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The Health and Nutritional Status of Immigrant Hispanic Children: Analyses of the Hispanic Health and Nutrition Examination Survey
The Health and Nutritional Status of Immigrant Hispanic Children: Analyses of the Hispanic Health and Nutrition Examination Survey
Pages 187-243
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From page 187... ...
. However, two questions arise: What do we know about the nutritional and health status of immigrant Hispanic children?
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From page 188... ...
This paper presents data on the growth patterns, dietary intakes, and prevalences of chronic medical conditions and the perceived health status of Mexican American, Puerto Rican, and Cuban American children and adolescents. We differentiate these findings by the birthplaces of the children and adolescents.
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From page 189... ...
As a result, for this study Mexican American children and adolescents were identified as being born either in Mexico or the United States; similarly, Cuban Americans were identified as being born in Cuba or the United States. Puerto Rican children were classified as being born either on the mainland or on the island of Puerto Rico.
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From page 190... ...
The physical health of children and adolescents was assessed by the presence of chronic medical conditions and parental reports of specific conditions. The assessment of chronic medical conditions was done by survey physicians through questionnaires and a standardized physical examination.
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From page 191... ...
, with age, sex, poverty, parental education, and whether the child or adolescent was foreign born as independent variables. The latter variable for Mexican American adolescents includes three groupings: foreign born, U.S.
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From page 192... ...
For children 6 months to 11 years old, the three Hispanic groups differed demographically among themselves and within groups by birthplace. Compared to U.S.-born Mexican American children, foreign-born ones tended to have families that were poorer, less educated, predominantly Spanish speaking, and less likely to have a female-headed household.
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From page 193... ...
counterparts. The data for height and weight medians by age, sex, and birthplace for Mexican American, Puerto Rican, and Cuban American children are shown in Appendix 4A, Tables 4A-1 through 4A-6.
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From page 194... ...
Because data were unstable owing to small sample sizes by age and sex, two-year averages are presented. Compared to the NCHS height standard for 1983, foreignborn Mexican American males had median heights that were greater than the 50th percentile for ages 2 to 3 but were generally less than the 50th percentile for ages 4 to 17 years (Figure 4-1~.
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From page 195... ...
'\ - - - - - Foreign born \ \ \ 1 1 1 1'\ 1 2 1 1 1 1 ) ` 1 1 3 ~ 7 ~1 "1~2 13 14 15 16 17 / \\: / `\ \ \ Years FIGURE 4-2 Median heights of Mexican American females by two-year intervals.
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From page 196... ...
Similarly, foreign-born Mexican American females had average median heights greater than the NCHS 50th percentile from ages 2 to 4 but then were generally below the 50th percentile from ages 5 to 17 (Figure 4-2~. Specifically, the median heights of foreign-born Mexican American females were 1 to 2 cm less than their age-appropriate NCHS standard during childhood and early adolescence and then averaged 7 cm below the NCHS 50th percentile in late adolescence.
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From page 197... ...
The median weights of Mexican American children were less variant than their heights from the NCHS median or 50th percentile. Foreign-born boys through age 12 showed median weights that varied around the NCHS 50th percentile, from +1.3 kg above the 50th percentile to -2.9 kg below (Figure 4-3~.
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From page 198... ...
Gender Female-0.88 Male0 00 Birthplace Other country0.69 U.S.0.00 Poverty score 0 00 Parental education < Grade 9-0.96 2 Grade 9 6-ll OverallR2 0.72 df 1117 Variable Leve/ Age 6 yrs.
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From page 199... ...
FERNANDO S MENDOZA AND LORI BETH DIXON pings 199 Mexican American Puerto Rican Cuban 0.739 778 -21 .1 4*
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From page 200... ...
. For 12- to 1 8-year-old Puerto Ricans and Cubans, the generation variable only has two levels (first, foreign born; second, U.S.
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From page 201... ...
FERNANDO S MENDOZA AND LORI BETH DIXON 201 Mexican American Puerto Rican Cuban 0.01 -0.50*
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From page 202... ...
Neither socioeconomic factor poverty index or parental education predicted weight for adolescents, and, as with height, being foreign born was not predictive of weight among Mexican American children or adolescents. Figures 4-5 and 4-6 show the proportion of Mexican American children and adolescents with BMI values above the 90th percentile.
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From page 203... ...
Like Puerto Ricans, data on BMI values for Cuban American children and adolescents showed a greater proportion of children above the 90th percentile, particularly children 6 to 11 years old (Appendix 4A, Table 4A-9. Regressions for BMI by age group showed age as the only consistent predictor; however, among school-age children, being foreign born was associated with a lower BMI.
