Eroding the healthy immigrant advantage in child mental health: The role of state-level policy climate.

Abstract

Children and youth in immigrant families benefit from the health immigrant paradox, in which immigrants display a mental health advantage over U.S.-born Americans in spite of increased socioeconomic risk. This study examined whether hostile state immigration policy contexts are associated with a weakening of this advantage and whether racial spillover effects are present for racially and ethnically minoritized youth beyond immigration background. Data were drawn from the 2023 National Survey of Children's Health and the 2022 Immigration Policy Climate index. Survey-weighted logistic regression models indicated that children with immigrant parents demonstrated a mental health advantage relative to children with U.S.-born parents. State-level immigration policy contexts moderated this association, such that children with immigrant parents experienced a modest but statistically significant increase in the likelihood of mental health problems as policy hostility increased compared to nonimmigrant children. Evidence for a racial spillover effect was present for Asian and Pacific Islander children who experienced a modest increase in odds of mental health issues as policy hostility increased, regardless of their own immigration status. Overall, these findings suggest the presence of the healthy immigrant advantage for child and youth mental health while complicating this narrative by finding that this advantage modestly decreases as state-level immigration policy hostility increases. Findings highlight the need for a more contextualized understanding of child mental health and for greater attention to political environments in clinical mental health care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).