Non-immigrant Families Research Articles

Predictors of Hydroxyurea Use in Children with Sickle Cell Disease

Background: Since hydroxyurea emerged as an effective therapy for sickle cell disease (SCD), there have been numerous studies that have demonstrated its safety and efficacy in children and adults with SCD. In their 2014 guidelines, the NHLBI recommended that hydroxyurea treatment should be offered to all infants and children with sickle cell anemia (HbSS and HbS/beta0 thalassemia) starting at 9 months of age. However, hydroxyurea is underused among children and adolescents with SCD and to date, there have been no studies that have identified the specific determinants that may predict hydroxyurea adherence in these patients.Objectives: 1. To identify predictors of hydroxyurea adherence in children with SCD. 2. To measure the rate of hydroxyurea use among CHEO patients with SCD who were born between January 1, 2003 and December 31, 2015; and 3. To compare the rates of SCD-related complications between patients who were not prescribed hydroxyurea, patients who were adherent to hydroxyurea and patients who were not adherent to hydroxyureaMethods: We extracted medical chart data to identify patients with SCD who were born between January 1, 2003 and December 31, 2015. Patients were classified as either “Not prescribed hydroxyurea” or “Prescribed hydroxyurea” based on clinical documentation and the presence of at least one hydroxyurea outpatient prescription. For those patients who were prescribed hydroxyurea, hematological indices were collected and analyzed over time to estimate adherence to hydroxyurea. To measure the adherence of children prescribed hydroxyurea, we examined the trends in the patient's hematological indices after their first prescription of hydroxyurea. Adherence was defined as increased hematological indices (from baseline) by greater than or equal to any 2 of the following: Mean corpuscular volume (MCV) by 10 fL; Hemoglobin levels (g/L) by 10 g/L and/or %HbF (fetal hemoglobin) by 10%. We measured the frequency of disease-related complications among CHEO patients with SCD according to their use of hydroxyurea and used multivariate analyses to evaluate immigration status, newborn screening status, SCD subtype, SCD complications, income, age and sex as predictors for hydroxyurea adherence.Results: Children with HbSS were more likely to have been prescribed hydroxyurea compared to children with HbSC (87.8% vs. 9.5%). Canadian citizenship, newborn hemoglobinopathy screening and lower familial income were associated with better hydroxyurea adherence (Table 1). Although the association was not statistically significant, patients were more likely to be prescribed hydroxyurea if they were from a lower income background (61.9% for lowest and second lowest quartiles vs. 38.1% for third and highest quintiles). Patients were also more likely to adhere to hydroxyurea if they did not have private medical insurance for hydroxyurea coverage (Table 1). Finally, hydroxyurea adherence was associated with reduced rates of health care utilization and SCD-related complications (Table 2).Conclusions: In line with previous studies of hydroxyurea for the treatment of SCD, patients who were adherent to hydroxyurea had fewer complications compared to those patients who were either non-adherent to or not prescribed hydroxyurea. Similarly, patients had fewer complications after being prescribed hydroxyurea compared to before they started hydroxyurea with a reduction in the rate of ED visits, acute chest syndromes, complications, transfusions and hospitalizations. Patients from non-immigrant families, patients who were identified through newborn hemoglobinopathy screening and patients from lower income families were more likely to be adherent to hydroxyurea. Although the results of this study were limited by its small sample size, further studies will clarify these determinants of hydroxyurea adherence among SCD patients and enable clinicians to improve hydroxyurea adherence for SCD patients. DisclosuresKlaassen:Shire: Consultancy; Novartis: Research Funding; Hoffman-La Roche: Consultancy; Amgen Inc.: Membership on an entity's Board of Directors or advisory committees; Octapharma AG: Consultancy, Honoraria; Agios Pharmaceuticals Inc.: Consultancy; Cangene: Research Funding.

A Comparison of the Parent-Child Interactions Between Russian Immigrant and Non-immigrant Families in a Rural Setting in Missouri

The purpose of this study was to compare the parent/child interactions between Russian immigrant and non-immigrant families in a rural Missouri school setting. A questionnaire was administered to 30 American families and 30 Russian immigrant families. Data concerning developmental level upon kindergarten entry were gathered from kindergarten screening protocols. Findings revealed that there were significance differences between the two sets of parents for the twelve literacy activities. Also significant differences were found regarding developmental levels between children who received Head Start as compared to those who attended preschool. Implications for early childhood literacy programs and the development of preschool language immersion programs within rural settings are significant. Also implications regarding understanding other ethnicities and cultures by rural educators are important.