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From page 204... ...
0.00 Poverty score 0 00 Parental education < Grade 9 -0.46 2Grade9 000 6-11 Overall R2 0.44 df 1120 Variable Age Gender Birthplace Poverty score Parental education Level 6yrs.
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FERNANDO S MENDOZA AND LORI BETH DIXON pings 205 Mexican American Puerto Rican Cuban 0.488 779 -6.45*
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From page 206... ...
However, in the 6- to 11-year age group, foreign-born Mexican American children consumed significantly higher amounts of bread, vegetables, and fruits and fewer servings of added fat than U.S.-born Mexican American children. No differ
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From page 207... ...
Overall, for children ages 2 to 11, the total daily intake was 67 percent of recommended USDA amounts for foreign-born Mexican American children and 64 percent for U.S.born Mexican Americans. Daily intakes for both mainland- and island-born Puerto Rican children were similar: 62 percent of recommended amounts.
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From page 208... ...
cant differences in daily intakes of the four food groups between foreign- and U.S.-born groups, Mexican American and Puerto Rican adolescents reported better intakes than Cuban American adolescents (54 and 52 percent, respectively, versus 47 percent of the recommended intakes)
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From page 209... ...
In general, His panic adolescents showed mean dietary intakes ranging from 45 to 55 percent of the recommended daily intakes of the four basic food groups. Although not statistically significant, foreign-born Mexican American teens did slightly better in their mean dietary scores than U.S.-born teens, but this relationship was reversed for Puerto Rican and Cuban American adolescents.
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From page 210... ...
0.00 Poverty score 0.001 Parental education < Grade 9 -0.07 2 Grade 9
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From page 211... ...
FERNANDO S MENDOZA AND LORI BETH DIXON 1gs 211 Mexican American Puerto Rican Cuban 0.038 777 0.52*
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From page 212... ...
The prevalence of chronic medical conditions for each subgroup is shown in Table 4-6. Both mainland- and island-born Puerto Rican children had the highest prevalences of chronic medical conditions and were the only Hispanic subgroup with a significant difference in prevalence between U.S.- and nonmainIand-born children.
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From page 213... ...
children; children born in Puerto Rico had a higher prevalence, though nonstatistical, compared to mainlandborn Puerto Ricans. Foreign-born Cuban American children had
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From page 214... ...
bFour basic refers to a dietary quality score that summed intakes from the four food groups (milk, meat, bread, vegetables and fruits) truncated at the recommended level for each age group according to the USDA Daily Food Guide.
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From page 215... ...
The two guidelines are similar regarding where to place foods, with the significant exception that dessert foods such as cakes, pies, and cookies belong in the added fats group according to the USDA Daily Food Guide and are counted as breads in the Food Guide Pyramid (hence the notable increase in the recommended number of servings)
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From page 216... ...
TABLE 4-7 Selected Parental Reportecl Meclical Conclitions for U.S.- and Foreign-Born Mexican American, Mainlancl Puerto Rican, and Cuban American Chilclren (ages 6 most to 12 yrs.; percents (sample sized) Mexican American Puerto R U.S.-Born Foreign-Born Mainlanc Reported Conditions (N= 2,493)
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From page 217... ...
1.1 (1) and Puerto Rican 2.7 (5)
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From page 218... ...
MainIandborn Puerto Rican children had the highest prevalence (3.8 percent) and foreign-born Mexican Americans the lowest (0.4 percent)
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From page 219... ...
16.5 (917) Puerto Ricans 2-11 year olds Physician 0.0 (148)
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From page 220... ...
Nonetheless, their data do provide a partial profile of the nutritional and health status of immigrant Cuban American children and adolescents. The data from HHANES show that the nutritional status of immigrant Mexican American children and adolescents is variable compared to their U.S.-born Mexican American counterparts.
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From page 221... ...
Therefore, from the HHANES data it appears that, as populations, both immigrant and U.S.-born Mexican American children are mildly stunted compared to the U.S. standard, principally because of SES conditions.
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From page 222... ...
, dietary intake, and anemia suggest that immigrant Mexican American children sampled in HHANES were not significantly wasted or clinically malnourished compared to either U.S.-born Mexican Americans or other U.S. children.
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From page 223... ...
(Since these data are by parental report, access to health care is an important bias that must be considered in the validity of these data.) Actual analysis of hemogiobin levels of the full sample of Mexican Americans confirmed that the prevalence of anemia among these children was similar to other U.S.
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From page 224... ...
