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 * Racial Equity and Health Policy
 * Living in an Immigrant Family in America: How Fear and Toxic Stress are
   Affecting Daily…


LIVING IN AN IMMIGRANT FAMILY IN AMERICA: HOW FEAR AND TOXIC STRESS ARE
AFFECTING DAILY LIFE, WELL-BEING, & HEALTH

Samantha Artiga and Petry Ubri
Published: Dec 13, 2017

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 * Executive Summary
 * Issue Brief
 * Appendices
 * Endnotes

Immigration policy has been and continues to be a controversial topic in the
U.S. Over the course of the election and since taking office, President Trump
has intensified national debate about immigration as he has implemented policies
to enhance immigration enforcement and restrict the entry of immigrants from
selected countries the Administration believes may pose a threat to the country.
The climate surrounding these policies and this debate potentially affect 23
million noncitizens in the U.S., including both lawfully present and
undocumented immigrants, many of whom came to the U.S. seeking safety and
improved opportunities for their families.1 They also have implications for the
over 12 million children who live with a noncitizen parent who are predominantly
U.S-born citizen children.2 We conducted focus groups with 100 parents from 15
countries and 13 interviews with pediatricians to gain insight into how the
current environment is affecting the daily lives, well-being, and health of
immigrant families, including their children. Key findings include:

> For #immigrant families, increased fears are having significant negative
> effects on the health and well-being of #children.

Immigrant families, including those with lawful status, are experiencing
resounding levels of fear and uncertainty. Fears affected participants across
backgrounds and locations, with particularly pronounced effects for Latinos and
Muslims. Undocumented parents fear being deported and separated from their
children while many of those with lawful status feel uncertain about their
status and worry they may lose their status or permission to remain in the U.S.
These feelings of uncertainty escalated after rescission of the Deferred Action
for Child Arrivals (DACA) program in September 2017. Parents said that although
they try to shield their children from these issues, many children are hearing
about them at school and fear potentially losing their parents to deportation or
having to leave the U.S., the only home many have ever known.

“…we wake up every day with the fear of being deported, of the separation of our
families, to have to leave the kids.” –Latino Parent, Boston, Massachusetts

“Uncomfortable and unstable; we feel that in any moment a new rule could be
issued leading to expelling us and sending us back.” –Arabic-speaking Parent,
Anaheim, California

Parents and pediatricians said that racism and discrimination, including
bullying of children, have significantly increased since the election. Many felt
that Latinos and Muslims have been the primary targets of increased racism and
discrimination. They also noted that the increased bullying of children in
schools extends beyond immigrants to children of color, regardless of their
immigration status.

“They get bullied… told things like, ‘now you and your family will have to
leave.’ …And so, even though those kids don’t actually have to worry about their
immigration status, I think obviously a child, they don’t know the details of
how the system works.” –Pediatrician, Pennsylvania

Daily life has become more difficult for immigrant families due to increased
fear and uncertainty. Some parents said that it is harder to find employment in
the current environment, further increasing financial strains on families.
Increased fears also are affecting some families’ daily routines. Some parents,
particularly those who are undocumented or who have an undocumented family
member, said they are only leaving the house when necessary, such as for work;
limiting driving; and no longer participating in recreational activities, like
visiting their local park. As a result, they and their children are spending
long hours in the house behind locked doors. Parents also indicated that they
and their children are increasingly fearful of interacting with police or
authorities.

“Before, there were many kids in the parks… but now… the kids spend more time
inside these days, because we are afraid of being deported.” –Latino Parent,
Boston, Massachusetts

“My spouse does not go out of the house… The last thing she wants is to get
stopped and that they start asking her questions…” –Latino Parent, San Diego,
California

Most parents said they are continuing to access health care for their children
and maintaining their children’s Medicaid and CHIP coverage, but there were some
reports of changes in health care use and decreased participation in programs.
Parents note that they highly prioritize their children’s health and generally
view hospitals and doctors’ offices as safe spaces. However, there were some
reports of changes in health care use, including decreased use of some care, and
decreased participation in Medicaid and CHIP and other programs due to increased
fears.

“The thing is… if you are at the hospital you are safe. They can’t go into a
hospital, a school or a church… because it is a sanctuary.” –Latino Parent,
Chicago, Illinois

Increased fears are having significant negative effects on the health and
well-being of children that have lifelong consequences. Parents and
pediatricians reported that children are manifesting fears in many ways. They
described behavioral changes, such as problems sleeping and eating;
psychosomatic symptoms, such as headaches and stomachaches; and mental health
issues, such as depression and anxiety. Parents and pediatricians also felt that
fears are negatively affecting children’s behavior and performance in school.
Pediatricians uniformly expressed significant concerns about the long-term
health consequences of the current environment for children. They pointed to
longstanding research on the damaging effects of toxic stress on physical and
mental health over the lifespan. They also expressed concerns about negative
effects on children’s growth and development, and felt that the current
environment is compounding social and environmental challenges that have
negative impacts on health.

“When you’re worried every day that your parents are going to be taken away or
that your family will be split up, that really is a form of toxic stress… we
know that it’s going to have long-term implications for heart disease, for
health outcomes for these children in adulthood.”  –Pediatrician, Minnesota

Together these findings show that immigrant families across different
backgrounds and locations are feeling increased levels of fear and uncertainty
amid the current climate, and that these feelings extend to those with lawful
status. The findings show that these fears are having broad effects on the daily
lives and routines of some immigrant families. In addition, they point to
long-term consequences for children in immigrant families, including poorer
health outcomes over the lifespan, compromised growth and development, and
increased challenges across social and environmental factors that influence
health.


Issue Brief

TOPICS

 * Racial Equity and Health Policy
 * Medicaid

TAGS

 * Immigrants


DOWNLOAD

 * ISSUE BRIEF


NEWS RELEASE

Dec 2017

 * In Focus: Immigrant Families, Including Immigrants Lawfully in the U.S. and
   Those Who Are Undocumented, Report Rising Fear and Anxiety Affecting Their
   Daily Lives and Health


ALSO OF INTEREST

 * Vivir en una Familia de Inmigrantes en los Estados Unidos: Cómo el Miedo y el
   Estrés Tóxico Están Afectando la Vida Diaria, el Bienestar y la Salud
 * Immigrant Families in America Today: How Fear and Toxic Stress Are Affecting
   Daily Life, Well-Being, and Health
 * Health Coverage and Care for Immigrants
 * How Americans Feel About Immigration and Muslims in a Time of Donald Trump
 * Medicaid/CHIP Coverage of Lawfully-Residing Immigrant Children and Pregnant
   Women

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