CHAPTER 6
The Health Status and Risk Behaviors of Adolescents in Immigrant Families

Kathleen Mullan Harris

Immigrant children and the children of immigrants are an increasing focus of social and economic concerns in America. Language barriers, low economic status and poverty, and alien social and cultural practices stigmatize and isolate immigrant youth from mainstream youth cultures and slow the process by which immigrant youth assimilate into American society. At a time when state and federal policies seek to restrict health care services and benefits to the immigrant population, immigrant families face increasing rates of poverty and limited access to health care (Wolfe, 1994). As a result, the health status of immigrant youth and families is thought to be especially precarious (Klerman, 1993). This chapter examines the physical and emotional health status and health risk behaviors of immigrant adolescents and native-born adolescents with immigrant parents relative to adolescent health in native-born families. Generational differences are assessed by country of origin and ethnic group background, and the extent to which family and neighborhood context explains the within and across ethnic group differences in health outcomes is analyzed.

BACKGROUND

The process of immigrant assimilation and adaptation to American culture and the extent to which immigrant youth



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Children of Immigrants: Health, Adjustment, and Public Assistance CHAPTER 6 The Health Status and Risk Behaviors of Adolescents in Immigrant Families Kathleen Mullan Harris Immigrant children and the children of immigrants are an increasing focus of social and economic concerns in America. Language barriers, low economic status and poverty, and alien social and cultural practices stigmatize and isolate immigrant youth from mainstream youth cultures and slow the process by which immigrant youth assimilate into American society. At a time when state and federal policies seek to restrict health care services and benefits to the immigrant population, immigrant families face increasing rates of poverty and limited access to health care (Wolfe, 1994). As a result, the health status of immigrant youth and families is thought to be especially precarious (Klerman, 1993). This chapter examines the physical and emotional health status and health risk behaviors of immigrant adolescents and native-born adolescents with immigrant parents relative to adolescent health in native-born families. Generational differences are assessed by country of origin and ethnic group background, and the extent to which family and neighborhood context explains the within and across ethnic group differences in health outcomes is analyzed. BACKGROUND The process of immigrant assimilation and adaptation to American culture and the extent to which immigrant youth

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Children of Immigrants: Health, Adjustment, and Public Assistance achieve equally with children from nonimmigrant families has occupied much of the recent research and political discourse over immigration (Portes, 1996; Rumbaut, 1995). The standard model of immigrant progress is conceptualized as an intergenerational process (Gordon, 1964; Lieberson, 1980). The first generation of immigrants, those who were not born in the United States, are rarely expected to achieve socioeconomic parity with the native population. Learning a new language, adjusting to a different educational system, and experiencing native prejudice and hostility toward those with a foreign accent and culture are major obstacles for immigrants. The second generation, U.S.-born children of immigrants, are socialized in American schools and neighborhoods, receive a mainstream education, and obtain the skills needed to participate in the American occupational structure. Their progress is evidenced by the narrowing of the gap in various educational and socioeconomic outcomes between the second generation and the native population (Hirschman, 1996). The third generation of immigrants, native-born children with native-born parents but immigrant grandparents, are thought to differ little from the fourth or higher generations because any ethnic influence of grandparents is thought to be relatively minor in a home in which parents do not speak a foreign language and were educated and socialized in American schools and neighborhoods. This ''straight-line" model of immigrant adaptation or "Americanization" can also be applied to an intragenerational process of assimilation. The classical hypothesis argues that longer residence in the United States leads to socioeconomic progress and the narrowing of differentials with the native-born population. There is evidence of this process in the reduction of income differentials (Jasso and Rosenzweig, 1990). More specific to immigrant youth, the age at which children arrive in the United States may affect their process of adaptation. Children who arrive in their preschool years can more easily adapt to the American educational system, learn the English language, and be less stigmatized without a noticeable accent than children who arrive in this country during their adolescence. Despite the popularity and longevity of the classical model of immigrant adaptation, scholars have recently begun to question

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Children of Immigrants: Health, Adjustment, and Public Assistance this hypothesis of Americanization. Revisionist theses of immigrant adaptation have evolved from the study of "new immigrants," who since the 1960s have largely come from Asia and Latin America (Gans, 1992; Reimers, 1992; Rumbaut, 1996). One revisionist perspective focuses primarily on the changing U.S. economy and the labor market in which immigrants work. Because employment opportunities for unskilled workers contracted appreciably during the 1980s as a result of the industrial restructuring of the U.S. economy (Wilson, 1987) and the early 1980s recession (Blackburn et al., 1990; Freeman and Holzer, 1991), the recent generation of immigrants is expected to experience declining economic and social prospects, relative to previous generations. Similar to other less educated or low-income segments of the U.S. population, low-and unskilled immigrants must find work in the service sector, which provides only jobs that are low paying and lack security or avenues for advancement that previous generations of immigrants enjoyed in blue-collar work and union-supported jobs. A revisionist thesis to the classical model is the segmented assimilation thesis (Portes and Zhou, 1993). This perspective argues that the new generation of immigrants may experience different adaptation processes according to the social and economic context of the "segment" of the U.S. population in which they assimilate. As a result, greater exposure to American culture may be associated with mixed prospects for socioeconomic attainment. For instance, the classical hypothesis would argue that adolescents who arrived in the United States at a younger age and who have spent more time here will assimilate into society more readily than immigrant adolescents who arrived more recently. If, however, greater exposure to American society has primarily been in inner-city environments, where many new immigrants settle and where the social environment and economic opportunities have been declining, immigrant children with longer U.S. residence (and a younger age at arrival) may not be doing better than recent arrivals. Revisionist theories developed from renewed scholarly interest in the social and economic mobility of immigrants when the "new immigration" waves were documented in the 1990 census. Almost 20 million immigrants were counted in the 1990 census,