Does Rural–Urban Migration Improve Employment Quality and Household Welfare? Evidence from Pakistan

Urban migration unlocks new employment opportunities for rural dwellers in a productive manner. This study assessed the quality of employment of migrant workers, and its effect on rural households’ welfare. To this end, we used primary data collected from the four major districts of Lahore, Gujranwala, Faisalabad, and Sialkot in Punjab, Pakistan. These data include 504 immigrant and non-immigrant families in rural areas, and 252 migrant workers in urban destinations. We use IV probit and two-step sequential estimation methods for the empirical analysis. The study provides new insights for migration in Pakistan. First, migrant workers are better off in their new urban settings in terms of improved incomes and living conditions, but their social protection status is still poor. Second, the results of the employment quality models show that migration is a successful strategy for rural households to improve the quality of their employment. In addition, the characteristics of migrants and native households affect the relative improvement in the quality of employment and migrants’ conditions. Third, the results of the propensity score matching technique suggest that migration has a positive impact on rural households’ income, and these impacts are more pronounced in large cities. Based on the findings, the study recommends that the government should invest in quality education in rural areas, and ensure that social security schemes are provided for migrant workers in urban areas.

Policy constructions, immigrants’ social rights and gender: The case of Swedish childcare policies

This article explores how policy constructions shape policy outcomes for immigrant women and men, focusing on two Swedish childcare policies: (1) parental leave and (2) childcare services. It sheds light on the dynamics between policy constructions and (1) the gender differentiation in immigrants’ social entitlements, (2) the gender differentiation in social entitlements of the Swedish-born population and (3) differences and similarities between the two. Among the major findings is that the universal construction of childcare services and parental insurance promotes parity in immigrant and Swedish-born parents’ utilization. Immigrant families have high enrolment rates in childcare programmes and their rates approach or equal those of non-immigrant families. In the case of parental benefits, over 40 percent of immigrant mothers would be ineligible without the universal construction, and a huge immigrant/ethnic divide in entitlement would exist. Second, a gender differentiation characterizes the claiming of parental benefits, and the differentiation is sharper for immigrant parents. Third, the ethnicity benefit differential is much wider for mothers’ parental leave benefits than for fathers’ benefits. Fourth, despite universal policy constructions, immigrants’ weaker attachment to the labour market affects their social rights, and the effect is greater for immigrant women.

Family Engagement Practices as Sites of Possibility: Supporting Immigrant Families through a District-University Partnership

In this article, we consider the ways in which family engagement practices foster sites of possibility for immigrant families in the public schools. As demographic change leads to a growing number of new immigrant destinations and amidst increasing hostility toward immigrant communities, educational institutions play an increasingly important role in supporting these students and their families. Drawing on a study of one school district’s partnership with a local university to identify and resolve engagement gaps between immigrant and nonimmigrant families, our article discusses asset-based approaches to family engagement practices. In addition to discussing district initiatives to engage immigrant families in 2-way communication and minimize barriers to participation, we also consider the role of university partners in building sites of possibility for immigrant youth and their families. We conclude with implications for expanded efforts to develop equitable family engagement practices in districts serving immigrant communities.

A Decade of Analysis: Household Food Insecurity Among Low-Income Immigrant Children

Our study advances literature on immigrant food insecurity by examining whether national-level differences in immigrant and nonimmigrant families’ risk of food insecurity persist across time and for different ethnic/racial groups. Using data from the Current Population Survey Food Security Supplement for low-income households with children aged 0 to 17 years, we examine trends (2003-2013) in immigrant and nonimmigrant food insecurity overall and for different ethnic/racial groups. We also assess how immigrant families are faring compared with their nonimmigrant peers in the wake of the Great Recession and its prolonged recovery period. We find that among low-income households with children, noncitizen immigrant households and their U.S.-born household counterparts experience similar levels of food insecurity, while citizen immigrant households demonstrate the lowest levels of food insecurity. Citizen immigrant households, however, appear to have been most affected by the Great Recession and the protective influences of citizenship status do not appear to extend to Hispanic immigrants.

