Immigrant Health

Immigrant Health Committee

The Immigrant Health Committee of the MCAAP is excited to start work on serving our colleagues who care for children of immigrant families; inform ourselves, our fellow MCAAP members, and the public of the special challenges  immigrant children face; and support advocacy efforts that can improve their health and well-being.

Summary: Immigrant Health Committee Dinner Meeting – Tuesday, 1 17 2017

Summary: Immigrant Health Committee Dinner – Friday, 1/8/16

Summary: Immigrant Health Committee Dinner – Wednesday, 6/17/15

An EMR Template for Pediatric Screening of Central American Immigrant Children

To start with a few numbers: In 2009, there were 948,061 immigrants in Massachusetts, comprising 14.4 percent of our population. (click here for more information).  Approximately 185,000 undocumented immigrants live in Massachussetts, according to recent estimates. (click here for more information). In 2012, 1,401,415 children lived in Massachusetts: 15.6% were Hispanic, 7.9% were black and 6% were Asian,  the census groups which comprise the most immigrants, though these “racial” or “ethnic” categories can be seen as meaningless. (click here for more information). For example, Brazilians make up the largest group of immigrants from any single country in Massachusetts – and they may define themselves as any one of these “racial” categories.

Many MCAAP members are caring for immigrant children, children with one or both parents not born in the United States, as these numbers show. We hope to provide useful resources for our colleagues.

Children in immigrant families face numerous serious challenges, which will be more fully addressed in a later post. For children with an undocumented parent or relative, a major, overarching social determinant of poor health has been the vast scaling up, throughout the United States, of immigration imprisonments and deportations since the mid-2000s ( In the 6 years of the current presidential administration alone, over 2,000,000 people were deported. Between July 1, 2010, and Sept. 31, 2012, nearly 23 percent of all deportations—or, 204,810 deportations—were issued for parents with United States citizen children ( The effects of these events, and of the constant threat of losing a parent to deportation, have been devastating. Not only children of parents threatened with deportation, but all children who see their playmates or classmates lose a parent and wonder whether it could happen to them, are impacted.

On 11/20/2104, President Obama announced a program of “deferred action” for parents of United States citizen children under certain conditions. This means that undocumented parents of U.S. citizen children can go through an application process at whose end they may receive a determination that they are not targets for deportation and can receive a work permit, which will be valid for 3 years and renewable. He also extended the eligibility criteria for undocumented youth for “deferred action.” See the statement of our AAP Immediate President, Dr. Perrin, about President Obama’s announcement, pasted in below.

See the statement of our AAP Immediate Past President, Dr. Perrin, about President Obama’s announcement, pasted in below.

As pediatricans, we can help in several ways. While avoiding questions to individuals about immigration status, we can generically

  1. advise parents to avoid high-priced offers of counseling and preparation of documents by unauthorized practitioners of immigration law or “notarios” – these are often fraudulent and may endanger someone’s immigration status. Factsheets for families in English, Spanish, French and Chinese with information about the President’s executive action and about avoiding legal scammers can be downloaded here: and in English, Spanish, Portuguese, simplified and traditional Chinese, and Vietnamese here:
  2. inform parents of events scheduled by reputable organizations to disseminate information about the exact content of the “deferred action” program. All events around the state are available here:
  3. provide parents with contact information for organizations near them that can advise them, answer questions, and eventually help prepare applications for deferred action, to be found here:

AAP colleagues in 2013 created an Immigrant Child Health Toolkit with many useful resources. It is available at “

The Council on Community Pediatrics has a Special Interest Group for Immigrant Health at the national level. This is a great way to stay in touch with colleagues across the country who take care of immigrant children, share information and opinions, and exchange resources. To join, please email

The MCAAP Immigrant Health Committee welcomes new members. To join, please email

Dr. Perrin’s statement:

For Immediate Release: November 20, 2014
Media contacts: Jamie Poslosky (202-724-3301;
AAP Statement on President Obama’s Executive Action on Immigration Reform

By: James M. Perrin, MD, FAAP, president, American Academy of Pediatrics

“President Obama’s executive action unveiled tonight includes needed, new commitments to protect immigrant children, youth and families. The nation’s pediatricians support the President’s plan to help keep millions of immigrant families together by delaying deportations for undocumented immigrants whose children are U.S. citizens or meet other residency requirements, and by expanding the existing Deferred Action on Childhood Arrivals policy to allow additional undocumented immigrants who came to this country as children to remain in the United States.