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Children of Immigrants: Health, Adjustment, and Public Assistance representing a smaller percentage of the total population than that recorded in the peak years of immigration in the early twentieth century but the highest absolute number of immigrants ever recorded (Farley, 1996). The most dramatic change in the contemporary waves of immigration, however, was a shift in the composition of immigrants away from Europe toward far greater representation from Asia and Latin America. Among the Asian immigrants counted in the 1990 census, more than half had arrived since 1980, and 50 percent of Latin American immigrants arrived in those 10 years as well. Among European immigrants, only 20 percent had entered the United States in the past 10 years. Moreover, the country-of-origin composition of immigrants to the United States between 1980 and 1990 shows that 90 percent of immigrants were from Asia, Latin America, and Africa. This chapter examines the health status and health risk behaviors of a population of adolescents who represent this "new immigration." Using data from a nationally representative study of adolescents in American schools in grades 7 through 12, the study includes immigrant youth who arrived in the United States between 1975 and 1994 and native-born youth of immigrant parents. Health outcomes and behaviors among foreign-born youth and native-born youth with foreign-born parents are contrasted with adolescents in native-born families (native-born youth with native-born parents). Adolescent Health, Development, and Assimilation As a minority group becomes more highly assimilated into mainstream American values and customs, changes in health-related attitudes and behaviors also may occur. Acceptance of the predominant values may make such a group more amenable to the prevailing social norms of health behaviors. The pattern of diseases characterizing the group may also shift toward that experienced by the majority group (Mendoza et al., 1990). However, behavioral changes may yield unwanted outcomes. For example, low levels of assimilation are associated with lower rates of completed suicide among Mexican Americans (Earls et al., 1990). An increasingly cited finding is that foreign-born Mexi-

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Children of Immigrants: Health, Adjustment, and Public Assistance can Americans experience lower rates of infant mortality and low birthweight than other groups (Bautista-Hayes, 1990; Landale et al., this volume). Subsequent generations of Mexican Americans appear to lose this advantage, which may be a consequence of adopting the lifestyle and habits of the dominant culture. How do assimilation theories apply to adolescents? Adolescence is often characterized as a period of turmoil and rebellion from traditional constraints associated with family, adult supervision, and institutional expectations. While much has been written about the developmental period of adolescence, how is this process of human development from a child into an adult compounded by being an immigrant or having immigrant parents? In a period where being different or "standing out" takes on crucial social significance to being accepted into peer networks and school culture, peer acceptance and blending into the current society may be even more important for immigrant adolescents, who are already different in their appearance, dress, or speech. The main socializing agents during adolescence include the family, peers, school, community, and the larger society, which all contribute uniquely to the socialization process (Dornbusch, 1989; Perry et al., 1993). Among immigrant youth, family influence can have especially poignant effects, either coddling youth within the boundaries of their ethnic culture and traditional behaviors or turning them away from their own ethnic culture and family traditions that define their difference within American society. As youth increasingly value peer friendships and peer relationships, concurrent distancing from the family origin constitutes a central task of adolescence (Perry et al., 1993). This normal developmental process of waning family involvement and increasing peer influence during adolescence may be especially alien to the cultural practices and models of respect in immigrant families and may create family tensions and divided loyalties for immigrant adolescents. For adolescents in immigrant families, development and socialization overlap with assimilation into American society, such that the sometimes rocky road of adolescence may be especially rocky for immigrant children who begin the developmental process as "more different" than adolescents in native-born families. Thus, there is an inherent tension in the adjustment process of

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Children of Immigrants: Health, Adjustment, and Public Assistance immigrant adolescents as they strive to be accepted by the majority population and at the same time cope with socializing agents in their families and neighborhoods who either wish to deter the assimilation process, which is compounded by adolescent rebellion and acting out, or facilitate it through the neighborhood influence of peers. How this tension plays out in the lives of immigrant adolescents will furthermore vary by ethnic background. ANALYSIS STRATEGY This analysis examines how ethnic background and immigrant status influence physical and emotional health status and health risk behaviors and whether family and neighborhood context explains any of the observed differences in health outcomes. Data are from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative study of over 20,000 adolescents in grades 7 through 12 in the United States in 1995 (see Appendix 6A for a more detailed description of the data and sample). This study focuses on three dimensions of health: physical health, emotional health, and health risk behaviors. Physical health outcomes are measured as dichotomous variables and include (1) fair or poor general health, (2) whether the adolescent ever missed school in the past month for a health or emotional problem, (3) learning difficulties, (4) obesity, and (5) asthma. A physical health problems index based on these five outcomes also is presented. Emotional health outcomes include two continuous indexes measuring psychological distress and positive well-being. Health risk behaviors are self-reported by the adolescent and include (1) ever having had sexual intercourse, (2) age at first intercourse, (3) use of birth control at first intercourse, (4) delinquency, (5) violence, and (6) use of controlled substances. Delinquency, violence, and use of controlled substances are measured as continuous indexes in multivariate models only, while dichotomous measures indicating high-risk involvement in these behaviors are used in descriptive analysis. A risky behaviors index based on sexual behavior, delinquency, violence, and use of controlled substances is presented as well. A detailed description of

