Disparities in Quality of Healthcare of Children from Immigrant Families in the US
The objective of this study was to examine disparities in quality of pediatric primary care among children from immigrant families in the US. Drawing from a nationally representative sample of 83,528 children ages 0–17 years from the 2007 National Survey of Children’s Health, weighted logistic regression was used to assess the effect of immigrant family type on five indicators of quality of healthcare across children’s racial/ethnic groups. Analyses controlled for indicators of child’s access to care, family socio-economic characteristics, and primary language spoken in the household. Unadjusted estimates revealed a pattern of decreasing disparities from immigrant children to second-generation children, native-born children of immigrant parents, and to third-generation children, native-born children of native-born parents. Controlling for confounders showed that the positive effect of generational status on the quality of healthcare of children from immigrant families varied across indicators and among racial/ethnic groups. Not even third-generation Hispanic and Black children reached parity with third-generation White children on reported amount of time that providers devoted to their care and on providers’ sensitivity to their family’s values and customs. In contrast, disparities in reports of providers listening carefully to caregivers disappeared after adjusting for confounders, and only families headed by immigrant parents reported receiving less specific health-related information than the families of native-born White children. Our study suggests that it is important to develop interventions that help healthcare professionals to learn how different types of immigrant families perceive the interactions with the healthcare system and how to deliver care that increases the satisfaction of children from different racial/ethnic groups.
KeywordsQuality of healthcare Immigrant families Race/ethnicity Disparities Children
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R00HD068506 to SSH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funder did not have any role in the study design; in the collection analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. We authors would like to thank the anonymous reviewers for their valuable comments and suggestions to improve the quality of the paper.
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