“Far too many children in this country live in constant fear that their parents will be taken into custody or deported, and this prolonged anguish takes a toll on their health. Children who experience at least one parent being deported can develop toxic stress, which manifests in serious mental, physical and emotional health problems that persist across the lifespan, from sleeping and eating disturbances to anxiety and depression. Forced separations due to immigration enforcement affect much more than the family’s health, and can lead to loss of income, poor school performance, unstable housing and food insecurity.

“We can and must do better for immigrant children and youth, who did not choose where they or their parents were born or how they came to this country. The mission of the American Academy of Pediatrics is to protect the health and well-being of all children, and pediatricians hold our elected leaders to this same standard.

“Adequately protecting our nation’s immigrant children and families will require additional steps beyond tonight’s executive action, which does not address the surge in unaccompanied children crossing the southwestern U.S. border, many of whom are victims of violence.

“All children, no matter where they or their parents were born, should be able to pursue a high-quality education, remain united with their families, and access health care services. Pediatricians welcome President Obama’s commitment tonight as an important step forward and urge its swift implementation.

“Children are not a political problem; they are a national treasure. It is time for Washington to set politics aside and craft public policy that gives children and their families our full compassion, attention and care.”



For Immediate Release: January 25, 2017

Media contacts: Jamie Poslosky and Devin Miller (202-347-8600; or
Susan Martin and Lisa Black (434-847-7877; or

AAP Statement on Protecting Immigrant Children
by: Fernando Stein, MD, FAAP, President, American Academy of Pediatrics

“The mission of the American Academy of Pediatrics is to protect the health and well-being of all children—no matter where they or their parents were born. Following today’s immigration-focused Executive Orders signed by President Donald Trump, the Academy underscores continued commitment to our mission and reiterates our support for immigrant children and their families.

“Immigrant families are our neighbors, they are part of every community, and they are our patients. The
Executive Orders signed today are harmful to immigrant children and families throughout our country. Many of
the children who will be most affected are the victims of unspeakable violence and have been exposed to
trauma. Children do not immigrate, they flee. They are coming to the U.S. seeking safe haven in our country
and they need our compassion and assistance. Broad scale expansion of family detention only exacerbates their

“Far too many children in this country already live in constant fear that their parents will be taken into custody or deported, and the message these children received today from the highest levels of our federal government exacerbates that fear and anxiety. No child should ever live in fear. When children are scared, it can impact their health and development. Indeed, fear and stress, particularly prolonged exposure to serious stress – known as toxic stress – can harm the developing brain and negatively impact short- and long-term health.

“The American Academy of Pediatrics is non-partisan and pro-children. We urge President Trump and his Administration to ensure that children and families who are fleeing violence and adversity can continue to seek refuge in our country. Immigrant children and families are an integral part of our communities and our nation, and they deserve to be cared for, treated with compassion, and celebrated. Most of all, they deserve to be healthy and safe. Pediatricians stand with the immigrant families we care for and will continue to advocate that their needs are met and prioritized.”


AAP Statement Opposing Separation of Mothers and Children at the Border

by: Fernando Stein, MD, FAAP, President and Karen Remley, MD, MBA, MPH, FAAP, CEO/Executive Vice President, American Academy of Pediatrics

“The American Academy of Pediatrics (AAP) opposes the Department of Homeland Security (DHS) proposal reported in the media that would separate immigrant mothers from their children when they arrive at the U.S. border.

“Pediatricians work to keep families together in times of strife because we know that in any time of anxiety and stress, children need to be with their parents, family members and caregivers. Children are not just little adults and they need loved ones to comfort and reassure them.

“Federal authorities must exercise caution to ensure that the emotional and physical stress children experience as they seek refuge in the United States is not exacerbated by the additional trauma of being separated from their siblings, parents or other relatives and caregivers. Proposals to separate children from their families as a tool of law enforcement to deter immigration are harsh and counterproductive.  We urge policymakers to always be mindful that these are vulnerable, scared children.

“The American Academy of Pediatrics is ready to assist federal officials in crafting immigration procedures that protect children.”

The American Academy of Pediatrics is an organization of 66,000 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 and follow us on Twitter @AmerAcadPeds


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