Acculturation conflict among Latino youth: Discrimination, ethnic identity, and depressive symptoms.

Patterns of parent-adolescent conflict differ between immigrant and nonimmigrant families living in the United States (Fuligni, 1998). Despite this, there is limited empirical literature examining the nuanced nature of parent-adolescent conflict in immigrant families. To fill this gap, the current study examined the role of 2 types of conflict (i.e., general and acculturation) in predicting psychosocial outcomes (i.e., depressive symptoms and ethnic identity) among Latino adolescents, and whether these relationships differ within the context of peer discrimination. All survey administration was completed in the participating school's cafeteria. The sample consisted of 7th through 10th graders (n = 172) with a mean age of 14.01 years (SD = 1.32.) The sample consisted of 53% females, and was primarily Mexican in origin (78%). As hypothesized, parent-adolescent acculturation conflict uniquely predicted greater depressive symptoms and lower ethnic private regard, even when controlling for parent-adolescent general conflict. However, acculturation conflict predicted lower ethnic private regard only in the presence of greater peer discrimination. More specifically, peer discrimination moderated the relation between acculturation conflict and ethnic private regard such that adolescents who reported the highest levels of acculturation conflict and peer discrimination reported the lowest levels of ethnic private regard. These results suggest that for Latino youth and their families, acculturation conflict may be particularly problematic, as compared with general conflict. In addition, youth who face ethnicity-based stressors in both familial and school contexts are especially at risk in their ethnic identity development. (PsycINFO Database Record

Early Academic Achievement Among American Low-Income Black Students from Immigrant and Non-Immigrant Families.

At least half of the well-documented achievement gap for low-income Black children is already present in kindergarten, due in part to limited opportunities for acquiring foundational skills necessary for school success. There is some evidence that low-income minority children from immigrant families have more positive outcomes than their non-immigrant counterparts, although little is known about how the immigrant paradox may manifest in young children. This study examines foundational school readiness skills (academic and social-emotional learning) at entry into pre-kindergarten (pre-k) and achievement in kindergarten and second grade among Black children from low-income immigrant and non-immigrant families (N = 299). Immigrant and non-immigrant children entered pre-k with comparable readiness scores; in both groups, reading scores decreased significantly from kindergarten to second grade and math scores decreased significantly for non-immigrant children and marginally for immigrant children. Regardless of immigrant status, pre-k school readiness and pre-k classroom quality were associated with elementary school achievement. However, declines in achievement scores were not as steep for immigrant children and several predictive associations were moderated by immigrant status, such that among those with lower pre-k school readiness or in lower quality classrooms, immigrant children had higher achievement test scores than children from non-immigrant families. Findings suggest that immigrant status provides young Black students with some protection against individual- and classroom-level risk factors for early underachievement in elementary school.

142: Iron Status of Young Children of Immigrant Families in Toronto

Iron deficiency (ID) is the most common micronutrient deficiency in the world. Pre-school age children are a well-known high risk group for ID. Children from immigrant families may be at risk for ID due to a greater burden of acute and chronic infections, difficulty accessing health services, and cultural dietary practices. Conversely, such children may have family and community supports or exposure to selection and settlement policies when immigrating to Canada that improve their health status. To assess serum ferritin levels (a measure of iron stores) in young children from immigrant versus non-immigrant families; and to evaluate the relationship between immigrant status and ID and iron deficiency anemia (IDA) and whether known dietary, environmental, or biologic determinants of low iron status influence this relationship. This was a cross-sectional study of healthy urban children (12 to 72 months of age), recruited as part of TARGet Kids!, a primary care practice-based research network in Toronto, Canada. Laboratory assessment of serum ferritin and hemoglobin (Hgb) and standardized parent-completed surveys were completed between December 2008 and February 2013 during routine health maintenance visits. Multiple regression analyses were used to evaluate the association between immigrant status (Canadian born, immigrant from non-industrialized regions, immigrant from industrialized regions) and serum ferritin, ID (serum ferritin <14 μg/L), and IDA (serum ferritin <14 ug/L and Hgb ≤110 g/L). Of 2614 children included in the analysis (median age of 37 months) 48.5% were non-immigrants. Median serum ferritin was 30 ug/L and 10.4% of children had ID and 1.9% had IDA. After adjusting for ethnicity, age, sex, education, income quintile, cow's milk intake, breastfeeding duration and bottle use, there were no significant associations between immigrant status and ferritin, ID or IDA. Significant predictors of low iron status included age, sex, cow's milk intake, and breastfeeding duration. We found no association between family immigrant status and iron status including serum ferritin, ID, and IDA. The relationships did not change when clinically and biologically important covariates were included in the models. These data suggest that children of immigrant families may not need enhanced screening for iron status or targeted interventions for iron supplementation.

