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Acculturation and the Health and Well-Being of
U.S. Immigrant Adolescents
Yu SM, ScD, MPHHuang ZJ, MB, PhD, MPH
Schwalberg R, MPHOverpeck 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
2.8 2.1Bullied at school
2.41.2 (NS)Parents expect too much
2.51.2 (NS)Parents not ready to help
1.6 (NS)1.5Students do not feel safe at school
2.21.4 (NS)Students in class do not enjoy being together
Only other languageN=123
Mixed languageN=395
Odds Ratios of Selected Outcomes Based on Language at Home Among N-H Blacks
EnglishN=2,426
Mixed languageN=161
Only other languageN=65
Stomachache (>=once/week)
2.0 2.2 1.2(NS)
Not feel confident 2.7 2.6 1.3Parents not ready to help 2.3 4.1 1.4Feel not belong to school 2.8 2.8 1.7Feel helpless 2.6 3.8 1.2
Odds Ratios of Selected Outcomes Based on Language at Home Among Hispanics
EnglishN=795
Mixed languageN=1,329
Only other languageN=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 1.8Parents expect too much 1.1 (NS) 1.6 2.1Not feel confident 1.4 1.5 1.8
Odds Ratios of Selected Outcomes Based on Language at Home Among Asians
EnglishN=190
Mixed languageN=332
Only other languageN=181
Do not spend any evenings with friends
1.1 (NS) 2.7 1.9
Bullied at school 3.6 3.5 4.3Parents 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
00.5
11.5
22.5
33.5
44.5
5
N-H White N-H Black Hispanic Asian
Odds
Rati
o
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
00.5
11.5
22.5
33.5
44.5
5
N-H White N-H Black Hispanic Asian
Odds
Rati
o
Reference group=English only N-H White
Odds Ratios of Parent Not Willing to Talk to Teacher Among Students
Who Speak Another Language
0
1
2
3
4
5
6
N-H White N-H Black Hispanic Asian
Odds
Rati
o
Reference group=English only N-H White
Odds Ratios of Being Bullied at School Among Students Who
Speak Another Language
0
1
2
3
4
5
6
7
8
N-H White N-H Black Hispanic Asian
Odds
Rati
o
Reference group=English only N-H White
Odds Ratios of Not Feeling Safe at School Among Students Who
Speak Another Language
0
0.5
1
1.5
2
2.5
3
3.5
4
N-H White N-H Black Hispanic Asian
Odds
rati
o
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