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Children of Immigrants: Health, Adjustment, and Public Assistance the construction of these measures is contained in Appendix 6A, and sample means for health outcomes are shown in the last column of Table 6A-1. The analysis will proceed in three stages. The first stage examines differences in physical and emotional health and health risk behaviors by immigrant status. Foreign-born adolescents with foreign-born parents are those children who were not born in the United States or were born U.S. citizens abroad and thus migrated to this country as children (in most cases with their immigrant parents). Native-born adolescents with foreign-born parents are children born in the United States (and thus are U.S. citizens) but who have at least one parent who is foreign born. Adolescents in native-born families are children who were born in the United States to native-born parents. Children in native-born families may have grandparents or great-grandparents who were immigrants, but because the immigration experience is much farther removed from the social context of their childhood and adolescent development, this category is considered the native population and the fundamental comparison group for immigrant children and the children of immigrants. This stage of analysis also explores the extent to which bivariate health differentials by immigrant status are due to differences in the demographic composition of the three immigrant groups by controlling for children's age and gender. Finally; the assimilation process for immigrant children is examined by contrasting health outcomes by age at entry into the United States and length of time here. Stage two of the analysis explores whether differences in health status and risky behaviors by immigrant status persist within country of origin and ethnic background. Ethnic background is controlled by contrasting health outcomes within the country of origin for immigrant children and the children of immigrants and the parallel ethnic group identified for youth in native-born families. Ethnic group backgrounds matched to country-of-origin classifications result in the following range of ethnic groups specific to countries or regions: Mexico, Cuba, Central and South America, Puerto Rico, Africa and the Afro Caribbean, China, the Philippines, Japan, Vietnam, other Asian and Pacific

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Children of Immigrants: Health, Adjustment, and Public Assistance Islands, and Europe and Canada (see Appendix 6A for a more detailed description of classification strategies). Stage three of the analysis employs multivariate regression methods to assess the relative effects of immigrant status by ethnic group categories on the various health outcomes compared to the baseline effect for non-Hispanic white adolescents in native-born families. Subsequent regression models then explore the extent to which these effects operate through differences in family context and neighborhood context, which vary by immigrant status and ethnic group background. Family context is defined by measures of family income, family structure, mother's education, and parental supervision in the home when the adolescent goes to school, comes home from school, during evening meals, and when the adolescent goes to bed. Aspects of the neighborhood context include region and urbanicity of residence, youth's familiarity and association with neighbors, and the cohesiveness and safety of the neighborhood. For greater description of these variables and the regression methods used, see Appendix 6A. RESULTS Health Differentials by Immigrant Status If we accept the view that native-born children of immigrants have adopted the values and culture of American society more so than immigrant youth, we can observe health differentials across immigrant status as representing an assimilation process. This perspective is based on the argument that the children of immigrants represent the first members of their community to be educated and socialized in American institutions, whereas immigrant adolescents may carry with them the socialization and educational experience they received in their country of origin, depending on the age at which they entered the United States. This perspective is addressed in Table 6A-1, which examines physical health status, emotional health, and health risk behaviors of immigrant adolescents and native-born adolescents with immigrant parents in comparison to adolescents in native-born families, who are further subgrouped into native populations of non-Hispanic whites, non-Hispanic blacks, non-Hispanic other

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Children of Immigrants: Health, Adjustment, and Public Assistance races, and Hispanics. If we view generation as representing the degree of assimilation, the results indicate a pattern of increasing adoption of the mainstream behaviors of adolescents in native-born families with increasing assimilation into American culture. For nearly all of the outcomes examined, native-born youth with immigrant parents have poorer physical health and a greater propensity to engage in risky behaviors than foreign-born youth. The children of immigrants are more likely than immigrant youth to have fair or poor health (10.7 versus 9.2 percent), to have missed school because of a health or emotional problem in the past month (36.5 versus 33.5 percent), to experience learning difficulties (12.5 versus 9.3 percent), to be obese (26.7 versus 17.0 percent), to have asthma (8.1 versus 4.8 percent), to have ever had sex (33.9 versus 31.3 percent) and at a younger age (14.9 versus 15.1 percent), to engage in four or more delinquent acts (25.0 versus 15.8 percent), to be involved in three or more violent acts (21.3 versus 14.6 percent), and to use three or more controlled substances (17.4 versus 8.3 percent). Differences in the likelihood of using birth control at first intercourse and in symptoms of psychological distress or feelings of positive well-being are negligible between the two immigrant generations. Reflecting the heterogeneity of the native-born families, health outcomes vary considerably across racial and ethnic groups in the native population. In general, non-Hispanic whites have more favorable health outcomes than the other native ethnic groups. For instance, non-Hispanic whites report the lowest levels of fair or poor general health, the highest use of birth control at first intercourse, and the fewest symptoms of psychological distress across both immigrant generations and all native populations. Certain health outcomes advantage or disadvantage particular native ethnic groups. For instance, non-Hispanic blacks are the most sexually active (55 percent), with the youngest average age at first sexual intercourse (13.8), but they are the least likely among the native groups to use three or more controlled substances (8.6 percent). The native subpopulations of youth of non-Hispanic other races and Hispanic youth stand out, however, with the poorest physical health and the highest levels of risky behaviors. Moreover, knowing that the ethnic composition of immigrant children

