Factors Influencing Low Prevalence of Neurodevelopmental Disabilities Among US Hispanic/Latino Children
Hispanic/Latino (H/L) children have lower prevalence of neurodevelopmental disabilities (NDD) than other groups. The explanations for this are complex, but may be related to nativity, language barriers, and lack of access to and utilization of healthcare. Previous research focused on how these factors affect children with NDD, but little research has jointly examined whether these factors predict NDD. This study examines whether social and environmental factors explain low prevalence of NDD in this population.
This study uses nationally representative Integrated Public Use Microdata Series National Health Interview Survey data (N = 200,622) and multivariate logistic regression analysis to compare NDD prevalence in white and H/L children (average age of 10.2), and examines whether nativity, healthcare access, healthcare utilization, and language barriers explain this disability disparity.
Findings reveal that the H/L NDD disparity is not explained by differences in access to or utilization of healthcare, or as a result of language differences that may create barriers to NDD diagnosis. While H/L children whose sampled adult was born in the USA have lower rates of NDD than whites, H/Ls whose sampled adult were not born in the USA have even lower probability of NDD than H/Ls who were born in the USA.
These findings may be a result of cultural differences in knowledge or understanding of what constitutes a disability or the result of differential treatment within the healthcare system among H/Ls. The findings underscore the importance of accessible and culturally appropriate health and clinical care interventions among H/L communities.
KeywordsNeurodevelopmental disabilities Racial and ethnic disparities Health disparities Healthcare
The authors would like to thank Rob Warren for his helpful feedback.
This study was supported by the Minnesota Population Center (P2C HD041023) funded through a grant from the Eunice Kennedy Shriver National Institute for Child Health and Human Development .
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 3.Blumberg, S. J., et al. Changes in prevalence of parent-reported autism spectrum disorder in school-aged US children: 2007 to 2011–2012. 2013: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.Google Scholar
- 5.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub; 2013.Google Scholar
- 7.Friedman DJ, Gibson Parrish R, Fox MH. A review of global literature on using administrative data to estimate prevalence of intellectual and developmental disabilities. J Policy Pract Intellect Disab. 2018;15(1):43–62.Google Scholar
- 8.Fujiura GT, Li H, Magaña S. Health services use and costs for Americans with intellectual and developmental disabilities: a national analysis. Intellect Dev Dis. 2018;56(2):101–18.Google Scholar
- 11.Pedersen, A., et al., Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 2012: p. peds. 2011–1145.Google Scholar
- 13.Zablotsky B, Black LI, Blumberg SJ. Estimated prevalence of children with diagnosed developmental disabilities in the United States, 2014-2016. NCHS data brief. 2017;(291):1–8.Google Scholar
- 14.CDC, Prevalence of autism spectrum disorders—autism and developmental disabilities monitoring network, 14 sites, United States, 2008. Morbidity and Mortality Weekly Report: Surveillance Summaries, 2012. 61(3):1–19.Google Scholar
- 16.CDC. Mental health in the United States: parental report of diagnosed autism in children aged 4-17 years--United States, 2003-2004. MMWR. Morb Mortal Wkly Rep. 2006;55(17):481.Google Scholar
- 17.Schieve LA, Boulet SL, Blumberg SJ, Kogan MD, Yeargin-Allsopp M, Boyle CA, et al. Association between parental nativity and autism spectrum disorder among US-born non-Hispanic white and Hispanic children, 2007 National Survey of Children’s Health. Disabil Health J. 2012;5(1):18–25.PubMedGoogle Scholar
- 18.Croen LA, Grether JK, Selvin S. Descriptive epidemiology of autism in a California population: who is at risk? J Autism Dev Disord. 2002;32(3):217–24.Google Scholar
- 23.Blewett, L.A., et al. IPUMS Health Surveys: National Health Interview Survey, Version 6.3 [dataset]. Minneapolis, MN: IPUMS, 2018. 2018; Available from: https://doi.org/10.18128/D070.V6.3.