Parent–child relationships among older Chinese immigrants: the influence of co-residence, frequent contact, intergenerational support and sense of children's deference

ABSTRACTImmigration disrupts the bonding process in families. Maintaining close relationships with adult children can be an important protective factor for older immigrants' health and wellbeing. Quantitative research explaining such close relationships is rare. This study examined factors associated with close parent–child relationships in a purposive sample of 236 older Chinese immigrants in Los Angeles who provided information regarding 365 children. Two-level regression models were estimated to investigate factors contributing to cohesive parent–child relationships among these older adults. The findings showed that co-residence, a characteristic that distinguishes immigrant families from most non-immigrant families, was associated with lower parent–child relationship quality. Frequent contact was associated with closer relationships. While receiving instrumental and monetary support from children was associated with favourable ratings of relationships with children, providing such support to children was not related to parents' assessment of relationship quality. Parental perceptions of children being respectful was also associated with better relationship quality ratings. Overall, the findings demonstrate how family-related changes in the immigration context shape parent–child relationships in later life. Implications for future research and practice are provided.

Intergenerational cultural conflict, mental health, and educational outcomes among Asian and Latino/a Americans: Qualitative and meta-analytic review.

Among immigrant Asian and Latino groups, the contrast between collectivism in traditional heritage and individualism in the mainstream American cultures presents unique challenges for their family relationships. This systematic review was designed to answer 3 fundamental questions: to what extent do(es) (a) acculturation mismatch (AM) correlate with intergenerational cultural conflict (ICC); (b) ICC correlate with offspring's mental health and educational outcomes; and (c) demographic and study characteristics moderate these relationships. Sixty-one research reports were reviewed, with 68 independent study samples (N = 14,453; 41 and 27 Asian and Latino/a samples, respectively) subjected to 3 meta-analyses. AM positively correlated with ICC (r = .23), which in turn negatively correlated with offspring mental health (r = -.20) and educational outcomes (r = -.09). Findings provided support for acculturation gap-distress theory. While these effect size estimates were small, participant and methodological variables affected their magnitude. Contrary to findings on intergenerational conflict within mainstream non-immigrant families, the relationships among AM, ICC, and mental health were larger in young adult than adolescent groups within immigrant families. ICC significantly correlated with internalizing problems and adaptive functioning, but not externalizing problems. AM was more closely related to ICC among women and second-generation immigrant offspring. AM and ICC were more problematic among offspring who were low-risk and lived in less ethnically disperse regions, particularly when studied in cross-sectional studies. Effect sizes also differed significantly across measurement tools for the key constructs. Limitations to generalizability (few studies on educational outcomes, relative under-representation of Latino/a to Asian American samples), and implications for intervention and future research are discussed.

Coverage for low-income immigrant children increased 24.5 percent in states that expanded CHIPRA eligibility.

The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 provided states with the option of expanding eligibility for federally funded public insurance to low-income immigrant children within their first five years of legal residence in the United States. By 2011 twenty states and the District of Columbia had adopted that option. Using cross-sectional data from the 2003, 2007, and 2011-12 National Survey of Children's Health, we compared trends in coverage and access to care among immigrant children in states that did expand eligibility to children in states that did not. Compared to immigrant children in states that did not expand eligibility, children in states expanding eligibility experienced a 24.5 percent increase in insurance coverage, largely due to greater enrollment in public insurance. Immigrant children in states that expanded eligibility also experienced significant reductions in unmet health care needs, compared to their counterparts in nonexpansion states. Disparities relative to children in nonimmigrant families were substantially reduced in states that expanded eligibility, compared to states that did not. Expanding eligibility for federally funded public insurance to immigrant children within their first five years of legal residence in other states could improve coverage for immigrant children and might also increase access to care.

