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Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 6/2009

Open Access 01-11-2009

The Health and Cognitive Growth of Latino Toddlers: At Risk or Immigrant Paradox?

Authors: Bruce Fuller, Margaret Bridges, Edward Bein, Heeju Jang, Sunyoung Jung, Sophia Rabe-Hesketh, Neal Halfon, Alice Kuo

Published in: Maternal and Child Health Journal | Issue 6/2009

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Abstract

Epidemiologists have shown how birth outcomes are generally robust for immigrant Latina mothers, despite often situated in poor households, advanced by their strong prenatal and nutritional practices. But little is known about (1) how these protective factors may differ among Latino subgroups, (2) the extent to which birth outcomes, ongoing maternal practices, and family supports advance Latino toddlers’ health and physical growth, and (3) whether the same processes advance toddlers’ early cognitive growth. We drew on a national probability sample of 8,114 infants born in 2001, including 1,450 of diverse Latino origins. Data come from birth records, maternal interviews when the child was 9 and 24 months of age, and direct assessments of health status, physical growth, and cognitive proficiencies. Descriptive analyses compared Mexican-heritage and other Latino mothers and toddlers relative to middle-class whites. Multivariate regression techniques identified predictors of child health, weight, and BMI, as well as cognitive proficiencies at 24 months. Infants of Mexican-heritage or less acculturated Latina mothers displayed robust birth outcomes, compared with other ethnic groups. The low incidence of premature births and low birthweight among these mothers continued to advance their cognitive growth through 24 months of age. Yet Latino children overall displayed smaller gains in cognitive proficiencies between 9 and 24 months, compared with middle-class populations, attributable to Latinas’ lower levels of maternal education, weaker preliteracy practices, and a higher ratio of children per resident adult. Health practitioners should recognize that many Latina mothers display healthy prenatal practices and give birth to robust infants. But these early protective factors do not necessarily advance early cognitive growth. Screening practices, early interventions, and federal policy should become more sensitive to these countervailing dynamics.
Footnotes
1
Initial evidence suggests that first-generation Latino children, paradoxically, are more engaged in school and often perform at higher levels, compared with the second generation, whether due to stronger family obligations, optimism about opportunities, or the selectivity parents migrating to the United States [15, 16].
 
2
See Landale et al. review [24] on how the family structure of Latino subgroups is changing across generations.
 
3
Child health researchers have questioned whether Latino parents may under report children’s health problems or fail to recognize certain disabilities. Recent work has found lower reports of health problems by parents utilizing different interview measures, and lower incidence among Mexican-heritage parents, compared with other Latino subgroups [27‐29]. This suggests that biases may occur for specific subgroups, but not severely for Latinos overall. We entered a control variable to account for the mother’s frequency of visiting a doctor or health practitioner to guard against bias in the perceived health of the child.
 
4
Field staff were trained and certified to administer the reduced form Bayley scales; they achieved inter-rater reliability for scoring accuracy at 97% or better [24].
 
5
Factor scores were calculated for inclusion in regression models: mother’s encouragement of the child to complete the task (Cronbach α = 0.80), responsiveness when child in distress (α = 0.76), display of warmth and emotional support (α = 0.79), verbal specificity and careful instructions (α = 0.57), and avoidance of negative affect or sanctions when the child made slow progress (α = 0.59). The latter index was highly skewed (92% of mothers avoided negative sanctions). So the variable was dichotomized.
 
6
For mothers born in the United States, the number of years resident was set to equal their age. Multiple measures of acculturation are somewhat collinear but not sufficiently so to bias parameter estimates, as assessed by the variance inflation factor, using the Stata VIF procedure [33].
 
7
To properly estimate regression coefficients and compute standard errors, given sampling weights, stratification, and clustering, we used the suite of “svy” commands available in Stata software. Due to missing data, strata at times were combined to ensure that sufficient PSUs per stratum were available in order to compute standard errors.
 
8
Mexican-American mothers reported being 24.0-years-old when first giving birth, compared with 23.7 years for whites and African American mothers. In contrast, non-Mexican Latinas first gave birth almost two years younger than Mexican mothers (22.2 years of age).
 
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Metadata
Title
The Health and Cognitive Growth of Latino Toddlers: At Risk or Immigrant Paradox?
Authors
Bruce Fuller
Margaret Bridges
Edward Bein
Heeju Jang
Sunyoung Jung
Sophia Rabe-Hesketh
Neal Halfon
Alice Kuo
Publication date
01-11-2009
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 6/2009
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-009-0475-0

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