Journal of Immigrant and Minority Health

, Volume 15, Issue 3, pp 453–461 | Cite as

The Association Between Acculturation and Health Insurance Coverage for Immigrant Children from Socioeconomically Disadvantaged Regions of Origin

  • Daphne C. Hernandez
  • Rachel Tolbert Kimbro
Original Paper


Among immigrant children whose parents have historically had lower education, the study explored which immigrant children were most likely to have coverage based on maternal region of origin. The direct and indirect relationship of acculturation on immigrant children’s coverage was also assessed. A subsample of US-born children with foreign-born mothers from the Early Childhood Longitudinal Survey-Kindergarten Cohort was analyzed using multinomial logistic regressions (n = 1,686). Children whose mothers emigrated from the Caribbean or Indochina had greater odds of being insured compared to children whose mothers emigrated from Mexico. Moreover, Latin American children did not statistically differ from Mexican children in being uninsured. Maternal citizenship was positively associated with children’s coverage; while living in a household with a mother who migrated as a child was negatively associated with private insurance. To increase immigrant children’s coverage, Latin American and Mexican families may benefit from additional financial assistance, rather than cultural assistance.


Immigrant children Coverage Health insurance Acculturation Low-income children 



Funding for this project was support by a grant from the Robert Wood Johnson Foundation New Connections program and a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12 HD055882) to the first author. In addition, funding for this project was support by a Young Scholar award from the Foundation for Child Development to the second author.


  1. 1.
    Capps R, et al. The health and well-being of young children and immigrants. Washington, DC: Urban Institute; 2004. p. 1–42.Google Scholar
  2. 2.
    Lynch V, et al. Uninsured children: who are they and where do they live?. Washington DC: Urban Institute; 2010.Google Scholar
  3. 3.
    Guendelman S, Schauffler HH, Pearl M. Unfriendly shores: how immigrant children fare in the US health system. Health Aff. 2001;20(1):257–66.CrossRefGoogle Scholar
  4. 4.
    Lessard G, Ku L. Gaps in coverage for children in immigrant families. Future Child. 2003;13(1):101–15.PubMedCrossRefGoogle Scholar
  5. 5.
    Kaiser Commission on Medicaid and the Uninsured. The role of employer-sponsored health coverage for immigrants: a primer. Washington DC: Kaiser Commission; 2006.Google Scholar
  6. 6.
    Mohanty SA, et al. Health care expenditures of immigrants in the United States: a nationally representative analysis. Am J Public Health. 2005;95(8):1431–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Hernandez DJ. Demographic change and the life circumstances of immigrant families. Future Child. 2004;14(2):17–49.CrossRefGoogle Scholar
  8. 8.
    Hernandez DJ, Charney E. From generation to generation: the health and well-being of children in immigrant families. Washington DC: National Academy Press; 1998.Google Scholar
  9. 9.
    Lara M, et al. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367–97.PubMedCrossRefGoogle Scholar
  10. 10.
    Institute for Health Policy Studies. Barriers to enrollment in healthy families and medi-cal: findings from focus groups of Chinese, Korean, and Vietnamese parents. San Francisco: University of California, San Francisco; 2000.Google Scholar
  11. 11.
    Perry M, et al. Medicaid and children: overcoming barriers to enrollment: findings from a national survey. Kaiser: Commission on Medicaid and the Uninsured, Washington DC; 2000.Google Scholar
  12. 12.
    Fremstad, S.: The INS public charge guidance: What does it mean for immigrants who need public assistance. 2000 [cited 2010 March 26]; Available from:
  13. 13.
    National Immigration Law Center: Questions and answers about “Public Charge”. 1999 [cited 2010 March 26]; Available from:
  14. 14.
    Akresh IR, Frank R. Health selection among new immigrants. Am J Public Health. 2008;98(11):2058–64.PubMedCrossRefGoogle Scholar
  15. 15.
    Oza-Frank R, Stephenson R, Venkat Narayan KM. Diabetes prevalence by length of residence among US immigrants. J Immigr Minor Health. 2011;13:1–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Graham JW. Missing data analysis: making it work in the real world. Annu Rev Psychol. 2009;60:549–76.PubMedCrossRefGoogle Scholar
  17. 17.
    Graham JW, Schafer JL. On the performance of multiple imputation for multivariate data with small sample size. In: Hoyle RH, editor. Statistical strategies for small sample research. Thousand Oaks, CA: Sage; 1999. p. 1–27.Google Scholar
  18. 18.
    Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–82.PubMedCrossRefGoogle Scholar
  19. 19.
    Sobel ME, Leinhardt S. Asymptotic confidence intervals for indirect effects in structural equation models. Sociol Methodol. 1982;13:290–312.CrossRefGoogle Scholar
  20. 20.
    Newacheck PW, et al. Health insurance and access to primary care for children. N Engl J Med. 1998;338(8):513–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Brown ER, Yu H. Latinos’ access to employment-based health insurance. In: Suarez-Orozco MM, Paez MM, editors. Latinos: remaking America. Berkeley: University of California Press; 2002. p. 236–53.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Health and Human PerformanceUniversity of HoustonHoustonUSA
  2. 2.Department of SociologyRice UniversityHoustonUSA

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