The Health of Children in Immigrant Families: Key Drivers and Research Gaps through an Equity Lens.

Ayalew, Betlihem; Dawson-Hahn, Elizabeth; Cholera, Rushina; Falusi, Olanrewaju; Haro, Tamar Magarik; Montoya-Williams, Diana; Linton, Julie M

OBJECTIVE The United States (U.S.) benefits economically and socially from the diverse skill-set and innovative contributions of immigrants. By applying a socio-ecological framework with an equity lens, we aim to provide an overview of the health of children in immigrant families (CIF) in the U.S., identify gaps in related research, and suggest future areas of focus to advance health equity. METHODS The literature review consisted of identifying academic and gray literature using a MeSH Database, Clinical Queries, and relevant keywords in three electronic databases (PubMed, Web of Science, and BrowZine). Search terms were selected with goals of: 1) conceptualizing a model to of key drivers of health for CIF; 2) describing and classifying key drivers of health for CIF; and 3) identifying knowledge gaps. RESULTS The initial search produced 1,120 results which were screened for relevance using a meta-narrative approach. Of these, 224 papers were selected, categorized by topic, and reviewed in collaboration with the authors. Key topic areas included patient and family outcomes, institutional and community environments, the impact of public policy, and opportunities for research. Key inequities were identified in health outcomes; access to quality health care, housing, education, employment opportunities; immigration policies; and inclusion in and funding for research. Important resiliency factors for CIF included strong family connections and social networks. CONCLUSIONS Broad structural inequities contribute to poor health outcomes among immigrant families. While resiliency factors exist, research on the impact of certain important drivers of health, such as structural and cultural racism, is missing regarding this population. More work is needed to inform the development and optimization of programs and policies aimed at improving outcomes for CIF. However, research should incorporate expertise from within immigrant communities. Finally, interventions to improve outcomes for CIF should be considered in the context of the socio-ecological model which informs the upstream and downstream drivers of health outcomes.