Childhood Migration and Well-being: A Framework for Understanding the Opportunities and Challenges

Krista M. Perreira, PhD

Presented at the 17th Annual Summer Public Health Research Videoconference on Minority Health, June 7, 2011, www.minority.unc.edu/institute/2011/

71 Million Children in 2009: 24% Had An Immigrant Parent

0

5

10

15

20

25

30

35

40Percent of Children with an Immigrant ParentPercent Foreign-Born of Total Population

Source: Calculations by Passel (2010) from Decennial censuses for 1850-2000, Current Population Surveys (CPS), and ACS data.

States with the Fastest Growing Immigrant Populations: 2000-2005

45%43%

41% 41%

32%

39%

48%

39%

32%34%

SC (1) NH (2) TN (3) AR (4) DE (5) AL (6) GA (7) NE (8) KY (9) NC (10)

Percent Growth in Foreign-Born Population, 2000-2005

Source: US Census, 2000 & American Community Survey, 2005

US Avg.16%

Children of Immigrants Settling across the US (Avg. 23%)

Source: Author’s Tabulations 2006-08 American Community Survey

Percent Children of Immigrants

Challenges in Emerging Latino and Immigrant Settlement States

• Limited data specific to immigrant and Latino populations

• High concentration of limited English proficiency children and adults

• Low availability of providers with specialized cultural competence

• Diversity among immigrants and especially Latinos

Critical Education Concerns for Latino Children of Immigrants

• School Readiness• High School Dropout Rates• College Enrollment/Completion Rates

Kindergarten School Readiness, Reading

0%

20%

40%

60%

80%

Letter Recognition Sound Recognition Word Recognition

3rd+ Generation White 3rd+ Generation Mexican American2nd Generation Mexican American 1st Generation Mexican American

Source: Reardon, SF & Galindo, C. (2006), Patterns of Hispanic Students’ Mathematics and English Literacy Test Scores. Report to the National Task Force on Early Childhood Education for Hispanics. Tempe, AZ: Arizona State University.

Kindergarten School Readiness, Math

0%

20%

40%

60%

80%

100%

Identifying Numbersand Shapes

UnderstandingOrdinality

Solving Addition andSubtraction

3rd+ Generation White 3rd+ Generation Mexican American2nd Generation Mexican American 1st Generation Mexican American

Source: Reardon, SF & Galindo, C. (2006), Patterns of Hispanic Students’ Mathematics and English Literacy Test Scores. Report to the National Task Force on Early Childhood Education for Hispanics. Tempe, AZ: Arizona State University.

High School Drop Out Rates

0%

5%

10%

15%

20%

25%

% 1

8-26

yea

r old

s (w

eigh

ted)

Hispanic Asian Black White

1st generation 2nd generation 3rd+ generation

Source: Perreira, Mullan-Harris, & Lee (2006), Making It in America: High School Completion among Immigrant Youth. Demography 43(3): 511-536.

% of Population with a Bachelors Degree

0%10%20%

30%40%

50%60%

70%

% 2

5-34

yea

r old

s (w

eigh

ted)

Hispanic Asian Black White

1st generation* 2nd generation 3rd+ generation

Source: Baum, S. & Flores, S. (2011), Higher Education and Children in Immigrant Families, Future of Children 21(1): 171-193. Based on CPS, March Supplement, 2009

* Includes adults who never attend school in US

Critical Health Concerns for Latino Children of Immigrants

• Declining Health of Immigrants with Time in the US

• Mental Health and Substance Use• Overweight/Obesity and related conditions

(e.g., Diabetes)• Asthma• Access to Health Care

The Latino Experience: Parent/Caregiver Mental Health

27%22%

14%

0%5%

10%15%20%25%30%35%40%45%50%

At Risk for Depression(PHQ-9)

Experienced Trauma Serious Symptoms ofDepression

Foreign-Born Latina Mothers (NC LAMHA Study 2004-05, N=275)

The Latino Experience: Adolescent Mental Health (ages 12-18)

0%

5%

10%

15%

20%

25%

1stgeneration

2ndgeneration

3rd+generation

1stgeneration

2ndgeneration

3rd+generation

Depressive Symptoms Suicidal Ideation

Source: Add Health Sample, 1993-94

The Latino Experience: Substance Use

0%5%

10%15%20%25%30%35%

ProblematicAlcohol Use

RepeatedMarijuana Use

1st generation2nd generation3rd+ generation

Source: Hispanic Add Health Sample, 1993-94 (ages 12-18)

The Immigrant Experience: Obesity

19%

22%

27%

17%

15%

24%

9%11%

12%15%

18%

0%

5%

10%

15%

20%

25%

30%

% C

hild

ren

ages

10-

17

Obesity

Hispanic 1st GenerationHispanic 2nd GenerationHispanic 3rd GenerationBlack 1st GenerationBlack 2nd GenerationBlack 3rd GenerationWhite 1st generationWhite 2nd GenerationWhite 3rd GenerationAsian 1st GenerationAsian 2nd GenerationAsian 3rd Generation

