Variation in state safety-net inclusivity and the health and well-being of children and parents in immigrant households

This study examined to what extent state variation in noncitizen eligibility for safety-net benefits predicts immigrant families’ access to resources for meeting basic needs and the health and well-being of young children and parents in these families. Drawing on nationally and state representative data from the 2019 and 2020 National Survey of Children’s Health, our analysis focused on a sample of 2,233 children ages 0–11 and their parents in immigrant households with income below 200% of the federal poverty threshold. Regression analyses were used to investigate whether a measure of state-level immigrant safety-net inclusivity (i.e., index of 12 state-funded public benefit policies) predicted family access to resources, child health and well-being, and parent physical and mental health. Analyses controlled for multiple child, parent, household, community, and state-level characteristics, and included appropriate sampling weights. Similar to other scholars, we found that immigrant families living in more inclusive states received more means-tested public assistance programs, were more likely to be food secure and have adequate and continuous child health insurance coverage and were less likely to experience financial struggles and forgo necessary healthcare for their child. Immigrant families living in states with more inclusive safety net policies were less likely to report poor child physical health, child anxiety problems, and child behavioral problems and reported higher levels of child flourishing. Fewer significant associations were found for parent outcomes; inclusive state policies were associated with a lower likelihood of poor physical health among mothers. Together, these findings join other work highlighting the potential role of more immigrant-inclusive safety net programs in promoting health and well-being for children and families.