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Children of Immigrants: Health, Adjustment, and Public Assistance and the children of immigrants largely represents the "new immigration" from Latin America and Asia, the native subpopulations represented by non-Hispanic other adolescents (largely Asian Americans) and Hispanic adolescents are most similar in their ethnic background and may represent the "segment" of the U.S. native population to which immigrant youth assimilate. If we contrast the health status and risky behaviors of foreign-born youth and native-born youth with foreign-born parents with the native populations of non-Hispanic Asian and American Indian and Hispanic adolescents, a fairly linear pattern is observed. Non-Hispanic Asian and American Indian and Hispanic native youth are more likely to report fair or poor health (14.5 and 13.1 percent, respectively) than native-born youth with foreign-born parents (10.7 percent) and foreign-born youth (9.2 percent). Similarly, non-Hispanic Asian and American Indian and Hispanic native youth are more likely to miss school because of a health or emotional problem, to have learning difficulties, to be obese, and to have asthma than native-born youth with foreign-born parents, who have the second-highest levels of health problems, and foreign-born youth, who have the lowest levels of health problems. This pattern is further reflected in the health problems index, showing that health problems increase as the immigrant experience becomes more distant by generation. A consistent linear pattern is also found for health risk behaviors. Non-Hispanic Asian and American Indian and Hispanic youth in native families are more likely to have ever had sex (39.2 and 45.3 percent, respectively) than native-born youth with foreign-born parents (33.9 percent) and foreign-born youth (31.3 percent) and to have had first intercourse at a younger age (14.4 and 14.2 years old, respectively) than native-born youth with foreign-born parents (14.9 years) and foreign-born youth (15.1 years). Similarly, non-Hispanic Asian and American Indian and Hispanic youth in native-born families are more likely to engage in delinquency, violence, and controlled substance use than native-born youth with foreign-born parents, who report the second-highest involvement in health risk behaviors, and foreign-born youth, who report the lowest involvement in risky behaviors. The risky behaviors index displays this linear pattern as well. In sum, the most striking finding from Table 6A-1 is the pat-

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Children of Immigrants: Health, Adjustment, and Public Assistance tern of assimilation displayed by the increasing health problems and increasing propensity to engage in health risk behaviors across immigrant generations of youth, especially comparing immigrant children and the children of immigrants to the native populations of non-Hispanic Asian and American Indian and Hispanic youth. Perhaps the most consistent finding, however, is that foreign-born adolescents have better physical health and engage in fewer risky behaviors, with the exception of the use of birth control at first intercourse. Foreign-born youth experience fewer physical health problems, have less experience with sex, are less likely to engage in delinquent and violent behavior, and are less likely to use controlled substances than native-born youth. Note that all of the differences reported in Table 6A-1 are statistically significant at the 0.01 level, with the exception of psychological distress and positive well-being. The findings on health status and health risk behavior are summarized in Figures 6-1 and 6-2, which show the percentage distributions on the physical health problems index (Figure 6-1) and the risky behaviors index (Figure 6-2) for foreign-born youth, native-born youth of foreign-born parents, and the native populations of non-Hispanic whites, non-Hispanic blacks, non-Hispanic other races (Asian and American Indian), and Hispanic youth. Figure 6-1 illustrates the linear relationship in physical health problems by immigrant status and the health advantage of foreign-born adolescents. The physical health problems index counts the number of health problems out of the five measured (Table 6A-1), and Figure 6-1 displays the percentage distribution with zero, one, and two or more health problems by immigrant status. Focusing on the bottom level of bars showing the percentage with no health problems, foreign-born youth have the fewest health problems, and native-born youth with foreign-born parents have the second-fewest health problems, equal with the native population of non-Hispanic whites. Non-Hispanic blacks have the next-largest percentage of youth with no health problems, followed by non-Hispanic Asian and American Indian youth; Hispanic youth have the fewest with no health problems. This same pattern is seen at the second level of bars in the percentage of youth with zero or one health problem. Conversely, the percentage with two or more health problems grows as one

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Children of Immigrants: Health, Adjustment, and Public Assistance   Delinquency Violence   1 2 3 1 2 3 Constant 0.14 0.26 0.29 0.15 0.23 0.24   (0.01) (0.02) (0.02) (0.01) (0.02) (0.02) MALE 0.04 0.04 0.04 0.10 0.10 0.10   (0.00) (0.00) (0.00) (0.00) (0.00) (0.00) AGE 0.00 0.00 0.00 0.00 -0.01 -0.01   (0.00) (0.00) (0.00) (0.00) (0.00) (0.00) MEX-FB 0.05 -0.03 -0.05 0. 00 -0.02 -0.03   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) MEX-NB/FB 0.02 0.03 0.02 0.04 0.03 0.02   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) MEX-NB 0.04 0.04 0.03 0.08 0.07 0.06   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) CUB-FB -0.06 -0.05 -0.04 -0.03 -0.05 -0.05   (0.01) (0.01) (0.01) (0.01) (0.01) (0.02) CUB-NB/FB 0.00 0.00 0.02 0.01 0.00 0.00   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) CUB-NB 0.01 0.00 0.00 0.02 0.01 0.01   (0.04) (0.03) (0.03) (0.04) (0.03) (0.03) CSA-FB -0.03 -0.03 -0.03 -0.01 -0.03 -0.03   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) CSA-NB/FB 0.02 0.02 0.01 0.04 0.03 0.02   (0.02) (0.02) (0.02) (0.02) (0.02) (0.02) CSA-NB 0.07 0.07 0.05 0.06 0.05 0.04   (0.02) (0.02) (0.02) (0.02) (0.02) (0.02) PR-IB 0.00 0.00 0.00 0.04 0.03 0.02   (0.03) (0.03) (0.03) (0.03) (0.03) (0.03) PR-MB/IB 0.03 0.03 0.02 0.08 0.06 0.05   (0.02) (0.02) (0.02) (0.02) (0.02) (0.02) PR-MB 0.04 0.04 0.02 0.10 0.08 0.07   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) CHIN-FB -0.03 -0.03 -0.03 -0.03 -0.03 -0.03   (0.03) (0.03) (0.03) (0.03) (0.03) (0.03) CHIN-NB/FB -0.04 -0.03 -0.03 -0.07 -0.05 -0.04   (0.02) (0.02) (0.02) (0.02) (0.02) (0.02) CHIN-NB 0.01 0.01 0.00 -0.05 -0.04 -0.04   (0.03) (0.03) (0.03) (0.03) (0.03) (0.03)

