Search

Children who arrived at the United States border without a parent or legal guardian (ie, unaccompanied children) are present in communities throughout the country in growing numbers. For them to receive the highest-quality medical and mental services available, pediatric practitioners should have a foundational understanding of their unique set of circumstances and experiences. However, formal education on how to care for this specific immigrant subpopulation is not routinely incorporated into pediatric training programs, and limited clinical guidance is available in the published literature. This article provides best-practice recommendations for pediatric practitioners caring for unaccompanied children after their release from government custody, incorporating guidance for clinical encounters as well as suggestions of processes to meet their health-related social needs and advocacy actions to improve their well-being. [Pediatr Ann. 2024;53(5):e178–e182.] [ABSTRACT FROM AUTHOR]

The article examines preparation and strategic planning for the allocation and distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in U.S. cities and towns with large immigrant populations, in addition to communication efforts regarding the availability of such vaccines. It discusses the impact of SARS-CoV-2 on immigrant groups in the U.S., vaccination rates of immigrant populations, and the significance of equitable vaccine distribution.

A personal narrative is presented which explores the author's experience as a pediatrician and being part of a team who attended to a sick and separated immigrant child who presented with fevers and status epilepticus due to influenza encephalitis.

Children in immigrant families (CIF) constitute 25% of all children in the United States. Known barriers to accessing and navigating the health care system for immigrants (i.e., poverty, fear, limited English proficiency, lack of insurance) lead to decreased medical home establishment among CIF, although the ways in which these obstacles affect medical home access are less studied. With a focus on Congolese, Afghan, Syrian/Iraqi, and Central American immigrants, key informant interviews and focus groups were conducted to identify mothers' perceptions of and experiences with pediatric primary health care. Five common themes emerged: mothers' critical role in children's health, uniqueness of the U.S. health care system, logistical challenges, influence of prior clinical experiences, and importance of culturally appropriate communication. Few, but distinct, differences among the groups revealed specific obstacles for individual populations. Improving rates of medical home use among CIF requires targeted, immigrant-informed approaches that involve population outreach as well as systems-level changes.

Introduction: Foreign-born children are subject to discrepant state policies in determining eligibility for Medicaid/Children's Health Insurance Program (CHIP) coverage. The objective of this study was to determine the effect of these policies on health care access., Methods: Data from the National Survey of Children's Health (NSCH) were used to assess associations between health care access outcomes and three categories of state health insurance eligibility: restrictive (only U.S. citizens plus immigrants who "qualified" after five-year waiting period), semi-restrictive (same as restrictive except no waiting period), and inclusive (all children)., Results: When compared with restrictive states, foreign-born children in inclusive states were significantly more likely to have current insurance, consistent coverage, recent preventive exams, and fewer problems paying medical bills., Discussion: Extending health care eligibility to all children, regardless of immigration status, improves health care coverage and access for foreign-born children. Expansion of eligibility criteria in all states is necessary to reduce health disparities in the immigrant population.

Background and Objectives: Studies supporta recent decline in public benefit enrollment among immigrant families. We aimed to describe health and resource use, barriers to use, and immigration-related fear in families with undocumented parents compared with families without undocumented parents. We also aimed to assess associations with discontinuation of public benefits and fear of deportation., Methods: We assessed immigration concerns and enrollment in Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with an 89-item anonymous, cross-sectional survey of English- and Spanish-speaking caregivers of hospitalized children. Multivariable logistic regression was used to assess associations with discontinuation of public benefits and fear of deportation., Results: Of 527 families approached, 399 enrolled (105 with 1 or more undocumented parent, 275 with no undocumented parent, and 19 with undisclosed immigration status). Compared with families without undocumented parents, families with undocumented parents had higher levels of poverty and food insecurity. Controlling for perceived eligibility, public benefit use was similar across groups. Of families with undocumented parents, 29% reported public benefit discontinuation because of immigration concerns, and 71% reported fear of deportation. Having an undocumented parent was associated with public benefit disenrollment (odds ratio: 46.7; 95% confidence interval: 5.9-370.4) and fear of deportation (odds ratio: 24.3; 95% confidence interval: 9.6-61.9)., Conclusions: Although families with undocumented parents had higher levels of poverty and food insecurity compared with families without undocumented parents, public benefit use was similar between groups. Immigration-related fear may be a barrier to public benefit use in this population., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2021 by the American Academy of Pediatrics.)

Competing Interests: MEB develops vaccines for NTDs and emerging pathogens including coronavirus vaccines.