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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.144394v1 AJPH.2008.144394v2 99/3/556    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chilton, M. Articles by Frank, D. A. Search for Related Content PubMed PubMed Citation Articles by Chilton, M. Articles by Frank, D. A. Related Collections Other Maternal and Infant Health Nutrition/Food Other Child and Adolescent Health Other Race/Ethnicity Immigration Women's Health

Mariana Chilton, PhD, MPH, Maureen M. Black, PhD, Carol Berkowitz, MD, Patrick H. Casey, MD, John Cook, PhD, Diana Cutts, MD, Ruth Rose Jacobs, PhD, Timothy Heeren, PhD, Stephanie Ettinger de Cuba, MPH, Sharon Coleman, MPH, Alan Meyers, MD and Deborah A. Frank, MD

Mariana Chilton is with the School of Public Health, Drexel University, Philadelphia, PA. Maureen M. Black is with the School of Medicine, University of Maryland, Baltimore. Carol Berkowitz is with the Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA. Patrick H. Casey is with the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock. John Cook, Ruth Rose Jacobs, Alan Meyers, and Deborah A. Frank are with the Department of Pediatrics, School of Medicine, Boston University, Boston, MA. Diana Cutts is with the Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN. Timothy Heeren, Stephanie Ettinger de Cuba, and Sharon Coleman are with the School of Public Health, Boston University, Boston.

Correspondence: Requests for reprints should be sent to Mariana Chilton, PhD, MPH, Drexel University School of Public Health, 1505 Race St, 11th Floor, Philadelphia, PA 19102-1192 (e-mail: mariana.chilton{at}drexel.edu).

Objectives. We investigated the risk of household food insecurity and reported fair or poor health among very young children who were US citizens and whose mothers were immigrants compared with those whose mothers had been born in the United States.

Methods. Data were obtained from 19 275 mothers (7216 of whom were immigrants) who were interviewed in hospital-based settings between 1998 and 2005 as part of the Children's Sentinel Nutrition Assessment Program. We examined whether food insecurity mediated the association between immigrant status and child health in relation to length of stay in the United States.

Results. The risk of fair or poor health was higher among children of recent immigrants than among children of US-born mothers (odds ratio [OR] = 1.26; 95% confidence interval [CI] = 1.02, 1.55; P < .03). Immigrant households were at higher risk of food insecurity than were households with US-born mothers. Newly arrived immigrants were at the highest risk of food insecurity (OR = 2.45; 95% CI = 2.16, 2.77; P < .001). Overall, household food insecurity increased the risk of fair or poor child health (OR = 1.74; 95% CI = 1.57, 1.93; P < .001) and mediated the association between immigrant status and poor child health.

Conclusions. Children of immigrant mothers are at increased risk of fair or poor health and household food insecurity. Policy interventions addressing food insecurity in immigrant households may promote child health.