Further research is needed to examine the question of dietary adequacy for Mexican American adolescents, both immigrants and nonimmigrants. The growth patterns of Puerto Ricans were similar to Mexican Americans.
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From page 225... ...
A previous report of chronic medical conditions among all Mexican American children and adolescents also demonstrated no increased prevalence of any one specific chronic illness (Mendoza et al., 1991; Mendoza, 1994~. Reported medical conditions by parents also had small sample sizes, and therefore it is difficult to make any definitive statement about the health status of immigrant Mexican American children from these data.
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From page 226... ...
With the association of urinary tract infections being higher in uncircumcised males, this is an interesting finding since Mexican Americans have a low rate of circumcision. The health parameter that seemed to differentiate foreignborn from U.S.-born Mexican Americans the most was the measure of perceived health status.
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From page 227... ...
However, it is interesting to note that the reported level of asthma was higher than in Mexican Americans but lower than in Puerto Ricans. Cuban American adolescents reported poor health perception levels similar to non-Hispanic white adolescents, about 5 to 10 percent.
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This survey, which unfortunately was not available at the time the present paper was written, oversampled Mexican Americans and will be a valuable too! in further researching immigrant Mexican American children.
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Martorell, and F Mendoza 1989 Fatness and fat distribution in Mexican American children and youths from the Hispanic Health and Nutrition Examination Survey.
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Martorell 1991 Selected measures of health status of Mexican American, mainland Puerto Rican, and Cuban American children.
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From page 232... ...
232 HISPANIC HEALTH AND NUTRITIONAL STATUS TABLE 4A-1 Meclian Heights and Weights for Mexican American Chilclren, Ages 2-1 1 Median Heights (cm) Median ~ Age NCHS U.S.-Born Foreign-Born NCHS Mexican American males, ages 2-1 1 2 90.4 91.6 93.7 13.5 3 99.1 98.4 101.0 15.7 4 106.6 104.4 103.5 17.7 5 113.1 111.0 110.7 19.7 6 119.0 118.8 113.8 21.7 7 124.4 123.9 120.7 24.0 8 129.6 128.3 126.1 26.7 9 134.8 133.2 134.2 29.7 10 140.3 138.6 141.1 33.3 11 146.4 145.5 145.0 37.5 Mexican American females, ages 2-1 1 2 90.0 89.2 91.2 13.0 3 97.9 96.8 99.5 15.1 4 105.0 104.6 107.1 16.8 5 111.6 110.8 108.9 18.6 6 117.6 117.2 116.8 20.6 7 123.5 121.6 122.2 23.3 8 129.3 128.0 127.9 26.6 9 135.2 136.2 135.2 30.4 10 141.5 139.7 143.2 34.7 11 148.2 146.6 145.9 39.2
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From page 233... ...
FERNANDO S MENDOZA AND LORI BETH DIXON clren, 233 Median Weights (kg)
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From page 234... ...
born and have one or both parents who are foreign born (USB&FBP) ; third-generation children are U.S.
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FERNANDO S MENDOZA AND LORI BETH DIXON lolescents 235 Median Weights (kg)
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236 HISPANIC HEALTH AND NUTRITIONAL STATUS TABLE 4A-3 Meclian Heights and Weights for Puerto Rican Males, Ages 2-18 Median Heights (cm) Median ~ Age NCHS U.S.-Born Foreign-Born NCHS 2 90.4 92.3 90.8 13.5 3 99.1 99.2 97.4 15.7 4 106.6 107.3 104.6 17.7 5 113.1 112.5 112.6 19.7 6 119.0 118.6 115.6 21.7 7 124.4 124.5 123.0 24.0 8 129.6 130.2 128.2 26.7 9 134.8 135.9 137.3 29.7 10 140.3 140.9 138.7 33.3 11 146.4 146.5 146.6 37.5 12 153.0 155.6 154.7 42.3 13 159.9 159.2 158.4 47.8 14 166.2 165.0 163.0 53.8 15 171.5 169.7 167.2 59.5 16 175.2 170.8 168.8 64.4 17 176.7 173.0 169.3 67.8 18 176.8 172.0 172.7 68.9 TABLE 4A-4 Meclian Heights and Weights for Puerto Rican Females, Ages 2-18 Median Heights (cm)
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From page 237... ...
