Children of immigrants are the fastest growing component of the child population. While immigrants are 11 percent of the total U.S. population, children of immigrants make up 22 percent of the 23.4 million children less than 6 in the United States. Correlatively, policies affecting young children and their families will increasingly be judged by their effects on the health, well-being, and school readiness of children of immigrants.

Why do immigrant’s children have such limited health care access? Much of the reason is related to insurance coverage and financial access; they also face other barriers like:

-Language barriers limit access. If patients know they will have difficulty explaining their medical needs or problems to a doctor or nurse, they are less willing to seek care. About 30% of the foreign born do not speak English or do not speak it well.

-Cultural differences also play a role. The medical care system is organized differently in the US than in immigrant’s home countries and managed care can be particularly difficult to navigate.

-Immigrants may have different perceptions of the need and appropriateness of medical care. The need for preventive care may be less familiar. In many countries, seeking help for mental health problems is stigmatized.

-Finally, legal status can be a concern. Unauthorized immigrants often worry that seeking care, particularly at a public facility, may lead to exposure of tier unauthorized status and increase the risk of sanctions such as deportation. Even legal immigrants may worry that using benefits could jeopardize their legal status and perhaps make it harder to gain citizenship or permanent residency.

Poverty is one of the most important predictors of negative child outcomes. Poverty rates are generally higher among children of immigrants than among children of natives and highest for young children of immigrants. Although children of immigrants are more likely to be in two-parent families, the second parent in these families is less likely to work. Immigrants earn lower wages, leading to lower family incomes. Low educational attainment and limited English proficiency which results in low performance in school and later in the labor force. At the same time, children of immigrants score lower on measures of parent-child interaction at young age.

Parents with less formal education appear less likely to enroll their children in center-based care or preschool. They may also have fewer resources at home such as books or computers to prepare their children for school.

They are also less likely to be taken on outings-such as to the grocery store, a park, a church, or a playground-than children of natives. These gaps may be associated with relatively high poverty and low educational attainment in immigrant families.

Economic hardship rates rise, and gaps between immigrant and native families narrow for food hardship measures. Over half of young, low-income children of immigrants live in families with one or more food-related problems.

Optimal childhood health is recognized as a key determinant of well-being and productivity throughout life. Early childhood in particular is increasingly viewed as a critical period in which adverse conditions and events can significantly influence subsequent physical and mental health status. For example nutritional deficits and toxic environmental exposure in both the prenatal months and in early childhood have been linked to a range of chronic conditions in adulthood, including cardiovascular disease, hypertension, lung disease, and diabetes. Associations have also been found between psychosocial stressors in childhood-such as socio emotional and economic deprivation – and the development of mental and physical problems later in life.

Additionally, childhood health is likely to influence the social and economic integration of immigrants. Experts regard delays in cognitive development during early childhood as a key reason for educational and social equality later in life. More specifically, children with cognitive and other delays in preschool are more likely to become high school dropouts and to experience delinquency, unemployment, low earnings, and dissatisfaction with their adult lives than their otherwise similar peers. Early cognitive development is also closely linked with physical health and overall well being.

Another major childhood health condition, obesity, is linked to a number of serious health issues, including hypertension, elevated blood pressure, cancer, and diabetes. Beyond its impact on physical health and mortality, obesity is related to difficulties in social adjustment, poor mental health, and lower academic achievement – factors that in turn have wide-ranging implications for children’s quality of life and productivity as adults.

Additionally, children of immigrants may be at higher risk for certain conditions. For eg; pesticide exposure is a problem among children of migrant workers. Immigrant children may be less up to date on certain immunizations, particularly DtaP, Hib, and Hep-B. Health risks appear to vary greatly depending on the origins of immigrant parents, with children of Latino immigrants often the most at risk.

Nearly one in every four US children has an immigrant parent; promoting health of children in immigrant families will maximize the long-term well – being and productivity of tomorrow’s adults. Policies targeting children of immigrants should promote access to health care, high-quality child care, healthy diets, and physical activity.