Means-Tested Safety Net Programs and Hispanic Families: Evidence from Medicaid, SNAP, and WIC

Hispanic families have historically used means-tested assistance less than high-poverty peers, and one explanation for this may be that anti-immigrant politics and policies are a barrier to program participation. We document the participation of Hispanic children in three antipoverty programs by age and parental citizenship and the correlation of participation with state immigrant-based restrictions. Hispanic citizen children with citizen parents participate in Supplemental Nutrition Assistance Program (SNAP) and Medicaid more than Hispanic citizen children with noncitizen parents. Foreign-born Hispanic mothers use Medicaid less than their socioeconomic status would suggest. However, little evidence exists that child participation in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) varies by mother’s nativity: foreign-born mothers of Hispanic infants participate in WIC at higher rates than U.S.-born Hispanic mothers. State policies that restrict immigrant program use correlate to lower SNAP and Medicaid uptake among citizen children of foreign-born Hispanic mothers. WIC participation may be greater because it is delivered through nonprofit clinics, and WIC eligibility for immigrants is largely unrestricted.

Racial/ethnic disparities in sleep in mothers and infants during the Covid-19 pandemic

ABSTRACTStudy ObjectivesTo quantify the association between race/ethnicity and maternal and infant self-reported sleep health at 4 months, exploring the role of maternal depression, stress and symptoms of trauma related to the COVID-19 pandemic as potential mediators.MethodsParticipants were recruited as part of the COVID-19 Mother Baby Outcomes (COMBO) cohort at Columbia University (N=71 non-Hispanic White, N=14 African American (AA), N=113 Hispanic, N=40 other/declined). Data on infant sleep were collected at 4 months postpartum. A subset of 149 women also completed questionnaires assessing maternal mental health and sleep. Multivariable regressions were used to separately estimate associations of race/ethnicity and mental health with multiple sleep domains for infants and mothers adjusting for individual-level covariates.ResultsCompared to non-Hispanic White, Hispanic infants slept less at night (β=- 101.7±17.6, p<0.0001) and AA and Hispanic infants went to bed later (respectively β =1.9±0.6, p<0.0001, β=1.7±0.3, p<0.0001). Hispanic mothers were less likely to perceive infant sleep as a problem (β=1.0±0.3, p=0.006). Compared to non-Hispanic White mothers, Hispanic mothers reported worse maternal sleep latency (β=1.2±0.4, p=0.002), and efficiency (β=0.8±0.4, p=0.03), but better subjective sleep quality (β=-0.7±0.4, p=0.05), and less daytime dysfunction (β=-0.8±0.4, p=0.04). Maternal mental health scores were statistically significant predictors of multiple domains of maternal sleep but did not mediate the association between race/ethnicity and sleep.ConclusionsRacial/ethnic disparities in maternal and infant sleep are observable at 4 months post-partum. Maternal stress, depression and symptoms of trauma related to the COVID-19 pandemic did not mediate these associations.

A Comparison of Weight-Related Behaviors of Hispanic Mothers and Children by Acculturation Level

Hispanic mothers and children in the United States experience a high prevalence of obesity, which may be affected by maternal acculturation level. Little is known about the association of acculturation on weight-related behaviors. This study describes differences in weight-related behaviors by acculturation level of Hispanic mothers residing in the U.S. and compares them to behaviors of White mothers. Acculturation level was determined using personal acculturation and acculturation environment variables. Cluster analysis of acculturation variables identified three groups of Hispanic mothers: low personal and environmental acculturation (n = 46), high personal and low environmental acculturation (n = 65), and high personal and environmental acculturation (n = 38). Results indicate that, compared to White mothers (n = 340), the least acculturated cluster of Hispanic mothers tended to model physical activity less often and the most acculturated exerted more pressure on children to eat. Mothers in the least acculturated cluster tended to rate children’s health status lower, indicate that children had greater fruit juice and less milk intakes, have more meals in locations associated with less healthy meals, and have the least space and supports for physical activity. Findings highlight relationships between maternal acculturation level and weight-related behaviors and suggest strategies for helping acculturating Hispanic mothers create healthier lifestyles and home environments.