The Healthy Immigrant Paradox and Child Maltreatment: A Systematic Review
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Prior studies suggest that foreign-born individuals have a health advantage, referred to as the Healthy Immigrant Paradox, when compared to native-born persons of the same socio-economic status. This systematic review examined whether the immigrant advantage found in health literature is mirrored by child maltreatment in general and its forms in particular. The author searched Academic Search Premier, CINAHL, CINAHL PLUS, Family and Society Studies Worldwide, MEDLINE, PsychINFO, Social Work Abstracts, and SocINdex for published literature through December 2015. The review followed an evidence-based Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist. The author identified 822 unique articles, of which 19 met the inclusion criteria. The reviewed data showed strong support for the healthy immigrant paradox for a general form of maltreatment and physical abuse. The evidence for emotional and sexual abuse was also suggestive of immigrant advantage though relatively small sample size and lack of multivariate controls make these findings tentative. The evidence for neglect was mixed: immigrants were less likely to be reported to Child Protective Services; however, they had higher rates of physical neglect and lack of supervision in the community data. The study results warrant confirmation with newer data possessing strong external validity for immigrant samples.
KeywordsChild maltreatment Immigrants Healthy immigrant paradox Systematic review Epidemiology
This research was supported by National Quality Improvement Center on Differential Response in Child Protective Services doctoral dissertation award through Administration of Children and Families, Department of Health and Human Services and the Brown Center for Violence and Injury Prevention, Washington University in St. Louis, doctoral fellowship (R49CE001510-01) through Centers for Disease Control and Prevention. Opinions expressed in the study do not necessarily reflect those of the funders. The author is grateful to Dr. Brett Drake from the Brown School of Social Work, Washington University in St. Louis, for his comments throughout the development of this manuscript.
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