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Immigrant Health Resources for Pediatricians

 

​​​Supporting the Health and Well-Being of Immigrant Children
April 25, 2017

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Background

Immigrant families are currently faced with a rapidly changing political landscape, and may be impacted by new federal policies that increase deportation and detention, restrict travel, and prevent access to public benefits. These developments may cause significant stress, anxiety, and uncertainty for immigrant families, and the pediatricians who care for their children.
 
The American Academy of Pediatrics is dedicated to the health of all children, no matter where they or their parents were born. The following resources were compiled to assist pediatricians with supporting the health and well-being of immigrant children. These resources address common issues related to:

  • Mental and Emotional Health
  • Talking with Children
  • Immigration Status and Family Separation
  • Community Resources
  • Advocacy

This information is provided for informational purposes only, and does not constitute legal advice. This information will be updated with additional resources as they become available.

For more information, please contact the AAP Immigrant Health Special Interest Group at cocp@aap.org.

Mental and Emotional Health

Immigrant children and families may experience mental and emotional health issues associated with prior trauma, family separation, fear, discrimination, and uncertainty in a new environment. The AAP Immigrant Child Health Toolkit provides detailed information on mental and emotional care for immigrant children. The AAP Trauma Toolbox includes information for pediatricians to address trauma in primary care.

Due to recent changes in immigration related public policies, pediatricians may be faced with families who are experiencing new and/or additional stressors. Signs of stress in children may manifest as physical symptoms, behavioral or developmental changes, or other psychological symptoms. If serious mental health issues are identified, the child should be actively linked to on-going psychological care.

In all cases, pediatricians should show empathy and understanding for families who are distressed, and reassure families that they are free and safe to share their concerns.
 
While you may not be able to address every family’s unique issues, you can show your support for their well-being. Pediatric practices can demonstrate that their practice is a supportive environment for families of all backgrounds. Posting welcoming language and signs in the practice can help indicate the environment is a “safe” or “welcoming” space.
 
Related Resources:

  • Ethnomed highlights information from the NW Refugee and Immigrant Health Coalition for health care providers to assist refugees, immigrants, and asylum seekers.
  • The American Psychological Association provides a variety of resources related to immigration and mental health.

Talking With Children

Parents may seek advice about helping their children understand and cope with issues related to immigration. Pediatricians should advise parents to allow their children to express their feelings, including fear, anxiety, or anger. Parents should focus on helping their children to feel safe. Children should be encouraged to tell a trusted adult, such as a parent or a teacher, if they feel threatened or experience bullying. Parents should be encouraged to monitor and limit children's exposure to the news.

Healthychildren.org provides additional tips for families to talk with their children. Information is available to help parents talk about Bullying, Racial Bias, and the 2016 Presidential Election. Tips are also provided on How to Support Children’s Resilience in Time of Crisis.

Related Resources

  • The Southern Poverty Law Center Teaching Tolerance Project provides information for educators on communicating with children about immigration orders.

Immigration Status and Family Separation

Immigrant families may have unique concerns related to their legal immigration status. Immigration enforcement actions can lead to the sudden removal of a parent/primary caregiver without giving the family notice or time to prepare for the parent’s removal. It is extremely important for parents who may face separation from their children to develop a plan for their children’s health and safety. The AAP Immigrant Child Health Toolkit recommends that pediatricians advise parents to take the following basic steps:

  • Appoint power of attorney to a trusted adult to care for children in the event of removal/deportation.
  • Maintain copies of medical records, including immunization history, medications and other health information. Give a copy to a trusted adult.
  • Maintain copies of your child’s birth certificate, social security card and passport(s). Give a copy to a trusted adult.
  • Maintain documentation of children’s school records. Give a copy to the adult that you have designated as Power of Attorney.

Families who need assistance with immigration cases should be advised to consult a licensed attorney.

 
Related Resources

Connecting Immigration Families to Community Resources

Many communities have local nonprofit organizations that focus on helping immigrant populations access services and supports. Pediatricians may consider learning about the services of these organizations, and opportunities to refer families. Key organizations may include:

  • Immigrant and refugee social service organizations
  • Faith-based organizations
  • Social Work organizations
  • Immigrant rights coalitions and legal organizations

Some state and local health departments have issued specific welcoming statements and information to reassure immigrant clients that they will continue to provide health care services. (ie San Francisco Department of Public Health Post-Election Information) Contact your state or local public health department to learn about any policies in your community.

Community Advocacy

Pediatricians with an interest in advocating for immigrant children can join efforts in their communities. Across the country, individuals and organizations have united to assist and advocate for their immigrant neighbors, friends, families, and colleagues.

Pediatricians can look for state immigrant rights coalitions that may be leading advocacy campaigns. Additional advocacy partners may include:

  • Immigration focused legal organizations
  • Educational institutions including school districts and universities
  • Faith-based organizations
  • Civil rights organizations
  • Immigrant and refugee social service organizations

Pediatricians can consider the following advocacy actions:

  1. Attend community meetings, town halls, and events. Many communities are hosting public events on immigration issues and related concerns. These events can provide an opportunity for you to support immigrant children and families, as well as learn about the specific issues in your local community.
  2. Write an Opinion Editorial or Letter to the Editor. Pediatricians can provide an important voice for immigrant children and families by discussing their health and safety in the media. AAP Talking Points (Log-in required)
  3. Contact your Congressional representatives, state, and local officials. Pediatricians can advocate for the health and safety of immigrant children, by contacting policy makers at the federal, state and local levels. Pediatricians may consider adding their voice to discussion of policies related to “sanctuary” cities and institutions, civil rights protections, and refugee resettlement.
  4. Assist immigration lawyers in directly advocating for children by being trained to perform medical and psychological asylum exams. By obtaining domestic asylum, children and families are legally allowed to remain in the United States. Physicians can volunteer for training to perform asylum exams through several organizations including Physicians for Human Rights and Health Right International.
  5. Engage your Local AAP Chapter. Find out if your AAP Chapter is involved in education or advocacy initiatives focused on immigrant child health at the state level. Chapters can use AAP policy and principles on immigrant child health to guide their advocacy.
  6. Offer to give a presentation on immigrant child health at an AAP Chapter meeting or in your community.
  7. Become an AAP Key Contact. Stay connected to AAP advocacy and information by signing up to become a key contact. Email kids1st@aap.org to become a key contact.
  8. Join the AAP Immigrant Health Special Interest Group and join a network of activity, support, and communication for pediatricians who care for diverse immigrant children.

Related Resources:

The National Immigrant Law Center (NILC) is a leading national immigrant rights advocacy organization. NILC provides up-to-date analyses, fact sheets and other materials on immigrants’ access to health care, immigration enforcement reforms, and other issues.

Immigration Advocates Network is a collaborative effort of leading immigrants' rights organizations designed to increase access to justice for low-income immigrants and strengthen the capacity of organizations serving them.

Acknowledgements:

Janine Young MD FAAP, Julie Linton MD FAAP, Marsha Griffin MD FAAP

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