Damian Jacob Sendler On Research Investigating Citizenship, Immigration, and Adolescent Mental Health

Damian Sendler: The period of "storm and stress" that is adolescence in a child's development.[1] The risk of depression, anxiety, and other mental health issues rises with newly acquired independence, the importance of peer interaction increasing, and significant physical and mental development.[2] It is true that the onset of psychiatric illness most frequently occurs during adolescence.[3] Not only are mental health issues more likely to surface during adolescence, but they also increase the risk of adverse life outcomes, such as disability, loss of potential productivity and community contribution, lower educational achievement, and a greater propensity for risky behaviors.[4]

Given the distinct and precarious position of the foreign-born in American society, immigrant adolescents would appear to be at particularly elevated risk of developing mental health issues. Surprisingly little is known about the impact of citizenship status on the mental health status of immigrant adolescents, and much of the prior literature on immigrant mental health has treated all foreign-born adolescents as a single group. The immigrant population in the United States today is made up of naturalized Americans (44.1%), legal permanent residents (26.6%), undocumented immigrants (24.5%), and temporarily legal residents (4.8%).[5]

Damian Jacob Sendler: Even though citizenship is frequently disregarded, research on the mental health of immigrant children and adolescents has shown that being foreign-born has advantages. A 2013 study that looked at nativity differences in kids discovered that immigrant kids have lower rates of depression and behavioral issues.[6] According to a study conducted in Southern Florida, Latino high school students who were born abroad had a lower prevalence of substance use disorders than Latino high school students who were born here.[7] Another study using nationally representative data discovered that first generation immigrant youth had higher levels of positive well-being and lower levels of depression in the 1990s compared to peers who were native-born, but the advantage did not last for second generation immigrants.[8]

The mental health and wellbeing of children with undocumented parents have been examined in other academic works in this field. According to research, parents' unauthorized status presents a significant obstacle to a child's healthy development and sustains health disparities in this population. [9] Children without legal status have been the subject of studies[10], but little has been said about how citizenship affects children's and adolescents' mental health. Given that more than half of the non-citizen populations are legal immigrants, this is a significant gap in the literature. Many other significant questions are still unanswered, including how mental health outcomes change over time in the United States and whether current outcomes are different from those seen in the 1990s, when the immigrant population and immigration policy were very different.[11]

Damian Sendler: People who immigrate to the United States frequently have a low socioeconomic status and are from nations with worse population health outcomes than the United States.[12] Despite these difficulties, immigrants typically have better mortality and health outcomes than native-born people, a pattern known as the "immigrant paradox."[13] Adult immigrants typically report better mental health and lower rates of depression and anxiety than Americans of American birth.[14] These benefits are believed to be the result of a number of variables, including selective migration and a high level of social support within the community. This advantage may disappear for the second generation as more time is spent in the U.S. for many health outcomes.[15]

While immigrant communities may have some general protective factors, there are also some risk factors that are disproportionately higher among immigrants for the mental health issues that are common during adolescence. For instance, first generation immigrants are more likely to experience discrimination, peer aggression, and socioeconomic disadvantage than non-immigrant U.S. citizens and second or third generation immigrants, which has been shown to reduce psychosocial wellbeing. [16] Additionally, they experience the strain of language barriers and American acculturation.[17]

The recent debate over the Deferred Action for Childhood Arrivals (DACA) program, which the President canceled before quickly making a public statement expressing his desire to extend protections for "DREAMers," is one recent example of how difficult immigration policies are for immigrant youth to navigate.[18] It is still unclear how the protective factors underlying the "immigrant paradox" balance against the importance of citizenship status in the immigrant population given the increasing social and policy pressures immigrant adolescents experience. A person who has been granted citizenship has been formally accepted into American society. Greater access to public benefits and economic opportunities are provided by citizenship, and it may also be viewed as a sign of successful cultural assimilation. Foreign-born citizens may also experience different levels or types of prejudice than non-citizens. These elements could all play a role in the variations in adolescent mental health.