Source: NSCH 2003, Singh (2009)

The Latino Experience: Childhood Asthma

8.8

15.7

6.8

19.2

3.6

0

5

10

15

20

Prev

alen

ce A

ges 3

-17

Currently Has Asthma

Non-Hispanic WhiteNon-Hispanic BlackHispanic-AllHispanic-Puerto RicanAsian

Source: NHIS 2008

The Latino Experience: Access to Health Care

6.77.5

17.2 18.2

6.34.5 4.8 6.2 6

1.4

0

5

10

15

20

% C

hild

ren

unde

r 18

Uninsured forHealth Care

Delayed CareDue to Cost

Non-Hispanic WhiteNon-Hispanic BlackHispanicMexican BackgroundAsian (data imprecise)

Source: NHIS 2008

The Immigrant Experience: Access to Health Care

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private InsuranceCoverage

Medicaid/ PublicInsurance

Uninsured

Adult US Citizen NonCitizen (> 5 yrs) NonCitizen (<= 5 yrs)Child US Citizen NonCitizen (>= 5 yrs) NonCitizen (< 5 yrs) Source: KFF 2009

Migration and Acculturation Process

Stages Pre-Migration

Migration Post-Migration

Threats and Challenges

- Poverty- Family Separation- Political Violence

- Physical Trauma- Emotional Trauma- Accidental Injury

- Family Conflict- Discrimination- Social Isolation - Legal Marginalization- N’hood. Disorganization

Strengths and Resiliencies

- Coping Skills- Remittances - Family Support- Community Ties

- Future Orientation- Good Health- Family Involvem’t.- Rite of Passage

- Adaptive Skills - Ethnic Identification- Economic Gains- Family Reunification- Ethnic Enclaves

Policy Trade & Econ. Dev’p. Policies

Immigration Policies

Immigrant Policies

Pre-Migration Poverty and Family Separation

Poverty • “ [In Mexico], there isn’t much money and you have a limit on things.

Clothing is bought once a year; sometimes there’s nothing more to eat than beans. Many people don’t have anything to eat and people [live] on the streets.” {adolescent, LAMHA}

Family Separation• “….When my husband would come visit us every 3 or 4 months, and he

would leave, [my daughters] would cry. They would tell him, ‘I will go with you Daddy. I will go with you.’ And so when my family would make comments that I could not come here, that I would never have a complete home like my father’s other daughters, that is what drove me to say, ‘I am going.’ And I decided to come.” {parent, LAMHA PILOT}

Migration Trauma

Trauma • “ [I traveled] on a bus for two days sitting down and not

stopping except at every gas station to buy whatever and go to the bathroom and from there arrive at the border and this…waiting a night, and walking, many hours walking through the desert. The water ran out, the food too and the sun was so strong. Lots of people fainted, lots of people die there and later you have to be hiding so the migra doesn’t catch you and all that…and the animals-scorpions, cobras-and sleeping on the ground, with nothing, you get cold, you get so hot, hungry, thirsty. {adolescent, LAMHA}

Post-Migration Acculturative Stress

Social Isolation• In Mexico, I knew all the families of my son’s friends. I knew the

mothers, the fathers, and even some of the grandparents. I had visited their homes and they, ours. Here, it’s different. I don’t know the families of his friends.” {Parent, LAMHA Pilot}

Perceived Discrimination and Racism• In school I always had problems because the Americans called me

“wetback” and “beaner” “Mexican, go back to Mexico, we don’t want you here.” And so, I answered back and I was the only one that got in trouble, not the American. And I was always stuck in the intervention center, In School Suspension, or detention. {Adolescent, LAMHA study)

Strength and Resilience

Family Reunification• “I moved here ‘cause I wanted to see my parents [and] ‘cause it had

been a long time since I hadn’t seen them…. I had even forgot their faces; I couldn’t even recognize them.” {adolescent, LAMHA}

Adaptive Skills• “At first I didn’t want to go because of the change. Sometimes a

person is afraid because it’s another country, it’s another culture, other people. And sometimes it’s as if you fear that. But really, it’s like the saying goes, ‘No one becomes a prophet in their own land.’ So at times one has to search for other places and that’s what I’ve found in this country, a great opportunity. {adolescent, LAMHA}

Strength and Resilience

Ethnic Identification and Selective Acculturation• “It’s hard because the things that our parents taught us, they’re not the

same as what our teachers or the things that are outside [the family] teach us right now. So, we have to kind of live with it; we have to change but keep what our parents taught us in some way.” {adolescent, LAMHA}

Future Orientation • “Even for an illegal [immigrant], I think if you put effort into learning the

language [and] doin’ good in school it’ll be way easier for to to be able to find a job. And then, if there is an opportunity for you to get legalized you will have the rest behind you. I’m not a legal immigrant. I don’t have a visa. I don’t have nothin’ And in school I graduated taking AP calculus…I took a college-level course… My GPA was like 3.97.” “If there’s ever a change [in the law] for me to go to college, I’ll have that behind me.”{adolescent, LAMHA}

Thank you