood health disparities, and mediation and moderation analyses will determine whether these associations are explained or vary by local health care supply. This aim will identify the locations where Latino/a early childhood health disparities are most pronounced and the health care supply resources that can address such inequalities. The third aim will examine whether associations between Latino/a destinations, health care supply, and early childhood health vary by Latino/a parental national origin and nativity. This aim will further identify the types of young children within the Latino/a population who are most in need of attention in different types of locations. This project will inform research on racial/ethnic health disparities and place-based determinants of health, and will have implications for policy and practice by identifying the types of geographic areas where young children of Latinos/as are the most at risk of experiencing adverse health outcomes.