Damian Jacob Sendler: Immigration and citizenship status may be affected by race in two significant ways. First, there is a strong correlation between race and an immigrant's country of origin, which may have an impact on their mental health. The racial and ethnic composition of children and adolescents who were born abroad has changed over the past few decades as a result of increased immigration from Asia, Africa, and the Caribbean.[5] Second, immigrants must deal with an additional dimension of inequality brought on by race. It is important to take into account racial differences in the roles of nativity and citizenship in adolescent mental health because immigrant adolescents may experience racial discrimination as they integrate into the American stratification system[19].

Comparing foreign-born people to Americans, it was found that they were generally younger, less likely to have a high school diploma, more likely to be poor, heavily concentrated in the central cities of metropolitan areas, and more likely to have large families. Compared to other immigrant groups, Hispanic immigrants were the least likely to have health insurance or a regular source of medical care. Regardless of their place of origin, non-Hispanic black and non-Hispanic Hispanic adults were more likely to be obese than non-Hispanic white and non-Hispanic Asian adults. However, compared to people born in the United States, adults who are black and Hispanic immigrants are significantly less likely to be obese. The longer Hispanic immigrants stayed in the country, the more likely it was that they would be obese. Compared to their American-born counterparts, adults who were non-Hispanic black and Hispanic immigrants who were born abroad showed fewer signs of severe psychological distress.

Each racial/ethnic group's immigrant children had a lower prevalence of behavioral issues and depression than native-born kids. Children of Asian immigrants had an autism prevalence of 0.3%, whereas children of non-Hispanic white and Hispanic native-born children ranged from 1.3% to 1.4%. Asthma, attention deficit/hyperactivity disorder, developmental delay, learning disability, speech, hearing, and sleep problems, school absence, and 1 chronic condition were less common in immigrant children than native-born children, with health risks rising sharply in direct proportion to the length of time the mother spent living in the U.S. Children of immigrants were significantly less likely than native non-Hispanic white children to be exposed to environmental tobacco smoke, with odds of exposure being 60%-95% lower among immigrant non-Hispanic black, Asian, and Hispanic children. The prevalence of obesity ranged from 7.7% for native-born Asian children to 24.9%–25.1% for native-born non-Hispanic Black children and immigrant Hispanic children. Children of immigrants had higher rates of physical inactivity than children of native-born individuals; however, the rates of inactivity decreased with each new generation of immigrants. Children of Hispanic immigrants were more likely to be obese and engage in sedentary habits. Even after adjusting for covariates, ethnic-nativity differences in health and behavioral indicators persisted.

Damian Sendler: An important area of public health research and policy in the United States has long focused on tracking the scope and causes of child health disparities among various population subgroups.1–3 While information on significant health, disease, and behavioral risk factors is frequently available in the United States by gender, race/ethnicity, and socioeconomic status (SES),1-3 such data is typically not categorized according to nativity/immigrant status. In the past forty years, there has been a significant increase in the number of immigrants and foreign-born Americans. 40.4 million people identified as immigrants in 2011, an increase of 30.8 million since 1970.4–8 At present, 13.0% of all Americans are immigrants.4,8 Significant growth has also been seen in the proportion of kids whose parents were immigrants. Between 1990 and 2011, the number of children living in immigrant families in the United States more than doubled, from 8.2 million to 17.5 million.8,9 In 2011, 24.4% of American children had at least one parent who was a foreign-born citizen.8,9

The need to pay attention to immigrants' health is growing as the immigrant population's size and proportion to the overall population increase. Healthy People 2020 does not have a single policy objective that specifically addresses the health of immigrants in the United States, despite the fact that reducing social inequalities in health remains its main goal.10,11 Furthermore, "Health, United States," the nation's most authoritative and thorough annual report on health statistics, lacks any information on the country's immigrant population.1