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Children of Immigrants: Health, Adjustment, and Public Assistance   Asthma Ever Had Sex   1 2 3 1 2 3 PHIL-FB -0.67 -0.61 -0.80 -0.58 -0.46 -0.37   (0.29) (0.29) (0.29) (0.14) (0.14) (0.15) PHIL-NB/FB -0.16 -0.15 -0.39 -0.16 -0.06 0.01   (0.23) (0.23) (0.24) (0.12) (0.13) (0.13) PHIL-NB 0.72 0.57 0.45 0.33 0.22 0.27   (0.29) (0.31) (0.32) (0.18) (0.19) (0.20) OTAS-FB -1.30 -1.22 -1.28 -1.21 -1.19 -1.19   (0.51) (0.51) (0.51) (0.28) (0.29) (0.30) OTAS-NB/FB -0.33 -0.31 -0.39 -0.12 -0.07 -0.01   (0.25) (0.25) (0.25) (0.13) (0.13) (0.14) OTAS-NB 0.22 0.15 -0.07 0.16 0.17 0.19   (0.27) (0.27) (0.28) (0.16) (0.16) (0.17) AFR-FB -1.18 -1.09 -1.12 -0.30 -0.33 -0.32   (0.72) (0.72) (0.73) (0.25) (0.25) (0.26) AFR-NB/FB -0.66 -0.67 -0.81 -0.28 -0.31 -0.22   (0.42) (0.42) (0.46) (0.19) (0.19) (0.20) AFR-NB 0.12 0.09 0.12 0.50 0.38 0.36   (0.06) (0.06) (0.07) (0.03) (0.03) (0.04) EUR-FB -0.13 -0.06 -0.07 -0.19 -0.24 -0.31   (0.53) (0.53) (0.54) (0.32) (0.36) (0.38) EUR-NB/FB -0.55 -0.52 -0.56 -0.23 -0.13 -0.12   (0.23) (0.23) (0.23) (0.12) (0.12) (0.12) INC16   0.10 0.14   0.10 0.07     (0.09) (0.09)   (0.05) (0.05) INC30   0.04 0.07   0.06 0.03     (0.08) (0.08)   (0.04) (0.04) INC50   -0.01 0.01   0.02 0.00     (0.07) (0.07)   (0.04) (0.04) INCMISS   -0.07 -0.06   -0.05 -0.08     (0.08) (0.09)   (0.05) (0.05) STEP   0.03 0.02   0.33 0.34     (0.06) (0.07)   (0.04) (0.04) MOTHONLY   0.14 0.12   0.23 0.25     (0.07) (0.07)   (0.04) (0.04) FATHONLY   -0.06 -0.07   0.24 0.25     (0.16) (0.16)   (0.08) (0.08) OTHER   -0.01 -0.02   0.42 0.41     (0.14) (0.14)   (0.07) (0.07)

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Children of Immigrants: Health, Adjustment, and Public Assistance   Delinquency Violence   1 2 3 1 2 3 PHIL-FB 0.01 0.01 -0.01 -0.01 -0.01 -0.01   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) PHIL-NB/FB 0.06 0.06 0.04 0.01 0.02 0.02   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) PHIL-NB 0.00 -0.01 -0.03 0.00 -0.01 -0.01   (0.02) (0.02) (0.02) (0.02) (0.02) (0.02) OTAS-FB -0.01 0.00 -0.01 -0.01 -0.01 -0.01   (0.02) (0.02) (0.02) (0.02) (0.02) (0.02) OTAS-NB/FB 0.04 0.04 0.03 0.04 -0.04 0.04   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) OTAS-NB 0.03 0.02 0.01 0.02 0.02 0.01   (0.02) (0.02) (0.02) (0.02) (0.02) (0.02) AFR-FB -0.08 -0.09 -0.10 0.00 -0.02 -0.02   (0.03) (0.03) (0.03) (0.03) (0.03) (0.03) AFR-NB/FB -0.03 -0.03 -0.04 0.03 0.02 0.02   (0.02) (0.02) (0.02) (0.02) (0.02) (0.02) AFR-NB -0.02 -0.03 -0.02 0.06 0.04 0.04   (0.00) (0.00) (0.00) (0.00) (0.00) (0.00) EUR-FB -0.06 -0.06 -0.07 -0.05 -0.05 -0.05   (0.03) (0.03) (0.03) (0.03) (0.03) (0.03) EUR-NB/FB 0.00 0.00 0.00 -0.02 -0.01 -0.02   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) INC16   0.00 0.00   0.04 0.04     (0.01) (0.01)   (0.01) (0.01) INC30   -0.01 -0.01   0.02 0.02     (0.00) (0.00)   (0.00) (0.00) INC50   -0.01 -0.01   0.01 0.01     (0.00) (0.00)   (0.00) (0.00) INCMISS   -0.03 -0.03   0.00 0.00     (0.01) (0.00)   (0.01) (0.01) STEP   0.02 0.02   0.03 0.03     (0.00) (0.00)   (0.00) (0.00) MOTHONLY   0.02 0.01   0.02 0.02     (0.00) (0.00)   (0.00) (0.00) FATHONLY   0.03 0.03   0.04 0.04     (0.01) (0.01)   (0.01) (0.01) OTHER   0.03 0.03   0.04 0.04     (0.01) (0.01)   (0.01) (0.01)

