Impact of Acculturation, Social Status, and Obesity-Related Risk Factors on Behavioral Problems among Children of Immigrant and US-born Parents

This study examined the impact of acculturation, obesity, physical activity, sedentary activities, sleep behavior, and other sociodemographic factors on the prevalence of behavioral problems among 67,404 children of immigrant and US-born parents. Data from the 2003 National Survey of Children's Health were used to calculate a factor analytic index and a dichotomous measure of behavioral problems in children aged 6-17 years. The continuous and binary outcome measures were derived from 11 items that asked parents to rate their children on a set of negative behaviors, including arguing, bullying, disrespect, not getting along with others, disobedience, irritability, lacking empathy and conflict resolution strategies, and feelings of worthlessness, depression, and detachment. Least squares regression showed significantly lower levels of behavioral problems among immigrant children than native children. However, immigrant children's risks and levels of behavioral problems increased with increasing acculturation levels as measured by children's generational status and English language use. Compared with immigrant Hispanic children, the adjusted odds of serious behavioral problems, estimated by logistic regression, were 85% and 89% higher for immigrant and native White children respectively and 68% higher for native Black children. The adjusted prevalence ranged from 7% for immigrant Hispanic children to 13% for immigrant Black and native white children. Obesity, physical inactivity, TV viewing, recreational computer use, sleeplessness, geographic mobility, social participation, social support, socioeconomic position, and neighborhood safety were all significant predictors of childhood behavioral problems. Health promotion strategies aimed at modifying obesity-related behaviors may lead to improved behavioral/emotional health in immigrant and native children.