By Andrew M. Seaman
NEW YORK (Reuters Health) - A group representing U.S. pediatricians said this week that its members should pay special attention to the healthcare needs of immigrant children and support health insurance for all - regardless of legal status.
"It doesn't make sense to have a policy that cares for kids but doesn't care for other kids. They are kids. They don't choose where to be born," said Dr. Gilbert Handal, who co-authored the new policy statement from the American Academy of Pediatrics (AAP).
Approximately 18.4 million - or one in every four - U.S. children are foreign-born or have foreign-born parents, according to the AAP. While about 90 percent are born in the U.S., the pediatricians say all face unique obstacles in getting care.
"Some of these barriers include poverty, fear and stigma, high mobility, limited English proficiency, little information or misunderstandings about how the US health care system works, and lack of insurance and/or access to care," says the statement published in the journal Pediatrics.
Making sure immigrant children grow up physically and developmentally healthy is in the national interest, says the AAP, because they represent such a large part of the economic and social future of the U.S.
"You have to look at the big picture and determine what is most beneficial for our future and our country," said Handal, from Texas Tech University Health Sciences Center in El Paso.
The group said both pediatricians and the AAP should advocate for health insurance coverage for every child and individual living in the U.S. Those efforts, they say, should focus on expanding access to quality care and breaking down barriers to enrollment, such as waiting periods for insurance.
The group said pediatricians should also pay attention to the unique challenges immigrant children and families face when providing care, says the statement. For example, the AAP says doctors should have access to information on support programs as resources for at-risk children and families.
Doctors should also play a role in making sure children who are having a difficult time in school get the appropriate help, says the group. They should also promote diversity and inclusion of immigrants in the community.
"I think there is a recognition all around that the demographics are changing and we all around the country need to think about how we care for our immigrant community members," said Dr. Francesca Gany, chief of the Immigrant Health and Cancer Disparities Service at Memorial Sloan-Kettering Cancer Center in New York.
The AAP also said children should not be separated from their families or home environments during immigration proceedings. Children, they also say, should not have to represent themselves.
In addition, the group says healthcare facilities should be safe places for immigrant families, and the facilities and its medical records should not be used in any immigration enforcement action.
Gany, who was not involved with writing the new policy statement, told Reuters Health government policy plays just as important of a role as pediatricians in improving immigrant health.
"It's both pediatricians owning and embracing (the recommendations) and equipping themselves with the skills, but also intervention from the policy level to make sure that's doable," she said.
SOURCE: http://bit.ly/18tU3iZ Pediatrics, online May 6, 2013.