Children in immigrant families now comprise 1 in 5 children in the United States. Eighty percent of them are US citizens, and 53% live in mixed-citizenship families. Their families are among the poorest, least educated, least insured, and least able to access health care. Nonetheless, these children demonstrate better-than-expected health status, a finding termed "the immigrant paradox" and one suggesting that cultural health behaviors among immigrant families might be protective in some areas of health. In this article the strength of the immigrant paradox, the effect of acculturation on health, and the relationships of acculturation, enculturation, language, and literacy skills to health disparities are reviewed. The current public policy issues that affect the health disparities of children of immigrant families are presented, and a research agenda for improving our knowledge about children in immigrant families to develop effective interventions and public policies that will reduce their health disparities is set forth. Copyright © 2009 by the American Academy of Pediatrics.

Immigrant paradox immigrant families health disparities Immigrant children health policy Acculturation

education immigrant health care policy poverty health disparity Health Status Disparities health insurance human Health Behavior Ethnic Groups priority journal health status Health Surveys language United States Humans Cross-Cultural Comparison Infant, Newborn Emigrants and Immigrants Acculturation female Infant Child, Preschool Risk Factors Review pregnancy cultural factor child health health care access Health Services Accessibility Health Policy Multilingualism Child