# Presentation: 717207

## Acculturation and the Health and Well-Being of U.S. Immigrant Adolescents

**Yu SM, ScD, MPH**
**Huang ZJ, MB, PhD, MPH**
** ****Schwalberg R, MPH**
**Overpeck MD,  DrPH **
**Kogan MD, PhD**

## Background

- Nearly 14 million immigrant children in U.S.
- Growth of immigrant students in K-12 from 6% in 1970 to 19% in 1997
- IOM report found first generation immigrant adolescents in better health and have lower risk behaviors; but adjustment problems and acculturative stress in LEP population
- Language at home is a measure of acculturation

## Study Objective

- To estimate prevalence of health, psychosocial and parental risk factors by race/ethnicity and language groups
- To examine association of the degree of acculturation and race/ethnicity and risk factors

## Methods

- 1997-98 WHO Study of Health Behavior in School Children (HBSC)
- National representative sample of grades      6-10 in U.S. schools
- Black and Hispanic youths oversampled
- 83 percent participation rate in 386 schools
- Anonymous standardized questionnaires

## Study Population

- Total N=15,220
- N-H White=8,915
- N-H Black=2,667
- Hispanic=2,942
- N-H Asian=696

## Variables

- Independent variable
- Language spoken at home
- Outcome variables
- Health factors
- Psychosocial school factors
- Parental factors
- Control variables
- Gender, maternal education, age

## Language at Home and Nativity Status Within Race/Ethnicity Groups (Percents)

|  | N-H White | N-H Black | Hispanic | Asian |
| --- | --- | --- | --- | --- |
| Language at Home |  |  |  |  |
| Only/mostly another language | 1.2 | 2.5 | 26.6 | 24.6 |
| Mixed language  | 4.4 | 5.4 | 45.4 | 44.1 |
| Only/mostly English | 94.4 | 92.1 | 28.1 | 31.3 |
| Nativity
 |  |  |  |  |
| U.S. born | 97.5 | 96.7 | 80.2 | 69.6 |
| Foreign born | 2.5 | 3.3 | 19.8 | 30.4 |

## Odds Ratios of Selected Outcomes Based on Language at Home Among N-H Whites

## Odds Ratios of Selected Outcomes Based on Language at Home Among N-H Blacks

|  | English
N=2,426 | Mixed languageN=161 | Only other language
N=65 |
| --- | --- | --- | --- |
| Stomachache (>=once/week) | 2.0 | 2.2 
 | 1.2(NS) |
| Not feel confident | 2.7 | 2.6 | 1.3 |
| Parents not ready to help | 2.3 | 4.1 | 1.4 |
| Feel not belong to school | 2.8 | 2.8  | 1.7 |
| Feel helpless
 | 2.6 | 3.8
 | 1.2 |

## Odds Ratios of Selected Outcomes Based on Language at Home Among Hispanics

|  | English
N=795
 | Mixed language
N=1,329 | Only other language
N=787
 |
| --- | --- | --- | --- |
| Do not always wear 
bicycle helmet  | 1.4 (NS) | 1.6 | 2.0 |
| Teachers expect too much | 1.2 (NS) | 1.6 | 1.6 |
| Bullied at school | 1.8 | 1.5 | 1.8 |
| Parents expect too much | 1.1 (NS) | 1.6 | 2.1 |
| Not feel confident
 | 1.4 | 1.5 | 1.8 |

## Odds Ratios of Selected Outcomes Based on Language at Home Among Asians

|  | English
N=190
 | Mixed language
N=332 | Only other language
N=181
 |
| --- | --- | --- | --- |
| Do not spend any evenings with friends | 1.1 (NS) | 2.7 | 1.9 |
| Bullied at school | 3.6 | 3.5 | 4.3 |
| Parents not willing to talk to teacher | 0.6 (NS) | 1.9 | 3.6 |
| Difficult to talk to mother | 0.6 | 1.2(NS) | 1.9 |

## Odds Ratios of Parents Not Ready to Help Among Students Who Speak Only Another Language at Home

- Reference group=English only N-H White

## Odds Ratios of Parents Expecting Too Much of Student at School Among Students Who Speak Only Another Language at Home

- Reference group=English only N-H White

## Odds Ratios of Parent Not Willing to Talk to Teacher Among Students Who Speak Another Language

- Reference group=English only N-H White

## Odds Ratios of Being Bullied at School Among Students Who Speak Another Language 

- Reference group=English only N-H White

## Odds Ratios of Not Feeling Safe at School Among Students Who Speak Another Language

- Reference group=English only N-H White

## Conclusions

- Complex interaction among immigration,  race/ethnicity, and linguistic assimilation
- All non-White youths at higher risk of being bullied
- All ‘other language’ youths experience elevated psychosocial and parental risks
- Level of acculturation associated with risk in each race/ethnicity

## Limitations

- Underestimate of risk due to in-school population
- Absenteeism
- Lack of citizenship information
- Lack of info. on length of time in U.S.

## Implications

- Risk reduction intervention should be targeted towards new immigrants of all races and ethnic groups
- Diversity within race/ethnic group should be recognized
- Outreach programs needed for parents of immigrant children