Nativity and cognitive disability among children: a unique comparison with reduced selection bias

Results: Self-reported cognitive disability was observed in 1.7 % of the sample. The prevalence was higher among first second-generation immigrants than among second first-generation immigrants (1.9 vs 1.1 %, p < 0.001). After multivariate adjustment, the advantage of being foreign-born remained (OR = 0.63, 95 % CI = 0.53–0.75). Further analysis revealed effect modification of the immigrant health advantage by household income (p = 0.003).

Conclusions: We observed an immigrant advantage in self-reported cognitive disability; however, it was only evident among economically disadvantaged children. Future research should examine the contribution of the accumulation of poverty over time to the relationship between nativity and children’s health.

Objectives: We examined the impact of nativity on self-reported cognitive disability by comparing children who were born outside of the USA (first-generation immigrants) with US-born offspring (second-generation immigrants) of foreign-born parents.

Methods: We analyzed a diverse, nationally representative, sample of 77,324 first-generation immigrant and second-generation immigrant children (aged 5–17 years) from the 2009 American Community Survey. Multivariate logistic regression was used to assess the association between nativity and self-reported cognitive disability after adjustment for demographics and household characteristics.