Association Between Parental Nativity and Mental Health Among U.S. Adolescents: Findings from the National Health Interview Survey, 2022 - 2024

Introduction: Studies have shown a high prevalence of mental health problems among immigrants, but findings for their children are mixed. We examined the association between parental nativity and mental health among U.S. adolescents and assessed whether these associations varied by sex and race/ethnicity. Methods: We analyzed pooled cross-sectional data from the 2022-2024 National Health Interview Survey, including 12,540 adolescents aged 12-17 years. The exposure was parental nativity. The outcomes were adolescents' mental health, including anxiety, depression, behavioral difficulties, and peer relationships. Inverse probability of treatment weighting (IPTW) and nearest neighbor matching were used to control confounders. Survey-weighted logistic regression was used to estimate the association between parent nativity and each outcome. Subgroup analyses were conducted by sex and race/ethnicity. Results: Compared with adolescents with U.S.-born parents, adolescents with at least one foreign-born parent had lower odds of anxiety (Odds Ratio [OR]=0.62, 95% confidence interval [CI]: 0.54-0.71), depression (OR=0.71, 95% CI: 0.60-0.84), and behavioral difficulties (OR=0.56, 95% CI: 0.43-0.72), but not relationship difficulties (OR=0.97, 95% CI: 0.74-1.26), in the IPTW analysis. Findings from nearest-neighbor matching were consistent. In exploratory stratified analyses, inverse associations were observed among Hispanic adolescents and adolescents classified as other race/ethnicity. Conclusion: Parental nativity was associated with adolescent mental health, with adolescents of at least one foreign-born parent showing lower odds of anxiety, depression, and behavioral difficulties. Future studies are needed to clarify the underlying mechanisms and identify protective factors that help inform interventions to promote adolescent mental health.