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Children of Immigrants: Health, Adjustment, and Public Assistance   Asthma Ever Had Sex   1 2 3 1 2 3 HS   0.00 -0.03   -0.04 -0.04     (0.08) (0.08)   (0.04) (0.04) SOMECOLL   0.20 0.16   -0.12 -0.10     (0.08) (0.08)   (0.04) (0.04) COLLPLUS   0.06 0.05   -0.28 -0.25     (0.09) (0.09)   (0.05) (0.05) PPRESIND   0.03 0.04   -0.14 -0.14     (0.03) (0.03)   (0.01) (0.01) URBAN     -0.04     -0.13       (0.08)     (0.04) SUBURBAN     -0.05     -0.02       (0.07)     (0.04) WEST     0.26     -0.07       (0.07)     (0.04) NRTHEAST     0.16     -0.06       (0.08)     (0.05) SOUTH     -0.13     0.03       (0.07)     (0.04) NFAM     0.07     0.20       (0.06)     (0.03) LOOKOUT     0.03     -0.10       (0.06)     (0.03) NSAFE     -0.14     -0.07       (0.08)     (0.04) N     16751     16891 -2 LOG L     11977     52918 Adjusted R             prob     0.0001     0.0001

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Children of Immigrants: Health, Adjustment, and Public Assistance   Delinquency Violence   1 2 3 1 2 3 HS   -0.01 -0.01   -0.02 -0.02     (0.00) (0.00)   (0.00) (0.00) SOMECOLL   0.01 0.01   -0.02 -0.02     (0.00) (0.00)   (0.00) (0.00) COLLPLUS   0.00 0.00   -0 .04 -0.03     (0.01) (0.01)   (0.01) (0.01) PPRESIND   -0.03 -0.03   -0.02 -0.02     (0.00) (0.00)   (0.00) (0.00) URBAN     0.01     0.01       (0.00)     (0.00) SUBURBAN     0.01     0.01       (0.00)     (0.00) WEST     0.01     0.01       (0.00)     (0.00) NRTHEAST     0.01     0.01       (0.00)     (0.00) SOUTH     -0.03     -0.01       (0.00)     (0.00) NFAM     0.03     0.04       (0.00)     (0.00) LOOKOUT     -0.03     -0.02       (0.00)     (0.00) NSAFE     -0.03     -0.05       (0.00)     (0.00) n     16815     16821 -2 LOG L             Adjusted R     0.06     0.12 prob     0.0001     0.0001

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Children of Immigrants: Health, Adjustment, and Public Assistance   General Health Fair/Poor Missed School   1 2 3 1 2 3 Constant -3.27 -2.62 -2.04 -0.71 -0.51 -0.41   (0.24) (0.29) (0.31) (0.15) (0.18) (0.20) MALE -0.33 -0.31 -0.31 -0.37 -0.36 -0.37   (0.05) (0.05) (0.05) (0.03) (0.03) (0.03) AGE 0.07 0.05 0.04 0.01 0.01 0.01   (0.02) (0.02) (0.02) (0.01) (0.01) (0.01) MEX-FB 0.61 0.24 0.16 -0.06 -0.18 -0.39   (0.20) (0.21) (0.22) (0.15) (0.16) (0.16) MEX-NB/FB 0.82 0.49 0.43 0.39 0.28 0.09   (0.12) (0.12) (0.14) (0.09) (0.09) (0.10) MEX-NB 0.61 0.42 0.34 0.32 0.24 0.11   (0.13) (0.13) (0.14) (0.09) (0.09) (0.10) CUB-FB -0.03 -0.46 -0.49 0.08 -0.10 -0.09   (0.26) (0.28) (0.29) (0.15) (0.16) (0.17) CUB-NB/FB 0.13 -0.22 -0.19 0.18 0.10 0.14   (0.23) (0.24) (0.25) (0.14) (0.14) (0.15) CUB-NB -0.33 -0.26 -0.23 0.14 0.20 0.22   (0.73) (0.74) (0.74) (0.37) (0.38) (0.38) CSA-FB 0.45 0.03 0.02 0.06 -0.05 -0.12   (0.21) (0.23) (0.23) (0.14) (0.15) (0.16) CSA-NB/FB 0.35 0.13 0.17 -0.35 -0.46 -0.50   (0.25) (0.26) (0.26) (0.18) (0.18) (0.18) CSA-NB 0.38 0.28 0.21 0.34 0.23 0.10   (0.26) (0.27) (0.27) (0.17) (0.18) (0.18) PR-IB 0.43 0.29 0.13 0.08 0.04 0.09   (0.48) (0.49) (0.54) (0.32) (0.33) (0.34) PR-MB/IB 0.88 0.66 0.66 0.57 0.48 0.41   (0.23) (0.24) (0.25) (0.18) (0.18) (0.19) PR-MB 0.56 0.32 0.27 0.35 0.24 0.17   (0.17) (0.18) (0.19) (0.12) (0.12) (0.13) CHI N-FB -0.43 -0.45 -0.49 -1.08 -1.05 -1.07   (0.60) (0.60) (0.60) (0.39) (0.39) (0.39) CHIN-NB/FB -0.86 -0.57 -0.56 -0.85 -0.72 -0.78   (0.59) (0.59) (0.59) (0.29) (0.29) (0.29) CHIN-NB 0.58 0.58 0.52 -0.08 -0.15 -0.34   (0.41) (0.44) (0.45) (0.30) (0.31) (0.31)

