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Immigrant Child Health Principles

   

One in four children in the United States lives in an immigrant family, and children in immigrant families account for all of the growth in the child population over the last decade.Immigrant children may be foreign-born or born in the United States and living with at least one foreign-born parent. While there is diversity across and within immigrant populations, common challenges related to health care access and health outcomes exist.

Some immigrant populations may also be impacted by additional challenges to health and well-being based on their immigration experience, separation from family members or adjustment to a new environment. The following principles provide guidance for the AAP’s advocacy on immigrant child health, particularly low-income and vulnerable populations.
  1. Every child including all immigrant children must have access to health care including a medical home, a primary care pediatrician, pediatric medical subspecialists, pediatric surgical specialists, pediatric mental and dental professionals, social workers, and hospitals with appropriate pediatric expertise.
  2. Barriers to children’s enrollment in health insurance should be removed regardless of immigration status. Policies that impose waiting periods, restrict eligibility, or impede enrollment should be eliminated. Immigrant children should have access to all public health insurance programs including Medicaid, CHIP, and programs within state health insurance exchanges.
  3. In the health care setting, qualified interpretation/translation services should be universally available and covered by health insurance in order to ensure that families receive the interpretation/translation services required by law. The use of children as family interpreters should be avoided.
  4. A health care facility or a patient’s medical record should not be used in any immigration enforcement action.
  5. The health, well-being, and safety of the child should be paramount in all immigration proceedings. Whenever possible the separation of a child from his/her family and home environment should be prevented and family reunions should be expedited.
  6. In no circumstances should a child have to represent him or herself in an immigration proceeding.

  7. In the case of deportation, protocols should be in place for parents to transfer guardianship to another adult and to have adequate and ongoing communication with the child(ren). Protocols should be developed to allow parents to contact an attorney, legal guardian, care-taker, physician and/or welfare agency. Law enforcement procedures should take into consideration the mental and physical impact of the deportation process on children.
  8. Children must have access to public education at all education levels regardless of family immigration status. Particular attention should be placed on providing early learning opportunities for immigrant children to support child development and later academic success.


Acknowledgements:

Immigrant Health Special Interest Group Steering Committee:

  • Ricky Choi MD, MPH, FAAP; Chair, Immigrant Health Special Interest Group 
  • Gonzalo Paz-Soldan, MD, FAAP; Vice Chair, Immigrant Health Special Interest Group   
  • Benjamin Gitterman, MD, FAAP; Chair, Council on Community Pediatrics
  • Mary Brown, MD, FAAP
  • Arturo Gonzalez, MD, FAAP
  • Steven Federico, MD, FAAP
  • Julia Koehler, MD, FAAP

Contributing Immigrant Health Special Interest Group Members:

  • Lance Chilton MD, FAAP
  • Julie Linton MD, FAAP
  • Kristine McVea MD, FAAP
  • Ryan Buchholz MD, FAAP
  • Mary Ellen Rimsza MD, FAAP
  • Natasha Sriraman MD, FAAP
  • Katherine Yun MD, FAAP
  • Robert Zarr MD, FAAP