In the 2016 presidential campaign no issue is more contentious than immigration. Often overlooked in the fevered debates over walls at the border and deportation are the fates of more than four million children who are U.S. citizens but live in families where one or more of their parents or guardians are not. They have a constitutional right to be here, and we have a moral obligation to provide them the opportunity to become healthy and productive adults – not just for their sake but for the future of our nation.
As a pediatrician and advocate working with immigrant families, I see firsthand the deleterious toll on children who live under constant fear that the person who takes care of them could at any moment be taken away. A robust body of research shows that children who grow up with family instability, economic strain and chronic stress suffer poorer health, lower educational achievement and increased poverty and hunger. Indeed the 1989 United Nations Convention on the Rights of the Child delineates the importance of maintaining family unity. It specifies that “the child has to know and be cared for by his or her parents…a child should not be separated from his or her parents against their will…and both parents have common responsibilities for the upbringing and development of the child.”
Last month, the Supreme Court heard oral arguments in United States v. Texas, a case that will determine whether President Obama’s 2014 executive actions to defer the deportation of millions of undocumented immigrants are within his legal authority. Texas and other states are challenging the legality of the DACA and DAPA programs that would defer the deportation of the undocumented parents of citizens and lawful permanent residents, and of people who arrived in the U.S. as children. Together the programs would provide up to 5.2 million undocumented immigrants – many of them parents of U.S born children or legal residents – a path to citizenship.
The president took executive action because Congress has failed for years to muster the political will to pass comprehensive immigration reform. This failure has not only fueled the hateful and xenophobic rhetoric of the presidential campaign, but has had profound impacts on the stability and security of families and the health and well-being of children and parents.
A study by Human Impact Partners found that in 2012 alone, when deportations were at record levels, approximately 152,000 children who were citizens had a parent taken away from them. From 1998 to 2012, over 660,000 children suffered such traumatic separation from a parent. As a result, tens of thousands of children suffered declines in their physical health, had poorer behavioral and educational outcomes, and experience higher rates of poverty and food insecurity. The study also reported that in surveys of undocumented parents, three-fourths said their child showed symptoms of post-traumatic stress disorder. Nearly half said their child was anxious and nearly a third said that their child had been afraid most or all of the time.
There is a growing body of evidence demonstrating how unmitigated stress – or toxic stress – can lead to long-term negative outcomes in childhood development, learning and health. In this bio-ecological framework, parental deportation becomes a double whammy for children, compounding the negative effect on a child’s health and well-being by increasing their risk for exposure to stressors and removing a key buffer to that stress, their parent.
Children are not the only ones harmed. When one parent is deported the health of the remaining parent suffers, sometimes even shortening the remaining spouse’s lifespan. And the impact of deportation ripples outward, creating a climate of fear and paralysis in the entire community – children whose class- mates are separated from their parents, businesses who lose valued workers, families who become scared to seek health care, to use public services or even to drive.
This past January, news that ICE was carrying out a new round of deportation raids spread like wildfire throughout our community. There was a deluge of calls to our health center. Families were afraid to leave their homes, send their children to school, or even come to the doctor’s office. In response, we organized a town hall meeting and worked with our patients to understand their legal rights. But their anxiety and confusion remained palpable. We too were alarmed, because much as we tried to allay their fears, we could not promise that families would not be separated, which was the ultimate source of stress and tension in their lives.
Doctors, nurses, mental health, and public health professionals nationwide bear witness to the physical and mental health harms that our broken immigration system inflicts on families and children. We can spend untold dollars trying to heal these children, but what’s desperately needed is a humane immigration policy that will keep these children’s families intact and healthy while their parents work to become full-fledged citizens. Then we can focus on supporting families and helping provide children the foundation to thrive and reach their full potential.
President Obama was right to take executive action to defer deportations for the parents of children who are citizens. Now the health and well-being of millions of immigrants and their children is in the hands of the US Supreme Court.
Any immigration reform worthy of our American ideals must have as its foundation concern and compassion for children and families. Prioritizing family unity will not only improve these families’ health and well-being but our society’s as a whole. By removing children’s fear we will restore their hope.
Dr. Alan Shapiro is senior medical director for Community Pediatric Programs, a collaboration or the Children’s Hospital at Montefiore and The Children’s Health Fund; an assistant clinical professor in pediatrics at Albert Einstein College of Medicine, both in New York. He is also co-founder of Terra Firma: Healthcare and Justice for Immigrant Children, a medical-legal partnership.