Diverse pathways to care for children with stomach pain in a Canadian cosmopolitan city

In Montreal, Quebec, 31% of the population is born outside Canada. Yet, only 9% of patient consultations for symptoms associated with functional gastrointestinal disorders (FGIDs) are from immigrants at the Paediatric Gastroenterology Clinic at Sainte-Justine's University Hospital Centre. This discrepancy inspired a multidisciplinary exploratory study (anthropological and paediatric) to examine the sociological, interpretative and pragmatic aspects of immigrant and non-immigrant patients and family life with FGIDs. This paper examines the discrepancy between immigrant and non-immigrant paediatric patients with FGIDs and presents the different pathways to care utilised by families. Semi-structured interviews were carried out between November 2008 and June 2009, with children and their parents. In total, 38 families were recruited: with 27 families (including a child experiencing abdominal pain, his/her siblings, mother and/or father as well as any other significant individual living in the family home) from the community and 11 from the paediatric gastroenterology clinic. A comparative analysis between the immigrant and non-immigrant groups focused on perceptions, meanings and actions taken to relieve/alleviate symptoms. Immigrant and non-immigrant families alternate and combine different therapeutic environments: home, alternative healing therapies and medical paths to care. Our analysis suggests that culture (as a set of values, beliefs and ways of being), as well as social interactions within family life and the clinic, shape pathways to care. The analysis highlights the centrality of receptiveness--and more widely the social dimensions--of all medical encounters. Treatment disparities between immigrant and non-immigrant families in pathways to care help us to understand these patients' social world and the intricate relationships between values and social milieux, between culture, practices of symptom management and rationales guiding diverse therapeutic actions.

Ethnic Identity Formation and Change in Canada: An Introduction

Ethnic Identity Formation and Change in Canada:An Introduction Chedly Belkhodja, Special Guest Editor (bio) This special issue of Canadian Ethnic Studies illustrates the wide range of research related to immigration, ethnicity and diversity in Canada. This issue contains a selection of the papers that were presented at the 3rd Joint Annual Conference of the Ethnic Studies Association in Niagara Falls, November 23-24, 2012. Under the title Ethnic Identity Formation and Change in Canada and Abroad, the conference was an opportunity to hear more than 50 presentations and exchange views and ideas. As guest editor, I hope the reader will be interested in this issue which explores the intersections of diversity and ethnicity in academic disciplines, such as education, sociology, social work, urban studies, and public policy, and contains valuable research related to ethnic and religious communities, francophone minorities, and ethnic diversity in large and medium-sized cities. One common thread in the papers is the influence that liberalism as an ideology and dominant discourse now has on policy formulation, and its impact on the recognition of ethnic and linguistic identities and minorities. But most of the articles also develop another perspective to diversity and ethnicity research. Beyond celebrating the virtues of multiculturalism, they see a need to understand the importance of ongoing change to the ethnic composition of the Canadian population. By focusing on the mobility of immigrants and the mobilization of ethnic communities, the contributions in this issue take a different direction that extends diversity beyond public discourse and perceptions. Growing ethnic diversity in Canada’s largest cities is an evidence of this perspective, and the following two articles present us with case studies in Montreal and Toronto. In the first article, Sandrine Jean and Annick Germain analyze the mobility of immigrant and non-immigrant families in two Montreal neighborhoods: Ahuntsic on the island of Montreal, and Vimont in the suburbs. In the present debate on Quebec’s Charter of Values, this article illustrates the value of research on urban environment transformation and sets our attention on the daily lives of immigrant families. The key findings of this research are the changing dynamics of diversity in urban settings, the impact of migration, and the mobility of immigrants and non-immigrants to new neighborhoods. According to the authors, immigrants are transforming public spaces, such as parks, libraries, and sports facilities. They are also transforming the ethnic composition of neighbourhoods and introducing new social cleavages. [End Page 1] In the second article, Arshia U. Zaidi, Amanda Couture, Eleanor Maticka-Tyndale and Mehek Arif continue the discussion with a qualitative analysis of experiences of second-generation South Asian youth cross-gender relationships in the Greater Toronto Area (GTA). In a multicultural country, young immigrants are experiencing diverse relations within their families and ethnic communities, and with the host society. The study presents the situation of a fast-growing immigrant population in a very large city. The authors’ focus is that of the various intersections of religion, gender, and ethnic identification of fifty-six unmarried, second-generation South Asians. The next two papers can be seen as case studies addressing more specific elements in the field of education. Anne-Marie Dionne’s paper is an interesting analysis of the place of diversity in children’s literature. She covers a vast corpus of French children’s multicultural literature and focuses on the notion of intercultural openness in the francophone education system. It seems that ideology plays a role in limiting the production of diversity in children’s books and the accessibility of migrant literature in the society. Dionne’s conclusion underlines the importance of more research to understand the importance of children’s literature in the fabric of a multicultural society. Robin Liu Hopson’s article examines equity policies and practices in the context of postsecondary admissions. She looks at the stories of racialized teachers acting as role models for minority students in an environment still characterized by a largely white majority. With growing numbers of students from visible minorities, the case of faculties of education in Ontario is similar to that of the rest of the country. Equity policies should not be limited to branding and a positive message of cultural...

Uncertainty, culture and pathways to care in paediatric functional gastrointestinal disorders

This paper examines how children and families of diverse ethnic backgrounds perceive, understand and treat symptoms related to functional gastrointestinal disorders (FGIDs). It is questioned how different ways of dealing with medical uncertainty (symptoms, diagnosis) may influence treatment pathways. Semi-structured interviews were conducted with 43 children of 38 family groups of immigrant and non-immigrant backgrounds. The analysis takes into account (a) the perceived symptoms; (b) the meaning attributed to them; and (c) the actions taken to relieve them. The social and cultural contexts that permeate these symptoms, meanings and actions were also examined. It is found that, in light of diagnostic and therapeutic uncertainty, non-immigrant families are more likely to consult health professionals. Immigrant families more readily rely upon home remedies, family support and, for some, religious beliefs to temper the uncertainty linked to abdominal pain. Furthermore, non-immigrant children lead a greater quest for legitimacy of their pain at home while most immigrant families place stomach aches in the range of normality. Intracultural variations nuance these findings, as well as family dynamics. It is concluded that different courses of action and family dynamics reveal that uncertainty is dealt with in multiple ways. Family support, the network, and trust in a child's expression of distress are key elements in order to tolerate uncertainty. Lastly, the medical encounter is described as a space permeated with relational uncertainty given the different registers of expression inherent within a cosmopolitan milieu. Narrative practices being an essential dynamic of this encounter, it is questioned whether families’ voices are equally heard in these clinical spaces.

The Big Difference a Small Island Can Make: How Jamaican Adolescents Are Advancing Acculturation Science

AbstractNew research with Jamaican adolescents has brought acculturation science into closer accord with two 21st‐century cultural realities: (a) multicultural destination societies for immigrant families and (b) intercultural contact among nonimmigrant families via modern globalization mechanisms. In this article, I review two theoretical expansions to the traditional conceptualization of acculturation (i.e., tridimensional acculturation and remote acculturation) along with supporting empirical evidence among Jamaican adolescents in the United States and on the Caribbean island. First, bidimensional acculturation lenses are exchanged for tridimensional ones to capture the acculturation of immigrant youth for whom three cultural dimensions are relevant. Second, acculturation pathways are expanded to include modern indirect and/or intermittent intercultural contact for nonimmigrant youth. Tridimensional and remote acculturation may be modern mechanisms by which today's and tomorrow's adolescents produce their own development. These advances reveal new avenues to investigate adolescent acculturation and adaptation in their increasingly complex cultural neighborhoods.

