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Open Access Publications from the University of California

Scholarly Works (13 results)

  • Article
On-Line Working Paper Series (2003)

This paper examines the effects of family and neighborhood factors on child health in one of the largest urban areas in the United States, Los Angeles County. We use data from a new representative survey of neighborhoods and households in L.A.—the Los Angeles Family and Neighborhood Survey, or L.A.FANS—to examine the effects of family and neighborhood characteristics on child health status. A particular focus is on differences between Latinos and other race/ethnic groups as well as differences by duration of family residence in the U.S. and other key factors. We seek to answer two questions. First, how are family background factors such immigrant status, ethnicity, and social class related to child health outcomes? Second, are there differences in health outcomes by neighborhood-level socioeconomic status, once individual and family differences are held constant? Among the child health outcomes we examine are the mother’s report of the child’s overall health status, reports of physician diagnoses of key chronic diseases (such as anemia and asthma), and, among children aged 12-17 years, body mass index adjusted for age as well as indicators of being overweight or at risk of overweight.

    Cover page: Neighborhood and Family Effects on Children's Health in Los Angeles
    • Article
    On-Line Working Paper Series (2003)

    This paper examines the effects of family and neighborhood factors on child health in one of the largest urban areas in the United States, Los Angeles County. We use data from a new representative survey of neighborhoods and households in L.A.—the Los Angeles Family and Neighborhood Survey, or L.A.FANS—to examine the effects of family and neighborhood characteristics on child health status. A particular focus is on differences between Latinos and other race/ethnic groups as well as differences by duration of family residence in the U.S. and other key factors. We seek to answer two questions. First, how are family background factors such immigrant status, ethnicity, and social class related to child health outcomes? Second, are there differences in health outcomes by neighborhood-level socioeconomic status, once individual and family differences are held constant? Among the child health outcomes we examine are the mother’s report of the child’s overall health status, reports of physician diagnoses of key chronic diseases (such as anemia and asthma), and, among children aged 12-17 years, body mass index adjusted for age as well as indicators of being overweight or at risk of overweight.

      Cover page: Neighborhood and Family Effects on Children's Health in Los Angeles
      • Article
      On-Line Working Paper Series (2003)

      In this paper, we examine recent research in the area of neighborhood effects on children’s development. We begin by reviewing the literature on the mechanisms through which neighborhoods may influence child development. Then we consider four issues which are fundamental to neighborhood effects research: (1) the definition of "neighborhood," (2) which aspects of neighborhood environments are important and how they should be measured, (3) neighborhood selection, and (4) children’s residential mobility. Next, we assess recent empirical work on neighborhood effects. Recent reviews by Sampson et al. (2002), Ginter et al. (2000), Duncan and Raudenbush (1999, 2000), and Leventhal and Brooks-Gunn (2000) catalog studies since 1990 and provide thorough reviews of their results. Rather than duplicate their efforts, we briefly summarize and compare their conclusions and then focus on the results of selected studies which provide novel approaches or insights. The final section of the paper summarizes the current state of knowledge about poor neighborhoods and their role in the intergenerational transmission of poverty.

        Cover page: Neighborhoods, Poverty and Children's Well-being: A Review
        • Article
        On-Line Working Paper Series (2002)

        In this paper, we investigate residents’ definitions of their own neighborhoods and the salience of neighborhoods for daily life in Los Angeles County. We use data from a new survey, fielded in 2000-2001, that was specifically designed to test hypotheses about neighborhood effects on children and adults. Known as the Los Angeles Family and Neighborhood Survey (or L.A.FANS), this survey collects data on approximately 40 households in each of 65 neighborhoods in Los Angeles County. As described below, respondents were asked to report on the size of their neighborhood and the geographic location of regular activities for themselves and their children (e.g., work, school, and shopping). Detailed data are also collected on family social and economic status and background as well as a variety of child and family behaviors and outcomes. In our analysis, we concentrate on locations that adult respondents spend their time, including work places, grocery stores, religious institutions, and health care providers.

          Cover page: Neighborhood Definitions and the Spatial Dimension of Daily Life in Los Angeles
          • Article
          • Peer Reviewed
          UCLA Previously Published Works (2018)
          : media-1vid110.1542/5789654354001PEDS-VA_2018-0023Video Abstract BACKGROUND AND OBJECTIVES: Adverse childhood experiences (ACEs) include stressful and potentially traumatic events associated with higher risk of long-term behavioral problems and chronic illnesses. Whether parents' ACE counts (an index of standard ACEs) confer intergenerational risk to their children's behavioral health is unknown. In this study, we estimate the risk of child behavioral problems as a function of parent ACE counts. We obtained retrospective information on 9 ACEs self-reported by parents and parent reports of their children's (1) behavioral problems (using the Behavior Problems Index [BPI]), (2) attention-deficit/hyperactivity disorder diagnosis, and (3) emotional disturbance diagnosis from the 2013 Panel Study of Income Dynamics (PSID) core interview and the linked PSID Childhood Retrospective Circumstances Study and 2014 PSID Child Development Supplement. Multivariate linear and logistic regression models were used to estimate child behavioral health outcomes by parent retrospective ACE count. Children of parents with a history of 4 or more ACEs had on average a 2.3-point (95% confidence interval [CI]: 1.3-3.2) higher score on the BPI, 2.1 times (95% CI: 1.1-3.8) higher odds of hyperactivity, and 4.2 times (95% CI: 1.7-10.8) higher odds of an emotional disturbance diagnosis than children of parents with no ACEs. Maternal ACEs revealed a stronger association with child behavior problems than paternal ACEs. Relationships between parents' 9 component ACEs individually and children's BPI scores revealed consistently positive associations. Mediation by parent emotional distress and aggravation were observed. Parents with greater exposure to ACEs are more likely to have children with behavioral health problems.
            Cover page: Parents' Adverse Childhood Experiences and Their Children's Behavioral Health Problems.
            • Article
            On-Line Working Paper Series (2004)

            Objectives: This study compares health insurance transitions between non-immigrants and immigrants.

            Methods: We use multivariate survival analysis to examine gaining and losing insurance by citizenship and legal status among adults using the Los Angeles Family and Neighborhood Survey.

            Results: There are significant differences by citizenship and legal status in health insurance transitions. Undocumented immigrants are less likely to gain and more likely to lose insurance than the native born. Legal residents are less likely to gain and border on being more likely to lose insurance than the native born. Naturalized citizens do not differ from the native born.

            Conclusions: Previous studies have not examined health insurance transitions by citizenship and legal status. Policies to increase coverage should consider the different experiences of immigrant groups.