NCHS U.S.-Born Foreign-Born 13.5 15.7 17.7 19.7 21.7 24.0 26.7 29.7 33.3 37.5 42.3 47.8 53.8 59.5 64.4 67.8 68.9 14.2 15.5 18.3 19.9 22.4 24.2 27.3 31.4 33.4 40.7 50.9 48.4 55.8 57.1 65.4 66.8 67.3 14.0 16.2 16.0 19.8 21.7 23.3 25.2 31.5 33.0 35.1 41.6 45.8 57.3 59.2 64.2 59.8 67.8 Ages 2-1 orn Median Weights (kg) NCHS U.S.-Born Foreign-Born 13.0 15.1 16.8 18.6 20.6 23.3 26.6 30.4 34.7 39.2 43.8 48.3 52.1 55.0 56.4 56.7 56.6 12.7 16.0 16.8 21.8 23.0 23.4 30.5 32.4 37.4 40.1 47.4 51.4 51.4 52.7 56.9 55.8 56.4 12.9 14.8 18.4 20.0 29.7 25.3 25.6 25.4 40.0 38.1 45.5 49.4 52.6 58.3 61.4 57.4 56.1
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From page 238... ...
238 HISPANIC HEALTH AND NUTRITIONAL STATUS TABLE 4A-5 Meclian Heights and Weights for Cuban Males, Ages 2-18 Median Heights (cm) Median Age NCHS U.S.-Born Foreign-Born NCHS 2 90.4 91.4 13.5 3 99.1 101.4 97.6 15.7 4 106.6 108.6 107.2 17.7 5 113.1 113.0 112.5 19.7 6 119.0 124.1 116.0 21.7 7 124.4 127.2 129.3 24.0 8 129.6 134.2 134.0 26.7 9 134.8 134.9 140.7 29.7 10 140.3 143.4 130.7 33.3 11 146.4 147.1 144.2 37.5 12 153.0 149.8 153.7 42.3 13 159.9 162.8 152.8 47.8 14 166.2 165.6 162.8 53.8 15 171.5 172.8 171.2 59.5 16 175.2 174.2 174.7 64.4 17 176.7 175.7 170.3 67.8 18 176.8 184.5 171.7 68.9 TABLE 4A-6 Meclian Heights and Weights for Cuban Females, Ages 2-18 Median Heights (cm)
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From page 239... ...
NCHS U.S.-Born Foreign-Born 13.5 15.7 17.7 19.7 21.7 24.0 26.7 29.7 33.3 37.5 42.3 47.8 53.8 59.5 64.4 67.8 68.9 13.7 16.6 19.5 20.0 27.6 28.2 35.8 32.2 41.2 52.8 39.5 51.4 52.6 58.6 58.3 65.6 84.2 16.3 17.2 23.3 18.7 31.8 33.0 40.1 29.3 40.6 35.8 47.6 52.4 65.4 65.4 65.3 64.4 2-18 orn Median Weights (kg) NCHS U.S.-Born Foreign-Born 13.0 15.1 16.8 18.6 20.6 23.3 26.6 30.4 34.7 39.2 43.8 48.3 52.1 55.0 56.4 56.7 56.6 12.4 16.5 17.6 20.6 26.3 25.4 34.4 36.2 41.0 45.6 49.4 44.4 55.6 55.2 49.9 51.0 52.1 20.6 16.2 22.1 25.2 24.4 28.6 27.0 38.5 49.9 42.6 49.3 56.6 48.7 54.8 57.8
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From page 240... ...
240 HISPANIC HEALTH AND NUTRITIONAL STATUS TABLE 4A-7 Bocly Mass Index and Percentage of BMI Above the 90th Percentile for Mexican American Chilclren and Aclolescents U.S Born with U.S.-Born Parents Age (years) U.S Born BMI Reference % > Reference Average Median Median BMI (A ~90th Percentile Median Mexican American males 2-5 6-11 12-18 Mexican American females 2-5 6-11 12-18 16 16.1 19.8 15.6 16.4 19.8 1 5.9 (42' 20.2 (320)
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From page 241... ...
FERNANDO S MENDOZA AND LORI BETH DIXON 241 ants reference ercentile U.S Born with Foreign-Born Parents Foreign-Born % > Reference Median BMI (A ~90th Percentile % > Reference Median BMI (A ~90th Percentile 15.9 (428)
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From page 242... ...
BMI Reference Average Median Median Puerto Rican Males 2-5 16 16.0 (111 6-11 16.1 16.8 (15' 12-18 19.8 20.8 (19 Puerto Rican Females 2-5 15.6 16.1 (9 6-11 16.4 16.8 (17 12-18 19.8 21.1 (19! TABLE 4A-9 Meclian Bocly Mass Index and Percentage of BMI Above the 90th Percentile for Cuban Chilclren and Aclolescents U.S.
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From page 243... ...
Foreign Born Median BMI (N) % > Reference 90th Percentile 1 6.2~27)
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