AAP Policy Statement Provides Guidance on Caring and Advocating for Immigrant Children and Families

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 happen.”

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 eligibility.

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 community.”

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.
• Providing trained 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.
• Assessing children’s 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 well-being.

AAP recommends that:

• Health coverage should be provided for all children, regardless of immigration status.
• Private and public insurance payers should pay for qualified medical interpretation and translation services.
• Immigrant children should not be detained or separated from parents.
• Immigration enforcement 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