Generation, Language, Body Mass Index, and Activity Patterns in Hispanic Children

Background

The acculturation hypothesis proposes an overall disadvantage in health outcomes for Hispanic immigrants with more time spent living in the U.S., but little is known about how generational status and language may influence Hispanic children's relative weight and activity patterns.

Purpose

To investigate associations among generation and language with relative weight (BMI z-scores), physical activity, screen time, and participation in extracurricular activities (i.e., sports, clubs) in a U.S.-based, nationally representative sample of Hispanic children.

Methods

Participants included 2012 Hispanic children aged 6–11 years from the cross-sectional 2003 National Survey of Children's Health. Children were grouped according to generational status (first, second, or third), and the primary language spoken in the home (English versus non-English). Primary analyses included adjusted logistic and multinomial logistic regression to examine the relationships among variables; all analyses were conducted between 2008 and 2009.

Results

Compared to third-generation, English speakers, first- and second-generation, non-English speakers were more than two times more likely to be obese. Moreover, first-generation, non-English speakers were half as likely to engage in regular physical activity and sports. Both first- and second-generation, non-English speakers were less likely to participate in clubs compared to second- and third-generation, English speakers. Overall, non–English-speaking groups reported less screen time compared to third-generation, English speakers.

Conclusions

The hypothesis that Hispanics lose their health protection with more time spent in the U.S. was not supported in this sample of Hispanic children.

Introduction

Hispanics have become the largest racial/ethnic minority group in the United States, and they are projected to constitute one quarter of the total U.S. population by 2050 (2008 U.S. Census). Recently, immigrants and their U.S.-born children comprise an increasing proportion of the total U.S. population,¹ the majority of which are of Hispanic or Asian origin.² Children of immigrants have contact with multiple cultural influences, which ultimately can affect their health status and behaviors.³ Research4, 5 suggests that social, economic, and environmental factors, as well as access to health care, influence the health of populations. Studies6, 7, 8 have shown that adult immigrants tend to have better health, longer life expectancy, and lower mortality rates when compared to their U.S.-born counterparts. However, studies have also demonstrated that this health protection tends to decrease with more time spent in the U.S.

The acculturation hypothesis proposes an overall disadvantage in health outcomes for Hispanic immigrants with more time spent living in the U.S.7, 9 Acculturation has been defined as the process by which immigrants adopt the attitudes, values, customs, beliefs and behaviors of a new culture.¹⁰ Previous studies¹¹ have linked acculturation in Hispanic adults with various negative health outcomes, including obesity, low fruit and vegetable intake, high fat and sugar intake, smoking, and alcohol consumption; however, the findings relating physical activity to acculturation in this adult population have been inconsistent. Several studies12, 13, 14, 15, 16, 17, 18, 19 report a positive association between acculturation and physical activity, whereas others20, 21 have shown a relationship between higher acculturation and lower levels of physical activity in Hispanic adults. Therefore, it is not clear whether patterns of physical activity behaviors in Hispanic adults are consistent with the acculturation hypothesis. It is evident that the influence of acculturation on Hispanic health behaviors and outcomes is quite complex and not well understood.²² Although there have been many studies examining the influence of acculturation on health behaviors in adults, little is known about the effects of acculturation on health behaviors in Hispanic children.

Of the few studies that have investigated the role of acculturation on health outcomes in Hispanic youth, most have observed a relationship between acculturation and poorer health and health behaviors.23, 24, 25, 26, 27, 28 Similar to what is found in the adult and adolescent literature, there seems to be a trend for BMI to increase with subsequent generations in the U.S. for Hispanic children.23, 26, 28 However, to the authors' knowledge, very limited data exist about the screen time or extracurricular activity prevalence in Hispanic children by generation or language. Of the studies the authors identified that examine the association between acculturation and physical activity in Hispanic immigrant children, the results have been conflicting, and include a wide variety of measures to estimate acculturation or physical activity.3, 24, 26, 29, 30, 31, 32 The purpose of the present study is to investigate associations among generational status and language with relative weight (BMI z-scores), screen time, physical activity patterns, and sport and club participation in a nationally representative sample of Hispanic children aged 6–11 years living in the U.S.