Urging health equity for immigrant children, the American
Academy of Pediatrics (AAP) published a policy statement that describes how
compassionate care and cultural understanding strengthens families, builds
individual resilience and enriches society at large.
The policy statement, “Providing Care for Children in Immigrant Families,” published in the September 2019 Pediatrics
(published online Aug. 19), offers guidance for physicians who treat immigrant
children and presents opportunities for advocacy -- and barriers to overcome.
“Like all children, when children in immigrant families are
healthy, happy and empowered to help others, they enrich and enliven our
communities,” said Julie M. Linton, MD, FAAP, lead author of the policy
statement. “Children’s strengths are most evident when they are able to be as
healthy as possible, and pediatricians are able and willing to help make that
In the statement, the AAP addresses how federal immigration
policies can harm immigrants’ health, access to care, and long-term health
outcomes. Increased fear about the use of public programs and immigration
status has deterred some families from accessing programs, regardless of their
Detaining and separating families are counterproductive and
threaten the short- and long-term health of children, according to the AAP.
Keeping families together and protecting those who are most vulnerable – such
as children without parents or a guardian – must factor into comprehensive
immigration reform, according to the report.
“One in every four children in the United States were born
in another country or have a parent who was born outside the U.S,” said Andrea
Green, MDCM, FAAP, co-author of the statement. “All children should receive
equitable health care that is sensitive to cultural difference, mindful of
global health concerns and supports resilience and integration into the
AAP urges pediatricians to start in their own offices, by
first examining their own inherent biases. AAP also recommends:
Integrating services for
mental health, social work, patient navigation and legal concerns within
the medical practice or locating the office near these services.
interpreters who can assist in person or by phone or video, to help
communicate with families. AAP advises against having the patient’s
family, friends or children serve as interpreters.
Offering staff training
on working effectively with language services and offering professional
development in immigrant health and related competencies.
When working with
patients, the physician should look for signs of trauma and screen for
social determinants of health, such as access to nutritious food, safe
housing and education.
development, learning and behavior, regardless of age.
The AAP calls for the federal government and private and
community-based organizations involved with immigrant children to adopt
policies that protect and prioritize the children’s health, safety and
AAP recommends that:
Private and public
insurance payers should pay for qualified medical interpretation and
should not be detained or separated from parents.
activities should not occur at or near sensitive locations, such as
hospitals, schools, childcare facilities or places of worship.
Children in immigration
proceedings should have free legal representation provided by
medical-legal partnerships such as Kids in Need of Defense (KIND) and the
Refugee and Immigrant Center for Education and Legal Services (RAICES).
“All children deserve to be treated with compassion and
respect, to be given a healthy start and an education to help them reach their
full potential,” Dr. Linton said. “By creating partnerships with families and
other professionals in our communities, we can provide services that help lift
families up. As we improve our understanding of different cultures, we all
become stronger in the process.”
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds