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APHA Scientific Session and Event Listing

Recorded presentation

Joyce R. Javier, MD, MPH¹, Paul H. Wise, MD, MPH², and Fernando S. Mendoza, MD, MPH¹. (1) Division of General Pediatrics, Stanford University School of Medicine, 750 Welch Road Suite 325, Stanford, CA 94305-6019, 650-725-0551, jjavier_joo@yahoo.com, (2) Division of General Pediatrics, Center for Health Policy/Primary Care and Outcomes Research, Stanford University School of Medicine, 117 Encina Commons, Stanford, CA 94305-6019

Background: Compared with children of U.S.-born parents, children of immigrants have generally better health outcomes. However, it is unclear whether this “immigrant paradox” applies to children with chronic conditions. Objectives: To compare patterns of health care access, health care utilization, and functional impact for children with asthma in immigrant families and children with asthma of U.S.-born parents. Methods: This cross-sectional study used data from the 2001/2003 California Health Interview Survey to examine the relationship between immigrant status and health care access, utilization, and outcomes in a sample of 2600 children (ages 1-11) with asthma. Results: Compared to asthmatic children of U.S.-born parents, asthmatic children of immigrants are more likely to be uninsured, lack a usual source of care, report a delay in medical care, report no visit to the doctor in the past year, and report no emergency room visit for asthma in the past year. They are less likely to report asthma symptoms in the past year, yet more likely to report fair or poor perceived health status. Multivariate analyses indicate that poverty status, non-English interview language, and lack of insurance were independent risk factors. Conclusions: Immigrant children with asthma experienced reduced access and utilization relative to their non-immigrant counterparts, in part related to poverty, language, and insurance status. The association of these findings with health outcomes was complex and may reflect differences in symptom awareness. Caution should be used in generalizing the health of immigrant children, particularly as health policies directed at immigrant families undergo continued scrutiny.

Learning Objectives:

• Describe three barriers to health care access and health care utilization for immigrant children with asthma.
• Recognize the need to consider special populations, such as children with chronic conditions when developing policies directed at immigrant families.

Keywords: Immigrants, Asthma

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation