Mariana Chilton ^1*, Maureen M. Black ², Carol Berkowitz ³, Patrick H. Casey ⁴, John Cook ⁵, Diana Cutts ⁶, Ruth Rose Jacobs ⁵, Timothy Heeren ⁷, Stephanie Ettinger de Cuba ⁷, Sharon Coleman ⁸, Alan Meyers ⁵, Deborah A. Frank ⁵

¹ Drexel University School of Public Health
² University of Maryland School of Medicine
³ Harbor-UCLA Medical Center
⁴ University of Arkansas for Medical Sciences
⁵ Department of Pediatrics, Boston University School of Medicine
⁶ Department of Pediatrics, Hennepin County Medical Center, Minneapolis
⁷ Boston University School of Public Health
⁸ -

^* To whom correspondence should be addressed. E-mail: mariana.chilton{at}drexel.edu.

	Abstract

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 19275 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.

Key Words: Child and Adolescent Health, Immigration, Maternal and Infant Health, Nutrition/Food, Race/Ethnicity, Women's Health