Immigrant Families and Children's Health: The Intergenerational Health Impact of Federal and State Immigration Policy

移民家庭和儿童健康：联邦和州移民政策对代际健康的影响

• 批准号: 10374174
• 负责人: Jens Hainmueller
• 金额: $ 61.04万
• 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/10374174
• 关键词: Address; Adopted; Affect; Anxiety; Anxiety Disorders; Arizona; Birth Records; California; Caring; Child; Child Health; Childhood; Communities; Complex; Data; Data Set; Databases; Decision Making; Documentation; Eligibility Determination; Family; Family health status; Fright; Generations; Geographic Locations; Goals; Health; Health Policy; Health Services Accessibility; Health Status; Healthcare; Hospitalization; Household; Immigrant; Immigrant community; Immigrant family; Immigration; Incidence; Infant Health; Information Systems; Laws; Licensing; Link; Local Government; Maternal Health; Measures; Medicaid; Medical; Mental Health; Methodology; Mothers; Natural experiment; Oregon; Outcome; Outpatients; Parents; Pattern; Personal Satisfaction; Policies; Population; Population Group; Prenatal care; Preventive; Primary Health Care; Public Health; Public Policy; Quasi-experiment; Regulation; Research; Research Design; Research Personnel; Role; Services; Shapes; Side; State Government; Statutes and Laws; Stress; Surveys; System; Techniques; Testing; Time; United States; Visit; Vulnerable Populations; Woman; Workplace; authority; cost effective; federal policy; health care availability; health care service utilization; health data; health disparity; health service use; hospital utilization; improved; innovation; intergenerational; member; obstetric outcomes; prenatal; programs; response; social determinants; stress disorder; stress related disorder

ABSTRACT One in four children in the United States lives in an immigrant family (i.e., with at least one immigrant parent in the household), and at least one in twenty lives in a mixed-immigration status family (i.e., variability in immigration status). 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 (including national, state and local immigration policies) in shaping child health outcomes. Historically, such 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 associations. 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. For this proposal, 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. Specifically, we will fulfill the following aims. Aim 1: we will 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, we will 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: we will 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.

抽象的 美国四分之一的儿童生活在移民家庭（即至少有一位移民父母居住在移民家庭） 家庭），并且至少二十分之一生活在混合移民身份的家庭中（即移民的可变性） 地位）。虽然一些研究已经证明了家庭移民身份作为社会因素的重要性。 儿童健康的决定因素——很少有人分析移民政策（包括国家、州和地方政策）的作用 移民政策）影响儿童健康结果。从历史上看，此类分析一直具有挑战性 由于包含必要的移民措施的全国数据集的可用性有限 状态，以及使用不够严格的分析技术，无法超越统计 协会。我们的跨学科小组在最近的一项研究中展示了克服这些问题的能力 州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。对于这项提案，我们的首要目标是通过以下方式在全国范围内扩展这种能力： 使用医疗补助数据来评估公共政策对医疗保健获取、医疗服务利用和 第一代移民父母在美国出生的孩子的健康状况。具体来说，我们将履行 以下目标。目标 1：我们将建立一个全国性的、纵向的、相互关联的医疗补助数据集，以检验 关于儿童健康的移民政策。目标 2：使用这个国家数据库，我们将检查 关于儿童健康（例如心理健康）和医疗保健使用（例如获得初级保健、 医院利用）。目标 3：我们将研究州和地方的移民政策，以确定差异 各种政策对移民父母及其在美国出生的孩子的影响。我们使用资格要求 医疗补助识别移民母亲及其在美国出生的孩子，然后使用概率匹配（通过 家庭计费识别系统和出生记录）以连接家庭单位。在 Aims 中进行分析 2-3，我们将使用因果推理研究设计（例如双重差异）来探讨 外部公共政策变化——随着时间的推移，利用政策实施中的“自然实验” 以及跨地理区域。这包括联邦和州移民政策（例如移民法、 包括或排除移民参与特定服务的法规）、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（例如联邦医疗补助 针对产前护理、儿科护理的立法、法规或指南）可能会产生不同的影响： 一代移民父母和他们在美国出生的孩子。我们假设这些政策将产生重要影响 对美国出生的移民子女的健康和福祉的代际影响。回答这些 具体目标对于决策者、公共卫生领导人和医学界的决策至关重要 致力于解决健康差距和改善儿童健康轨迹的专业人士 在移民家庭中，儿童人口增长最快的群体之一。