番茄社区

CHICAGO -- Children of U.S.-born parents were more likely to experience adverse childhood experiences than children of immigrant parents, researchers said here.

Compared with parents of immigrant children, parents of U.S.-born children were more likely to report conventional adverse childhood experiences, such as poverty and bullying, for themselves and their children, reported Keith Martin, DO, of Children's Mercy Hospital in Kansas City, and colleagues.

This furthers the "immigrant paradox," which he defined as immigrant children having "better health, achievement or well-being, despite disadvantages," Martin said at a at the annual meeting.

He added that because "public perception helps shape immigration policy," that this research may help to inform about the "reality faced by immigrants in the United States."

This was a secondary analysis of a study on adverse childhood experiences and a child's weight, taken from anonymous surveys at two Midwestern academic medical centers. They examined adverse childhood experiences on a household-level parent, out-of-home placement as proxy for abuse/neglect questions, and expanded community-level parent and child adverse childhood experiences. Immigrant status was determined by asking, "Were you/your child born in the United States?"

Overall, 331 parents participated in the survey, two-thirds of whom were born in the U.S. and spoke English, and almost 90% were women. Half of participants had an annual household income less than $20,000. While 99% of all children were born in the U.S., 94% of children of immigrant parents were of Hispanic ethnicity.

Among U.S.-born parents, loss of parent was the most commonly reported adverse childhood experience (40%), followed by poverty (32%), and bullying (32%). The most common adverse childhood experience among immigrant parents was poverty (30%), unsafe neighborhood (20%), and emotional neglect (18%).

After adjusting for confounders, Martin's group found that U.S. parents were more likely to report one to three conventional adverse childhood experiences (RRR 2.4, 95% CI 1.3-4.5) and four or more conventional adverse childhood experiences (RRR 2.7, 95% CI 1.6-6.2) compared with immigrant parents, albeit with wide confidence intervals.

In addition, U.S. parents had a higher risk of reporting one to two expanded adverse childhood experiences (RRR 3.4, 95% CI 1.1-3.8) and three or more expanded adverse childhood experiences (RRR 10.3, 95% CI 2.5-42.2), again with similar wide confidence intervals.

While not involved with the research, Gigi Chawla, MD, of Children's Minnesota in St. Paul, told 番茄社区 that this abstraction should cause "reflection on our part" about whether or not health literacy or paradoxical reporting might be the cause of underreporting.

"The acknowledgement of fewer [adverse childhood experiences] by immigrant parents may also be an indication that we are screening for U.S. cultural adversity: results created by our social structure, family structure, and values," Chawla said. "But what internalized, past traumas are experienced by and culturally relevant to immigrant-born parents? Do these manifest directly or indirectly in parenting and translate into negative health outcomes for children?"

Martin's group recommended that further study may be needed about more diverse immigrant populations to examine adverse childhood experiences that may be unique to immigrants.

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