Department of Pediatrics, Boston University School of Medicine (MN Tang), Boston, Mass.
Department of Pediatrics, Boston University School of Medicine, Children's HealthWatch (S Ettinger de Cuba, M Sandel), Boston, Mass.
Acad Pediatr. 2020 Mar;20(2):225-233. doi: 10.1016/j.acap.2019.09.005. Epub 2019 Sep 18.
Among US-born children of Latina US (USB) and Latina foreign-born mothers (FBM), to determine whether 1) household and child characteristics differ; 2) child health outcomes differ; 3) these differences diminish for children of FBM with longer duration of residence in the United States; and 4) these differences can be explained by food insecurity (FI) or by Supplemental Nutrition Assistance Program (SNAP) participation.
Cross-sectional survey of 2145 Latina mothers of publicly insured US-born children 0 to 48 months old in a Boston emergency department (ED) 2004 to 2013. Predictors were FBM versus USBM and duration of residence in the United States. Outcomes were mothers' report of child health, history of hospitalization, developmental risk, and hospital admission on the day of ED visit. Multivariable logistic regression adjusted for potential confounders and effect modification.
FBM versus USBM households had more household (31% vs 26%) and child (19% vs 11%) FI and lower SNAP participation (44% vs 67%). Children of FBM versus USBM were more likely to be reported in fair/poor versus good/excellent health (adjusted odds ratios 1.9, 95% confidence interval [1.4, 2.6]), with highest odds for children of FBM with shortest duration of residence, and to be admitted to the hospital on the day of the ED visit (adjusted odds ratios 1.7, 95% confidence interval [1.3, 2.2]). SNAP and FI did not fully explain these outcomes.
When providing care and creating public policies, clinicians and policymakers should consider higher rates of food insecurity, lower SNAP participation, and risk for poor health outcomes in Latinx children of FBM.
在美国出生的拉丁裔美国儿童(USB)和拉丁裔外国出生的母亲(FBM)中,确定以下内容:1)家庭和儿童特征是否存在差异;2)儿童健康结果是否存在差异;3)这些差异是否会随着 FBM 在美国居住时间的延长而缩小;4)这些差异是否可以用食品不安全(FI)或补充营养援助计划(SNAP)的参与来解释。
2004 年至 2013 年,在波士顿急诊部对 2145 名有公共保险的美国出生的 0 至 48 个月大的拉丁裔母亲进行了横断面调查。预测因子为 FBM 与 USBM 以及在美国居住的时间长短。结果为母亲报告的儿童健康状况、住院史、发育风险以及在 ED 就诊当天的住院情况。多变量逻辑回归调整了潜在的混杂因素和效应修饰。
与 USBM 家庭相比,FBM 家庭的家庭(31%比 26%)和儿童(19%比 11%)FI 更高,SNAP 参与率(44%比 67%)更低。与 USBM 相比,FBM 的儿童更有可能报告健康状况为一般/较差(调整后的优势比为 1.9,95%置信区间[1.4,2.6]),其中居住时间最短的 FBM 儿童的优势比最高,并且在 ED 就诊当天住院的可能性更高(调整后的优势比为 1.7,95%置信区间[1.3,2.2])。SNAP 和 FI 并不能完全解释这些结果。
在提供护理和制定公共政策时,临床医生和政策制定者应考虑到 FBM 的拉丁裔儿童的更高食品不安全率、更低的 SNAP 参与率和较差健康结果的风险。