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Research on behavioral functioning among Mexican-origin children primarily uses an individual-centered approach that ignores the residential context. In addition, most studies have been unable to consider an important measure of inequality for this population, legal status; and mental health of children with undocumented parents is underexplored. We address these gaps by investigating the influence of parental legal status and neighborhood characteristics on Mexican-origin children’s behavioral functioning using a multilevel approach.

We use data from the Los Angeles Family and Neighborhood Study and 2000 decennial census. Our primary focus is variation in internalizing and externalizing behavior problems among Mexican-origin youth (N = 2,535) with mothers who are undocumented, documented or naturalized citizens, or US-born using multilevel models.

The multilevel results show the importance of considering parental legal status. Mexican children of unauthorized mothers are more likely to exhibit internalizing and externalizing problems than all other groups of Mexican children. Furthermore, neighborhood-concentrated disadvantage is significantly associated with internalizing behavior problems, and neighborhood-concentrated affluence is significantly associated with externalizing behavior problems. In short, the results demonstrate the importance of considering both parental legal status and neighborhood contexts for understanding behavior problems of Mexican-origin children.

Our findings suggest that Mexican children’s mental health outcomes – measured by internalizing and externalizing behavior problems – vary significantly by parental legal status and neighborhood contexts. This study provides important nuances for public policy for health care prevention and interventions.

Recently, the institutional performance model has been used to explain the increased distrust of health care system by arguing that distrust is a function of individuals’ perceptions on the quality of life in neighborhood and social institutions. We examined (1) whether individuals assess two dimensions of distrust consistently, (2) if the multilevel institutional performance model explains the variation of distrust across neighborhoods, and (3) how distrust patterns affect preventive health care behaviors.

Using data from 9,497 respondents in 914 census tracts (neighborhoods) in Philadelphia, we examined the patterns of how individuals evaluate the competence and values distrust using the Multilevel Latent Class Analysis (MLCA), and then investigated how neighborhood environment factors are associated with distrust patterns. Finally, we used regression to examine the relationships between distrust patterns and preventive health care.

The MLCA identified four distrust patterns: Believers, Doubters, Competence Skeptics, and Values Skeptics. We found that 55 percent of the individuals evaluated competence and values distrust coherently, with Believers reporting low levels and Doubters having high levels of distrust. Competence and Values Skeptics assessed distrust inconsistently. Believers were the least likely to reside in socioeconomically disadvantaged and racially segregated neighborhoods among these patterns. In contrast to Doubters, Believers were more likely to use preventive health care, even after controlling for other socioeconomic factors including insurance coverage.

Our findings suggest that distrust patterns are a function of neighborhood conditions and distrust patterns are associated with preventive health care. This study provides important policy implications for health care and future interventions.

This chapter provides both an introduction to the volume and a brief review of literature on education and other social factors and health beliefs in health care services.

Literature review.

The chapter argues for the importance of greater examination of education, other social factors, and health beliefs in the use of health care services.

Reviews the issues of education, social factors, and beliefs and previews this volume.