- 24.United States Census Bureau. Facts for features: Hispanic heritage month 2017. Fast Facts 2017; Available from: https://www.census.gov/newsroom/facts-for-features/2017/hispanic-heritage.html.
- 25.Fry RA. Latino settlement in the new century. Washington, DC: Pew Hispanic Center; 2008.Google Scholar
- 26.Cauce, A.M. and M. Domenech-Rodriguez, Latino families: myths and realities. Latino children and families in the United States: Current research and future directions, 2002: p. 3–25.Google Scholar
- 28.Macartney, S., A. Bishaw, and K. Fontenot, Poverty rates for selected detailed race and Hispanic groups by state and place: 2007–2011. 2013: US Department of Commerce, Economics and Statistics Administration, US ….Google Scholar
- 29.Adhanom-Ghebreyesus, T. Health is a fundamental human right. 2017 [cited 2018 September 4, 2018]; Available from: http://www.who.int/mediacentre/news/statements/fundamental-human-right/en/.
- 32.Abdullahi I, Leonard H, Cherian S, Mutch R, Glasson EJ, de Klerk N, et al. The risk of neurodevelopmental disabilities in children of immigrant and refugee parents: current knowledge and directions for future research. Rev J Autism Dev Disord. 2018;5(1):29–42.Google Scholar
- 39.Toomey RB, Umaña-Taylor AJ, Williams DR, Harvey-Mendoza E, Jahromi LB, Updegraff KA. Impact of Arizona’s SB 1070 immigration law on utilization of health care and public assistance among Mexican-origin adolescent mothers and their mother figures. Am J Public Health. 2014;104(S1):S28–34.PubMedPubMedCentralGoogle Scholar
- 41.Fountain C, Bearman P. Risk as social context: immigration policy and autism in California 1. In: Sociological Forum, vol. 26: Wiley Online Library; 2011. p. 215–40.Google Scholar
- 43.Amant HGS, et al. Language barriers impact access to services for children with autism spectrum disorders. J Autism Dev Disord. 2018;48(2):333–40.Google Scholar
- 44.Coker, C.C., A comparison of job satisfaction and economic benefits of four different employment models for persons with disabilities. 1995.Google Scholar
- 46.Guevara JP, Gerdes M, Localio R, Huang YV, Pinto-Martin J, Minkovitz CS, et al. Effectiveness of developmental screening in an urban setting. Pediatrics. 2013: p peds. 2012-0765;131:30–7.Google Scholar
- 49.Blacher J, Lopez S, Shapiro J, Fusco J. Contributions to depression in Latina mothers with and without children with retardation: implications for caregiving. Fam Relat. 1997;46:325–34.Google Scholar
- 50.Bailey DB Jr, et al. Awareness, use, and satisfaction with services for Latino parents of young children with disabilities. Except Child. 1999;65(3):367–81.Google Scholar
- 51.Reyes NM, Lindly OJ, Chavez AE, Folan A, Macias K, Smith KA, et al. Maternal beliefs about autism: a link between intervention services and autism severity in White and Latino mothers. Res Autism Spectr Disord. 2018;51:38–48.Google Scholar
- 53.Marolda CA. Effects of cultural assimilation on Latino parents’ knowledge and attitudes towards autism and perceived barriers to health care: Capella University; 2018.Google Scholar
- 56.Cuy Castellanos D. Dietary acculturation in Latinos/Hispanics in the United States. Am J Lifestyle Med. 2015;9(1):31–6.Google Scholar
- 58.Chang, J.A., Health, health insurance coverage, health care service utilization and family structure among children of immigrants. 2018.Google Scholar
- 61.Johnson B. Early intervention in children with developmental disabilities. BMH Med J. 2016;3(1).Google Scholar
- 63.Petrenko CL. A review of intervention programs to prevent and treat behavioral problems in young children with developmental disabilities. J Dev Phys Disabil. 2013;25(6):651–79.Google Scholar
- 67.Individuals with Disabilities Education Act. Statute and regulations. 2018; Available from: https://sites.ed.gov/idea/statuteregulations/.