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Children of Immigrants: Health, Adjustment, and Public Assistance   Learning Difficulties Obesity   1 2 3 1 2 3 Constant -2.29 -2.51 -2.55 -0.36 -0.31 -0.18   (0.20) (0.24) (0.26) (0.16) (0.20) (0.22) MALE 0.65 0.67 0.68 0.31 0.33 0.32   (0.04) (0.04) (0.05) (0.04) (0.04) (0.04) AGE 0.02 0.02 0.03 -0.06 -0.07 -0.06   (0.01) (0.01) (0.01) (0.01) (0.01) (0.01) MEX-FB -1.02 -1.27 -1.45 0.03 -0.27 -0.20   (0.28) (0.28) (0.29) (0.18) (0.19) (0.20) MEX-NB/FB -0.32 -0.55 -0.69 0.57 0.37 0.41   (0.13) (0.13) (0.14) (0.09) (0.10) (0.11) MEX-NB 0.11 -0.02 -0.17 0.53 0.43 0.45   (0.11) (0.12) (0.12) (0.09) (0.10) (0.10) CUB-FB -0.52 -0.93 -1.03 -0.05 -0.25 -0.20   (0.24) (0.25) (0.27) (0.18) (0.19) (0.19) CUB-NB/FB 0.06 -0.10 -0.12 0.31 0.16 0.23   (0.17) (0.18) (0.18) (0.15) (0.15) (0.16) CUB-NB -0.69 -0.70 -0.76 0.44 0.54 0.57   (0.61) (0.62) (0.62) (0.38) (0.39) (0.39) CSA-FB -0.52 -0.86 -0.97 -0.09 -0.25 -0.19   (0.22) (0.24) (0.24) (0.17) (0.18) (0.18) CSA-NB/FB -0.09 -0.24 -0.41 0.17 0.08 0.16   (0.22) (0.22) (0.23) (0.18) (0.19) (0.19) CSA-NB 0.29 0.16 0.01 -0.15 -0.13 -0.11   (0.21) (0.22) (0.22) (0.21) (0.21) (0.21) PR-IB 0.15 -0.14 -0.26 0.29 0.21 0.33   (0.40) (0.42) (0.43) (0.35) (0.35) (0.35) PR-MB/IB 0.15 -0.06 -0.48 0.81 0.69 0.79   (0.23) (0.23) (0.25) (0.18) (0.18) (0.19) PR-MB 0.04 -0.13 -0.42 0.36 0.28 0.34   (0.16) (0.16) (0.17) (0.13) (0.13) (0.14) CHIN-FB -1.68 -1.59 -1.68 -1.03 -1.05 -1.00   (0.72) (0.72) (0.73) (0.47) (0.47) (0.47) CHIN-NB/FB -2.93 -2.73 -2.77 -1.26 -1.20 -1.31   (1.01) (1.01) (1.01) (0.40) (0.40) (0.43) CHIN-NB -0.85 -0.73 -0.85 -0.30 -0.31 -0.26   (0.52) (0.53) (0.53) (0.35) (0.37) (0.37)

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Children of Immigrants: Health, Adjustment, and Public Assistance   General Health Fair/Poor Missed School   1 2 3 1 2 3 PHIL-FB -0.14 0.08 -0.18 0.42 0.44 0.17   (0.26) (0.27) (0.28) (0.14) (0.15) (0.15) PHIL-NB/FB 0.38 0.63 0.49 0.26 0.32 0.12   (0.22) (0.22) (0.23) (0.14) (0.15) (0.15) PHI L-N B 1.26 1.05 0.88 0.58 0.52 0.33   (0.28) (0.31) (0.32) (0.24) (0.25) (0.26) OTAS-FB -0.18 -0.31 -0.48 -0.22 -0.14 -0.19   (0.37) (0.40) (0.43) (0.21) (0.21) (0.21) OTAS-NB/FB 0.39 0.44 0.38 0.08 0.10 -0.02   (0.23) (0.23) (0.23) (0.15) (0.15) (0.15) OTAS-NB 0.46 0.49 0.34 0.31 0.30 0.07   (0.29) (0.29) (0.31) (0.19) (0.19) (0.20) AFR-FB -1.62 -1.79 -1.78 0.16 0.03 0.06   (1.01) (1.02) (1.02) (0.29) (0.30) (0.30) AFR-NB/FB -0.14 -0.18 -0.07 -0.06 -0.07 -0.13   (0.40) (0.40) (0.41) (0.22) (0.22) (0.24) AFR-NB 0.42 0.18 0.18 0.14 0.02 0.01   (0.06) (0.07) (0.07) (0.04) (0.04) (0.05) EUR-FB -0.45 -0.33 -0.40 -0.62 -0.67 -0.90   (0.73) (0.74) (0.74) (0.40) (0.43) (0.46) EUR-NB/FB -0.62 -0.49 -0.50 -0.09 -0.03 -0.05   (0.29) (0.29) (0.29) (0.13) (0.13) (0.13) INC16   0.52 0.50   0.21 0.22     (0.09) (0.10)   (0.06) (0.06) INC30   0.42 0.41   0.15 0.16     (0.09) (0.09)   (0.05) (0.05) INC50   0.09 0.09   0.10 0.10     (0.08) (0.08)   (0.05) (0.05) INCMISS   0.23 0.22   0.06 0.07     (0.09) (0.09)   (0.06) (0.06) STEP   0.19 0.20   0.11 0.10     (0.07) (0.07)   (0.04) (0.04) MOTHONLY   0.27 0.25   0.19 0.17     (0.07) (0.07)   (0.05) (0.05) FATHONLY   0.44 0.42   0.18 0.16     (0.15) (0.15)   (0.10) (0.10)

