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

基本信息

批准号：
10597612
负责人：
Jens Hainmueller
金额：
$ 41.19万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-25 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10597612
关键词：
Address Adopted Affect Anxiety Anxiety Disorders Arizona Authorization documentation Birth Records California Caring Child Child Health Childhood Communities Complex Data Data Set Databases Decision Making Documentation Eligibility Determination Exclusion 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 Policy Maker Population Population Group Prenatal care Preventive Primary 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 access restrictions authority cost effective federal policy health assessment health care availability health care service utilization health data health disparity health service use hospital utilization improved innovation intergenerational member obstetric outcomes poor health outcome prenatal programs response social determinants stress disorder stress related disorder

项目摘要

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孩子生活在一个移民家庭中（即，至少有一个移民父母家庭），至少有二十分之一的生活在混合移民状态家族中（即移民的差异地位）。虽然几项研究表明了一个家庭作为社会地位的移民地位的重要性儿童健康的决定因素 - 很少分析移民政策的作用（包括国家，州和地方）移民政策）塑造儿童健康成果。从历史上看，这种分析已受到挑战由于全国数据集的可用性有限，该数据集包含所需的移民措施状态，以及无法超越统计的不足的分析技术协会。我们的跨学科小组在最近的一项研究中表明了其能够克服这些问题的能力国家医疗补助数据和创新分析技术，以检查移民政策对婴儿的影响，孩子和孕产妇健康。对于这项提议，我们的总体目标是通过使用医疗补助数据来评估公共政策对医疗保健访问，健康服务利用的影响以及我们出生的第一代移民父母的孩子的健康成果。具体来说，我们将实现以下目标。目的1：我们将建立一个国家，纵向，链接的医疗补助数据集，以检查关于儿童健康的移民政策。目标2：使用此国家数据库，我们将研究国家儿童健康移民政策（例如，心理健康）和医疗保健使用（例如，初级保健访问，医院利用）。目标3：我们将检查国家和地方移民政策以确定差异各种政策对移民父母及其出生的孩子的影响。我们使用资格要求医疗补助以识别移民母亲及其出生的孩子，然后使用概率匹配（通过家庭账单识别系统和出生记录）以将家庭单位联系起来。在目标中进行分析 2-3，我们将使用因果推理研究设计（例如差异差异）来探索外部公共政策变化 - 随着时间的推移利用政策实施中的“自然实验” 以及整个地理区域。这包括联邦和州移民政策（例如，移民法，包括或将移民排除在特定服务之外的法规），州和地方移民行动（例如，工作场所级别和社区级执行）以及联邦和州卫生政策（例如，联邦医疗补助法律，法规或针对产前护理的指导，儿科护理）可能会对第一一代移民父母及其出生的孩子。我们假设这些政策将具有重要的代际对我们出生的移民儿童的健康和福祉的影响。回答这些具体目标对于政策制定者，公共卫生领导者和医疗的决策至关重要致力于解决健康差异并改善儿童健康轨迹的专业人员在移民家庭中，是成长最快的儿童人群之一。