              Cover page: Immigration Status and Health Insurance Coverage: Who Gains? Who Loses?
              • Article
              • Peer Reviewed
              UC San Francisco Previously Published Works (2015)
              To compare the association between neighborhood Latino immigrant concentration and infant mortality by maternal nativity among singleton births to Mexican-origin women in Los Angeles County. Information about births, infant deaths, and infant and maternal characteristics were obtained from geocoded Los Angeles County vital statistics records (2002-2005). Linked data on neighborhood characteristics (census tracts) were obtained from the 2000 census. Logistic regression models were used to predict infant mortality while accounting for spatial clustering by census tract. Two-thirds of births to Mexican-origin mothers were to foreign-born women. Foreign-born mothers were older, had less education, and were more likely to have delivery costs paid by Medicaid than US-born mothers. Infants born to foreign-born women had a lower infant mortality rates than infants born to US-born women (3.8/1,000 live births vs. 4.6, p = .002). Among infants of foreign-born mothers, the odds of infant mortality increased with increasing immigrant concentration (OR 1.29; 95 % CI 1.01-1.66). There was a similar pattern of association between immigrant concentration and mortality for infants of US-born mothers (OR 1.29; 95 % CI 0.99-1.67). In Los Angeles County, the odds of infant mortality among foreign-born Mexican-origin Latina were higher in higher-density immigrant neighborhoods, with a similar trend among US-born mothers. Thus, living in immigrant enclaves likely does not help to explain the lower than expected infant mortality rate among infants born to Latina women. Instead, higher neighborhood Latino immigrant concentration may indicate a neighborhood with characteristics that negatively impact maternal and infant health for Latinos.
                Cover page: Immigrant Latino Neighborhoods and Mortality Among Infants Born to Mexican-Origin Latina Women
                • Article
                • Peer Reviewed
                UCLA Previously Published Works (2021)
                We revisit a novel causal model published in Demography by Hicks et al. (2018), designed to assess whether exposure to neighborhood disadvantage over time affects children's reading and math skills. Here, we provide corrected and new results. Reconsideration of the model in the original article raised concerns about bias due to exposure-induced confounding (i.e., past exposures directly affecting future exposures) and true state dependence (i.e., past exposures affecting confounders of future exposures). Through simulation, we show that our originally proposed propensity function approach displays modest bias due to exposure-induced confounding but no bias from true state dependence. We suggest a correction based on residualized values and show that this new approach corrects for the observed bias. We contrast this revised method with other causal modeling approaches using simulation. Finally, we reproduce the substantive models from Hicks et al. (2018) using the new residuals-based adjustment procedure. With the correction, our findings are essentially identical to those reported originally. We end with some conclusions regarding approaches to causal modeling.
                  • Article
                  • Peer Reviewed
                  UCLA Previously Published Works (2019)
                  INTRODUCTION:Adverse childhood experiences are associated with higher risk of common chronic mental and physical illnesses in adulthood, but little evidence exists on whether this influences medical costs or expenses. This study estimated increases in household medical expenses associated with adults' reported adverse childhood experience scores. METHODS:Household out-of-pocket medical cost and adverse childhood experience information was collected in the 2011 and 2013 waves of the Panel Study of Income Dynamics and its linked 2014-2015 Panel Study of Income Dynamics Childhood Retrospective Circumstances Study supplement and analyzed in 2017. Generalized linear regression models estimated adjusted annual household out-of-pocket medical cost differences by retrospective adverse childhood experience count and compared costs by family type and size. Logistic models estimated odds of out-of-pocket costs that were >10% of household income or >100% of savings, as well as odds of household debt. RESULTS:Adverse childhood experience scores were associated with higher out-of-pocket costs. Annual household total out-of-pocket medical costs were $184 (95% CI=$90, $278) or 1.18-fold higher when respondents reported one to two adverse childhood experiences and $311 (95% CI=$196, $426) or 1.30-fold higher when three or more adverse childhood experiences were reported by an adult in the household. Odds of household medical costs >10% of income, >100% of savings, and the presence of household medical debt were 2.48-fold (95% CI=1.40, 4.38), 2.25-fold (95% CI=1.69, 2.99), and 2.29-fold (95% CI=1.56, 3.34) higher when an adult in the household reported three or more adverse childhood experiences compared with none. CONCLUSIONS:Greater exposure to adverse childhood experiences is associated with higher household out-of-pocket medical costs and financial burden in adulthood.
                    Cover page: Adverse Childhood Experiences and Household Out-of-Pocket Healthcare Costs.
                    • Article
                    • Peer Reviewed
                    UCLA Previously Published Works (2018)
                    Prior research has suggested that children living in a disadvantaged neighborhood have lower achievement test scores, but these studies typically have not estimated causal effects that account for neighborhood choice. Recent studies used propensity score methods to account for the endogeneity of neighborhood exposures, comparing disadvantaged and nondisadvantaged neighborhoods. We develop an alternative propensity function approach in which cumulative neighborhood effects are modeled as a continuous treatment variable. This approach offers several advantages. We use our approach to examine the cumulative effects of neighborhood disadvantage on reading and math test scores in Los Angeles. Our substantive results indicate that recency of exposure to disadvantaged neighborhoods may be more important than average exposure for children's test scores. We conclude that studies of child development should consider both average cumulative neighborhood exposure and the timing of this exposure.
                      Cover page: Sequential Neighborhood Effects: The Effect of Long-Term Exposure to Concentrated Disadvantage on Children’s Reading and Math Test Scores
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