Children of immigrants are the fastest growing population of children in the U.S. A greater proportion of children of immigrant than US-born parents are from households with low incomes. Despite this reality, eligibility rules are complex for many services and supports, including healthcare, that could help immigrant families to financially stabilize, often barring certain immigrants from getting help. For others who are eligible, the confusion creates barriers to assistance, with the result that they also do not receive help.
Children’s health suffers when their basic needs are not met, especially in early childhood. The first three years of life are a critically important period of development. When families are unable to provide sufficient food, shelter, healthcare, responsive caregiving, and/or safety, children’s health and development suffer, with the potential to affect their trajectory for physical, mental and academic well-being over the lifecourse. In recent years, and accelerating under the Trump Administration, immigration and public assistance eligibility policies have changed rapidly and dramatically, increasing many immigrant parents’ confusion and concern about their eligibility.
Immigration, healthcare, and social service policies intersect at the household level. Young children are not the decisionmakers about their own health or healthcare, thus public health professionals, healthcare and social service providers, and policymakers need a household view of these policies. However, relationships between access to healthcare, family material well-being, and the wider sociopolitical environment for immigrant families with young children are understudied. In a multifaceted world of interconnecting identities and policies, there is an urgent need to examine child and family issues in their full complexity, including race and ethnicity alongside nativity.
In this mixed methods dissertation, I use a cross-sectional dataset to assess whether and how health care hardship varies among young children of immigrant compared to US born mothers, as well as by immigrant mothers’ self-reported racial and ethnic backgrounds. I also examine relationships between health care hardship and young children’s health and development and family material well-being. Additionally, I present a difference-in-differences analysis of the impact of President Trump’s election on young children of immigrant and US-born mothers’ health care utilization. I examine impacts on both preventive and acute care outcomes for young children. Using qualitative analysis based on semi-structured interviews with immigrant mothers, I explore mothers’ daily experiences navigating decisions about health care with the many other demands they face. Their perspectives on seeking healthcare and public assistance in the current political and policy environment provide important context to inform policy at the state, federal and health systems level.
This dissertation expands understanding of early childhood care from a child to a household focus, sheds light on the interplay between race, ethnicity, and nativity for families with young children, and adds nuance and detail to the ways in which families navigate health care and other competing needs. / 2024-08-31T00:00:00Z
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/42943 |
| Date | 26 August 2021 |
| Creators | Ettinger de Cuba, Stephanie |
| Contributors | Jones, David K. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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