- 68.Johnson PJ, Blewett LA, Ruggles S, Davern ME, King ML. Four decades of population health data: the integrated health interview series as an epidemiologic resource. Epidemiology (Cambridge, Mass.). 2008;19(6):872–5.Google Scholar
- 69.Artiga S, Ubri P. Key issues in children’s health coverage. Medicaid. 2017; Available from: https://www.kff.org/medicaid/issue-brief/key-issues-in-childrens-health-coverage/.
- 70.Musumeci M, Foutz J. Medicaid’s role for children with special health care needs: a look at eligibility, services, and spending. In: Kaiser Family Foundation: Kaiser Family Foundation website; 2018.Google Scholar
- 71.CDC. Learn the signs. Act Early 2018; Available from: https://www.cdc.gov/ncbddd/actearly/index.html.
- 72.Hall-Lande J, et al. Age of initial identification of autism spectrum disorder in a diverse urban sample. J Autism Dev Disord. 2018:1–6.Google Scholar
- 75.Portes A, Rivas A. The adaptation of migrant children. Futur Child. 2011;21:219–46.Google Scholar
- 76.Ono H. Assimilation, ethnic competition, and ethnic identities of US-born persons of Mexican origin. Int Migr Rev. 2002;36(3):726–45.Google Scholar
- 77.U.S. Census Bureau, Americans Are Visiting the Doctor Less Frequently, Census Bureau Reports. 2012, U.S. Census Bureau U.S. Census Bureau website.Google Scholar
- 82.CDC. Screening and Diagnosis of Autism Spectrum Disorder 2018; Available from: https://www.cdc.gov/ncbddd/autism/screening.html.
- 83.Attention Deficit Disorder Association. Adult ADHD test. 2018; Available from: https://add.org/adhd-test/.
- 84.Data-USA. Speech-language Pathology. 2016 08/15/18]; Available from: https://datausa.io/profile/cip/510203/#demographics.
- 87.U.S. Department of Education. Fast facts: students with disabilities. 2018; Available from: https://nces.ed.gov/fastfacts/display.asp?id=64.
- 88.Bronheim SM, Soto S, Anthony BJ. Addressing disparities in access to information for Hispanic families of children with special health care needs: increasing use of family-to-family centers. J Health Dispar Res Pract. 2015;8(2).Google Scholar
- 90.Bernier R, Mao A, Yen J. Psychopathology, families, and culture: autism. Child Adolesc Psychiatr Clin. 2010;19(4):855–67.Google Scholar
- 93.Livingston, G. and A. Brown, The rise of multiracial and multiethnic babies in the US. Pew research center, 2017. 6.Google Scholar
- 94.Maguire, C. Autism on the rise: a global perspective. Harvard Global Health Review 2013; Available from: http://www.hcs.harvard.edu/hghr/online/autism-on-the-rise-a-global-perspective/.
- 95.Schmidt RJ, Hansen RL, Hartiala J, Allayee H, Schmidt LC, Tancredi DJ, et al. Prenatal vitamins, one-carbon metabolism gene variants, and risk for autism. Epidemiology (Cambridge, Mass). 2011;22(4):476–85.Google Scholar
- 97.Yang Q-H, Carter HK, Mulinare J, Berry RJ, Friedman JM, Erickson JD. Race-ethnicity differences in folic acid intake in women of childbearing age in the United States after folic acid fortification: findings from the National Health and Nutrition Examination Survey, 2001–2002. Am J Clin Nutr. 2007;85(5):1409–16.PubMedGoogle Scholar
- 98.Tinker SC, Devine O, Mai C, Hamner HC, Reefhuis J, Gilboa SM, et al. Estimate of the potential impact of folic acid fortification of corn masa flour on the prevention of neural tube defects. Birth Defects Res Part A. 2013;97(10):649–57.Google Scholar
- 99.Karoly LA. Investing in our children: what we know and don’t know about the costs and benefits of early childhood interventions: Rand Corporation; 1998.Google Scholar