Health Literacy in Unauthorized Mexican Immigrant Mothers and Risk of Developmental Delay in their Children
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BRIEF COMMUNICATION
Health Literacy in Unauthorized Mexican Immigrant Mothers and Risk of Developmental Delay in their Children Robin Hernandez-Mekonnen1 • Elise K. Duggan2 • Leonel Oliveros-Rosen2 Marsha Gerdes3 • Stanton Wortham4 • Jack Ludmir2,5 • Ian M. Bennett6
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Ó Springer Science+Business Media New York 2015
Abstract The incidence of developmental delay and early intervention (EI) service utilization is not well documented among unauthorized Mexican immigrants, a vulnerable population. Individual interviews were conducted in Spanish with Mexican born women receiving maternal health care. Children 12–60 months of age were screened for developmental delay using the Ages and Stages Questionnaire. 12 % (n = 8) of children assessed (n = 65) were at risk for developmental delay. Of those at risk 38 % (n = 3) participated in EI. An additional 26 % of the children (n = 17) qualified for further monitoring, and of those 59 % (n = 10) received EI. Women with low health literacy had more than four times the odds of having a child with risk of developmental delay (aOR 4.4; 95 % CI 1.3–15.4). Developmental delay was associated with low maternal health literacy in unauthorized Mexican immigrants; however, rates of self-reported EI use in this population are higher than those seen nationally.
& Robin Hernandez-Mekonnen [email protected] 1
School of Social and Behavioral Sciences, Stockton University, 101 Vera King Farris Dr., Galloway, NJ 08205, USA
2
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
3
Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
4
Graduate School of Education of the University of Pennsylvania, Philadelphia, PA, USA
5
Pennsylvania Hospital, Philadelphia, PA, USA
6
Department of Family Medicine, University of Washington, Seattle, WA, USA
Keywords Immigrants Child development Health literacy Urban
Background Developmental delay in preschool age children is a critical target for health care given its potential negative impact on a child’s life course. Early detection and treatment of developmental delays with early intervention (EI) services confers maximum benefits [1]. Despite the evidence of benefit, there is a gap between early identification of developmental concern and EI service delivery, particularly for vulnerable populations [2]. While approximately 13 % of children in the general population show signs of developmental delay by 24 months of age, just 10 % of those children receive needed evaluations and about only 3 % receive services [2]. A recent evaluation of developmental screening in pediatric practices found that of 438 children in need of assessment, only 254 (60 %) were appropriately referred for EI evaluations, and only 170 (38.8 %) completed the process [3]. Unauthorized immigrants from Mexico (58 % of the total unauthorized immigrant population within the US, or 6.5 million people), are a vulnerable population likely to face difficulties in
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