Latino children living in states with systemic inequities have increased odds of physical and mental health issues, according to a new study.
“This study underscores the importance of addressing the health impacts of state laws as well as the effects of public attitudes that perpetuate racist and/or antiimmigrant sentiments, all of which influence access to opportunities and resources that promote healthy development,” authors wrote in “State-Level Anti-Immigrant Sentiment and Policies and Health Risks in US Latino Children,” (Slopen N, et al. Pediatrics. Aug. 15, 2023).
Researchers analyzed nationally representative data on 17,855 Latino children ages 3-17 years, including those born in and outside the U.S. About 30% lived below the federal poverty level and just over half were from an immigrant family.
Caregivers who were surveyed provided information on children’s recent health issues as well as specific provider-diagnosed chronic physical conditions and mental health conditions. The chronic physical conditions in the survey were allergies, asthma, blood disorders, diabetes, heart condition and arthritis. The mental health conditions were depression, anxiety, behavioral/conduct problems and attention-deficit/hyperactivity disorder.
Researchers scored states’ discrimination level using a system that took into account policies toward immigrants related to health services, employment, business licensing, immigration policy enforcement, discrimination prohibition and access to rental housing, driver’s licenses and higher education, among other factors. Prejudicial attitudes toward immigrants and Latinos also were measured using data from the American National Election Study.
Systemic inequities were significantly associated with 1.13 times the odds of having a chronic physical health condition and 1.24 times the odds of having multiple mental health conditions, according to models adjusted for demographic characteristics and individual discrimination.
“Of note, although the observed associations are small in magnitude, research reveals that small effects can be meaningful when scaled across populations, as is the case in our measure of structural inequalities,” authors wrote.
There was no link with past-year health difficulties like trouble eating or digesting food, chronic physical pain and dental issues.
The study was limited by including a limited number of health conditions and requiring a diagnosis for many of them while some of the children may have difficulty accessing health care. In addition, surveyors may not have reached some of the most at-risk families.
Authors called for pediatricians to educate their communities about systemic racism and advocate for changes, as recommended in the AAP policy The Impact of Racism on Child and Adolescent Health.
The author of a related commentary wrote, “At the societal level, this study provides further evidence that immigrant policy is health policy.”
She advocated for funding of early education, K-12 education for dual language learners, social support services for children in immigrant families, resources in multiple languages, and improved access to housing and higher education. She also echoed the call for pediatricians to act.
“We can influence the sense of belonging and inclusion of our patients by incorporating trauma- and culturally informed care that will build on the strengths and address the needs of our patients and their families who have immigration experience,” she wrote.