Are immigration policies adversely affecting citizen children?
Before the family separation policy of the Trump administration created a flash point in the ongoing immigration debate, state legislatures enacted more than 1,500 pieces of increasingly punitive immigration legislation dating back to 2005. In a research paper published in the Harvard Medical Student Review, UNC School of Medicine student Sebastian Werner, synthesized existing research to outline the acute and long-term health impacts these policies have had and may continue to have on Latinx citizen-children.
In the short term, the fear of their parents facing criminal proceedings or deportation has been shown to increase anxiety, depression, and ADHD in children. Furthermore, Werner reports that increased fear of deportation could lead to a decrease in the enrollment of Latinx citizen-children in public insurance programs like Medicaid and the Children's Health Insurance Program (CHIP), benefits they are entitled to receive, just like any other citizens who meet requirements. According to Werner, the reduction in enrollment could be traced at least in part to fear that Immigration and Customs Enforcement (ICE) may apprehend personal information from applications. This fear, he said, also played a role in missed medical appointments.
"The fear of deportation and sense of discrimination transcends beyond the undocumented population," Werner said. "While immigration policies may seem targeted at the undocumented population, they affect all sorts of people, including citizens."
According to Werner, the potential for decreased enrollment in public assistance programs is highest in parts of the country with more strict deportation and detention policies. Werner fears this could create a 'lost generation' of children who lose touch with the health care system, especially in rural areas without the free or community-based health resources available in larger cities.
"As the government paints parents as criminals, it is the children who will end up facing the worst consequences," Werner said.
Werner says medical providers must do as much as possible to make certain patients feel safe in their clinics while also establishing outreach programs for this population.
"The medical community risks losing contact with a vulnerable patient population unless providers make a concerted effort to maintain hospitals and clinics as refuges for community members, regardless of immigration status," Werner wrote.
Clinics, he said, can start with making patients feel welcome through the use of language and culturally sensitive interpreting services, making clear to patients that what they share during a visit is private, and emphasizing their rights as patients. Beyond that, Werner said robust case management and social work programs should also be top priorities.
"It is the duty of the health care community to reach people. We can't just be a receptive body," Werner said. "We are doing ourselves a disservice if we don't reach out now, because we know that these patients will end up at the hospital eventually. We must establish relationships early to discuss things that will benefit children and families in the long run. And we have a duty to perform this work both in and out of our clinics."
Werner is a third-year medical student at UNC-Chapel Hill.