Having an Adult Child in the United States, Physical Functioning, and Unmet Needs for Care among Older Mexican Adults

Background: Migration of adult children may impact the health of aging parents who remain in low-and middle-income countries. Prior studies have uncovered mixed associations between adult child migration status and physical functioning of older parents; none to our knowledge has examined the impact on unmet caregiving needs. Methods: Data come from a population-based study of Mexican adults ≥50 years. We used longitudinal targeted maximum likelihood estimation to estimate associations between having an adult child US migrant and lower-body functional limitations, and both needs and unmet needs for assistance with basic or instrumental activities of daily living (ADLs/IADLs) for 11,806 respondents surveyed over an 11-year period. Results: For women, having an adult child US migrant at baseline and 2-year follow-up was associated with fewer lower-body functional limitations [marginal risk difference (RD) =-0.14, 95% confidence interval (CI) =-0.26,-0.01] and ADLs/IADLs (RD =-0.08, 95% CI =-0.16,-0.001) at 2-year follow-up. Having an adult child US migrant at all waves was associated with a higher prevalence of functional limitations at 11-year follow-up (RD = 0.04, 95% CI = 0.01, 0.06). Having an adult child US migrant was associated with a higher prevalence of unmet needs for assistance at 2 (RD = 0.13, 95% CI = 0.04, 0.21) and 11-year follow-up for women (RD = 0.07, 95% CI =-0.02, 0.15) and 11-year follow-up for men (RD = 0.08, 95% CI = 0.00, 0.16). Conclusion: Having an adult child US migrant had mixed associations with physical functioning, but substantial adverse associations with unmet caregiving needs for a cohort of older adults in Mexico.