Giving Voice to Underserved Foreign-Born Latino Youth: Trauma, Stress, and Health in the Primary Care Setting

Exposure to potentially traumatic events (PTEs) is common in the United States and may be more frequent among foreign-born Latino youth. Research has shown that PTEs negatively affect mental health outcomes, such as depression and anxiety. However, less is known about physical health outcomes during childhood and adolescence. Furthermore, foreign-born Latino youth, who are often a high-risk group, have been largely neglected in the trauma literature. Thus, the purpose of this study was to: (1) examine rates of pre-, during, and post-migration PTEs in foreign-born Latino youth and (2) assess the relationship between PTEs and markers of physical health problems (e.g., somatic symptoms, sleep problems, cardiometabolic risk factors) in the primary care setting. Furthermore, (3) key risk factors, including proximal migration-related stressors (economic stress and acculturative stress), low family functioning, and child and parent depressive symptoms were assessed as moderators of the trauma-health relationship. The mediating role of Post-traumatic Stress Disorder (PTSD) was also assessed. A total of 152 children, ages 8 to 17 [53% female, mean age=13.02 (SD=2.54), mean years in US=2.45 (SD=3.91)], and 143 parents, were recruited from a primary care clinic that provides medical services to underserved youth in the community. Youth participants completed questionnaires measuring PTEs and stressors, PTSD, depression, family functioning, and health symptoms. Parents completed questionnaires measuring their child’s PTEs and parental depression. Analyses examined the relationship between PTEs and physical health outcomes, as well as moderators and a mediator of this relationship. Results indicated high rates of PTEs for foreign-born Latino youth compared to epidemiological samples of US-born youth. Also, there was a significant, positive relationship between more PTEs and somatic symptoms, as well as sleep problems, but not BMI or blood pressure. Moderation analyses revealed greater acculturative stress and female sex were found to strengthen the relationship between PTEs and somatic symptoms, but not other health outcomes. In addition, greater PTSD symptom severity partially mediated the relationship between PTEs and somatic symptoms, as well as sleep problems. The results from this study filled a significant gap in the literature on trauma and health for Latino youth and will aid in the dissemination of trauma-related screening and treatment to clinics serving Latino immigrant youth across the United States. Further research that focuses on longitudinal analysis of how trauma and migration affects health in Latino youth, as well as moderators of the trauma-health relationship will be important