title: A scoping review of female disadvantage in health care use among very young children of immigrant families.
abstract: Preference for sons culminates in higher mortality and inadequate immunizations and health care visits for girls compared to boys in several countries. It is unknown if the negative consequences of son-preference persist among those who immigrate to Western, high-income countries. To review the literature regarding gender inequities in health care use among children of parents who migrate to Western, high-income countries, we completed a scoping literature review using Medline, Embase, PsycINFO and Scopus databases. We identified studies reporting gender-specific health care use by children aged 5 years and younger whose parents had migrated to a Western country. Two independent reviewers conducted data extraction and a quality assessment tool was applied to each included study. We retrieved 1547 titles, of which 103 were reviewed in detail and 12 met our inclusion criteria. Studies originated from the United States and Europe, using cross-sectional or registry-based designs. Five studies examined gender differences in health care use within immigrant groups, and only one study explored the female health disadvantage hypothesis. No consistent gender differences were observed for routine primary care visits however immunizations and prescriptions were elevated for boys. Greater use of acute health services, namely emergency department visits and hospitalizations, was observed for boys over girls in several studies. Studies did not formally complete gender-based analyses or assess for acculturation factors. Health care use among children in immigrant families may differ between boys and girls, but the reasons for why this is so are largely unexplored. Further gender-based research with attention paid to the diversity of immigrant populations may help health care providers identify children with unmet health care needs.
authors: Dalla Lana School of Public Health, Department of Epidemiology, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada; Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1W8, Canada. Electronic address: ariel.pulver@mail.utoronto.ca.
authors: Ariel
authors: A
authors: Pulver
authors: Dalla Lana School of Public Health, Department of Epidemiology, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada.
authors: Chantel
authors: C
authors: Ramraj
authors: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, 2075 Bayview Avenue, Veterans Hill Trail, Toronto, ON M4N 3M5, Canada; Departments of Medicine and Obstetrics and Gynaecology, St Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
authors: Joel G
authors: JG
authors: Ray
authors: Dalla Lana School of Public Health, Department of Epidemiology, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada; Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, 2075 Bayview Avenue, Veterans Hill Trail, Toronto, ON M4N 3M5, Canada.
authors: Patricia
authors: P
authors: O'Campo
authors: Dalla Lana School of Public Health, Department of Epidemiology, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada; Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, 2075 Bayview Avenue, Veterans Hill Trail, Toronto, ON M4N 3M5, Canada.
authors: Marcelo L
authors: ML
authors: Urquia
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012042:Registries; D012737:Sex Factors; D035862:Vulnerable Populations
keywords: Children; Ethnicity; Gender; Health inequities; Immigration; Pediatrics