child health

Immigrant Mothers of Young Children Struggle to Juggle Family Needs and their Own Health

Immigrant mothers of young children reported neglecting their own health to ensure that their children have healthcare, housing, and food in the face of a host of challenges, including chronic economic hardship, the COVID-19 pandemic, anti-immigration policies, xenophobia, and racial discrimination.

Many low-income immigrant mothers must navigate an increasingly complex sociopolitical and economic climate to ensure that they meet the household needs of their families. This is particularly true of parents to very young children, who have distinct, often expensive material needs such as formula and diapers, require close supervision, and are highly dependent on caregivers for meals, bathing, and other daily tasks.

According to a new study led by the School of Public Health, low-income immigrant mothers often neglect their own health to prioritize that of their children in the face of economic hardship and a challenging policy landscape. Published in the journal Social Science & Medicine, the study found mothers were under great strain, feeling as though they must perform “mental gymnastics” to balance the family budget and meet their children’s needs, while shielding their children from their worries about being separated through deportation.

During fall 2020, the team interviewed 30 mothers with children under the age of 6. The mothers were recruited through Children’s HealthWatch, a research and policy network that collects and analyzes data on low-income young children and families to advance public policies supportive of their health and development. Qualitative interviews conducted in English or Spanish via telephone were coded to capture emergent themes and to better understand how the participants’ physical and emotional wellbeing were impacted by their economic and political environment. The mothers were asked about their healthcare coverage, birth country, self-identified race and ethnicity, immigration status, and experiences meeting their family’s needs.

Five themes emerged during analysis of the data:

• economic strain is persistent
• government support alleviated some economic strain but brought other problems
• mothers developed strategies drawing on community and creativity to mitigate economic strain
• racism and anti-immigrant sentiment harm maternal well-being and shape access to healthcare and social service
• mothers prioritized children’s healthcare

Study lead author Stephanie Ettinger de Cuba, research associate professor of health law, policy & management and executive director of Children’s HealthWatch, notes that while more than half of the mothers had legal status in the US, that did not protect them from feeling the same deep-seated fear in the face of openly hostile political rhetoric and discrimination that mothers with more precarious status reported feeling.

“The constant worry took a serious emotional toll on all of the women, especially the Black and Afro-Latina women, jeopardizing their health as well as their children’s well-being,” says Ettinger de Cuba. “However, despite a host of challenges stacked against them, including chronic economic hardship, the COVID pandemic, and multiple anti-immigrant policy choices during the first Trump administration, immigrant mothers of young children were determined to ensure their children had the health care, housing, and food their children needed, even at the expense of their own well-being as mothers.”

While prior studies have investigated families’ efforts to meet particular household needs such as food or housing, says Ettinger de Cuba, this study was the first to look broadly at decision-making aimed at balancing multiple needs across the family, as well as the first to focus specifically on the unique vulnerability of families with young children.

“What women mostly talked about was how they fiercely protected their children and essentially ‘took the hit’ on behalf of their families,” says Ettinger de Cuba. Previous research has shown that racialized patterns in law and policies often exclude immigrants of color from the resources that would allow them to achieve financial security and enable them to take care of their own health. Public policies must build inclusive, respectful systems that account for the ways family members’ needs are intertwined, says Ettinger de Cuba, because whole communities stand to benefit when mothers are able to prioritize their own health.