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Children of Immigrants: Health, Adjustment, and Public Assistance   Learning Difficulties Obesity   1 2 3 1 2 3 PHIL-FB -1.21 -1.27 -1.43 -0.76 -0.67 -0.71   (0.30) (0.33) (0.33) (0.22) (0.22) (0.23) PHIL-NB/FB -1.02 -0.91 -1.06 -0.06 0.02 0.02   (0.27) (0.28) (0.29) (0.17) (0.17) (0.18) PHIL-NB -0.28 -0.31 -0.51 0.14 0.06 -0.04   (0.34) (0.36) (0.39) (0.28) (0.29) (0.31) OTAS-FB -0.21 -0.25 -0.36 -1.18 -1.28 -1.22   (0.27) (0.28) (0.29) (0.35) (0.37) (0.37) OTAS-NB/FB -0.74 -0.66 -0.76 0.32 0.30 0.35   (0.25) (0.25) (0.25) (0.16) (0.16) (0.16) OTAS-NB -0.66 -0.63 -0.69 0.09 0.14 0.07   (0.32) (0.32) (0.32) (0.22) (0.22) (0.23) AFR-FB -0.51 -0.80 -0.93 -0.52 -0.66 -0.83   (0.44) (0.48) (0.48) (0.41) (0.44) (0.48) AFR-NB/FB 0.02 -0.07 -0.10 0.18 0.20 0.19   (0.29) (0.30) (0.30) (0.25) (0.25) (0.26) AFR-NB -0.18 -0.38 -0.40 0.34 0.26 0.26   (0.06) (0.06) (0.06) (0.04) (0.05) (0.05) EUR-FB -0.30 -0.25 -0.32 -2.35 -2.27 -2.22   (0.48) (0.49) (0.50) (1.02) (1.02) (1.02) EUR-NB/FB -0.16 -0.04 -0.12 -0.38 -0.37 -0.35   (0.17) (0.17) (0.18) (0.16) (0.16) (0.16) INC16   0.35 0.38   0.23 0.21     (0.08) (0.08)   (0.07) (0.07) INC30   0.27 0.30   0.20 0.17     (0.07) (0.07)   (0.06) (0.06) INC50   -0.01 0.01   0.16 0.15     (0.06) (0.06)   (0.05) (0.05) INCMISS   0.02 0.03   0.01 0.00     (0.08) (0.08)   (0.06) (0.06) STEP   0.45 0.45   -0.15 -0.15     (0.06) (0.06)   (0.05) (0.05) MOTHONLY   0.40 0.36   0.05 0.05     (0.06) (0.06)   (-0.05) (-0.05) FATHONLY   0.30 0.30   -0.02 -0.02     (0.13) (0.13)   (0.11) (0.12)

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Children of Immigrants: Health, Adjustment, and Public Assistance   General Health Fair/Poor Missed School   1 2 3 1 2 3 OTHER   0.27 0.23   0.29 0.26     (0.13) (0.14)   (0.09) (0.09) HS   -0.31 -0.31   -0.10 -0.11     (0.07) (0.07)   (0.05) (0.05) SOMECOLL   -0.45 -0.47   -0.11 -0.14     (0.08) (0.08)   (0.05) (0.05) COLLPLUS   -0.83 -0.82   -0.27 -0.28     (0.10) (0.10)   (0.06) (0.06) PPRESIND   -0.09 -0.09   -0.04 -0.04     (0.03) (0.03)   (0.02) (0.02) URBAN     -0.29     0.11       (0.09)     (0.05) SUBURBAN     -0.13     0.06       (0.08)     (0.05) WEST     0.22     0.24       (0.09)     (0.05) NRTHEAST     0.17     -0.01       (0.09)     (0.06) SOUTH     0.10     -0.12       (0.08)     (0.04) NFAM     -0.09     0.15       (0.06)     (0.04) LOOKOUT     -0.20     -0.16       (0.06)     (0.04) NSAFE     -0.33     -0.16       (0.07)     (0.05) N     16892     16847 -2 LOG L     10255     21477 Adjusted R2             prob     0.0001     0.0001 NOTE: Bolded coefficients statistically significant at the .05 level or less.

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Children of Immigrants: Health, Adjustment, and Public Assistance   Learning Difficulties Obesity   1 2 3 1 2 3 OTHER   0.32 0.24   0.12 0.15     (0.12) (0.13)   (0.10) (0.10) HS   -0.31 -0.30   -0.12 -0.11     (0.07) (0.07)   (0.06) (0.06) SOMECOLL   -0.29 -0.29   -0.19 -0.17     (0.07) (0.07)   (0.06) (0.06) COLLPLUS   -0.43 -0.42   -0.33 -0.31     (0.08) (0.08)   (0.06) (0.07) PPRESIND   0.07 0.08   0.02 0.02     (0.02) (0.02)   (0.02) (0.02) URBAN     0.21     -0.25       (0.07)     (0.06) SUBURBAN     0.15     -0.13       (0.06)     (0.05) WEST     0.20     0.07       (0.07)     (0.06) NRTHEAST     0.31     0.08       (0.07)     (0.06) SOUTH     -0.03     0.12       (0.06)     (0.05) NFAM     0.06     -0.01       (0.05)     (0.04) LOOKOUT     0.04     -0.06       (0.05)     (0.04) NSAFE     -0.45     -0.07       (0.07)     (0.06) N     16684     16470 -2 LOG L     13553     18109 Adjusted R2             prob     0.0001     0.0001