Barriers and facilitators to health and social service access and utilization for immigrant parents raising a child with a physical disability

Purpose – The purpose of this paper is to examine the barriers and facilitators to health and social service access and utilization for immigrant parents raising a child with a physical disability, in order to understand their specific needs and experiences of care. Design/methodology/approach – The research involves qualitative interviews with five immigrant parents of four children with a physical disability in two cities in Ontario, Canada. Findings – The findings indicate that divergent perceptions of health care and disability, language, knowledge of service systems, and finances may create obstacles to family-centered and culturally sensitive care. Formal supports, including a third person to navigate the system and services provided in families’ homes, are facilitators that enhance the service care experiences of parents. Practical implications – Service providers need to accommodate and work with immigrant parents who have a child with a disability to overcome the barriers to their care. To enhance service experiences formal support and home services should be provided when possible. Originality/value – There is little research on immigrant families’ experiences with pediatric rehabilitation services and this study contributes to this area. This paper shows that immigrant families of children with disabilities have barriers to service access, utilization, and service care experiences that are similar to those of non-immigrant families. There are few studies on facilitators to service access and utilization and positive experiences; therefore, this study makes a contribution to this area.

At the Interface of Ethnicity and Recent Immigration: Family Functioning of Chinese with School-Age Children in Canada

This study examined the family functioning of recent Chinese immigrants living in Canada in terms of its status and those socio-ecological factors that influence it. Recent immigration has resulted in an increasingly large number of residents in Canada and the US who represent both an immigrant and an ethnic minority status. Among such residents are Chinese immigrants. Because of the potentially large number of school-age children who are part of these families, the family functioning of the new Chinese immigrants with school-age children would be important for the children’s development. This study therefore compared 112 Chinese families who recently immigrated to Canada with 90 Caucasian non-immigrant families. Scales were administered to the families to measure various aspects of family functioning. The results showed that the Chinese immigrants experienced a lower degree of family cohesion. Their socio-ecological factors were both similar and different from the non-immigrants, with a lower degree of social support and certain differences in child-rearing practices than the non-immigrants. Social support and child-rearing practices were differentially related to different dimensions of family functioning. However, these relationships were not entirely unique to the immigrants. The results have increased our understanding of immigrants and may contribute to the provision of effective support for immigrants. Implications are suggested for community support for immigrants and for further research.

Autism Spectrum Disorders and Developmental Disabilities in Children From Immigrant Families in the United States

Recent census data show that nearly one-quarter of US children have at least 1 immigrant parent; moreover, there has been a dramatic increase in children diagnosed with autism spectrum disorders (ASDs) and select developmental disabilities (DDs). However, little is known about access to medical home and adequacy of insurance coverage for children with ASDs and select DDs from immigrant families. By using the 2007 National Survey of Children's Health, we compared children with ASDs and select DDs from immigrant (n = 413, foreign born or reside with at least 1 immigrant parent) and nonimmigrant (n = 5411) families on various measures of medical home and insurance coverage. We used weighted logistic regression to examine the association between immigrant family and selected outcome measures while controlling for confounding factors. Compared with nonimmigrant families, children with ASD and select DD from immigrant families were more than twice as likely to lack usual source of care and report physicians not spending enough time with family. Furthermore, multivariable analyses indicate that insurance coverage is an important factor in mitigating health care barriers for immigrant families. The study demonstrates important areas of deficits in the health care experiences of children with ASD and select DD from immigrant households. Public policy implications include increasing access to existing insurance programs, augmenting public awareness resources for ASD and select DD, and offering assistance to immigrant families that are struggling with the medical needs of their children.

Which States Enroll Their Medicaid‐ Eligible, Citizen Children with Immigrant Parents?

To identify which states achieve comparable enrollment rates for Medicaid-eligible, citizen children with immigrant and nonimmigrant parents. A total of 810,345 Medicaid-eligible, citizen children drawn from the 2008-2010 American Community Survey. This study estimates a state fixed-effects probit model of uninsured status for Medicaid-eligible, citizen children. State and immigrant family interaction variables test whether citizen children in immigrant families have a higher probability of remaining uninsured compared to children in nonimmigrant families. Simulations predict the uninsured rates for Medicaid eligible children in immigrant and nonimmigrant families and rank states by the differences between the two groups. While some states have insignificant and near zero differences in predicted uninsured rates, many states have enrollment disparities reaching 20 percent points between citizen children with immigrant and nonimmigrant parents. Many states have large differences in enrollment rates between their Medicaid-eligible, citizen children with immigrant and nonimmigrant parents. Addressing these enrollment disparities could improve the health status of citizen children in immigrant families and earn Children's Health Insurance Program Reauthorization Act bonus payments for many states.