The children of Latinos/as in the U.S. are a large and fast-growing demographic group at risk of experiencing adverse health outcomes in early childhood. Infants born to Latinos/as have a number of health advantages including higher birthweights, but this health paradox is not sustained into early childhood based on outcomes such as general health status and cognitive development. The recent dispersion of the Latino/a population to ?new? immigrant-receiving gateways across the U.S. in places such as North Carolina and Nebraska could further place the health of young children of Latinos/as at risk. Relative to more established gateways, new destinations pose challenges to Latino/a families due to fewer co-ethnic and institutional supports and higher levels of residential segregation. Additionally, because they encompass rural, suburban, and urban locations, new destinations may be more likely to include communities with a lower supply of health care options such as pediatricians and non-profit community clinics. This project, therefore, will address how the geographic dispersion of Latino/a families to new destinations is associated with Latino/a early childhood health disparities. The first specific aim is to compare health care supply characteristics across new and established Latino/a destinations using demographic data from the U.S. Census Bureau and publicly available data on community health care supply from the U.S. Department of Health and Human Services and National Center for Charitable Statistics. Analyses of these data will determine whether new destinations have a lower supply of health care options than established destinations. The second specific aim is to examine health disparities between young Latino/a and non-Latino/a non-immigrant white children across Latino/a destinations and to determine whether health care supply characteristics mediate and/or moderate these associations. Utilizing a database on Latino/a destinations and health care supply merged with restricted-use geocoded data on early childhood health in the National Health Interview Survey and National Health and Nutrition Examination Survey, statistical analyses will examine associations between Latino/a destinations and Latino/a early childhood health disparities, and mediation and moderation analyses will determine whether these associations are explained or vary by local health care supply.
This aim will identify the locations where Latino/a early childhood health disparities are most pronounced and the health care supply resources that can address such inequalities.
The third aim will examine whether associations between Latino/a destinations, health care supply, and early childhood health vary by Latino/a parental national origin and nativity.
This aim will further identify the types of young children within the Latino/a population who are most in need of attention in different types of locations. This project will inform research on racial/ethnic health disparities and place-based determinants of health, and will have implications for policy and practice by identifying the types of geographic areas where young children of Latinos/as are the most at risk of experiencing adverse health outcomes.

Public Health Relevance

This project investigates health disparities related to race, ethnicity, and immigrant-origin status by examining health outcomes among young children of Latinos/as across diverse health care contexts. By focusing on the associations among Latino/a destinations, community health care supply, and early childhood health, this work informs public health research on place-based disparities in access to health care resources and the implications of these disparities for population health.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Small Research Grants (R03)
Project #
Application #
Study Section
National Institute of Child Health and Human Development Initial Review Group (CHHD)
Program Officer
Chinn, Juanita Jeanne
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Texas Austin
Schools of Arts and Sciences
United States
Zip Code