28 Modern Healthcare | August 19, 2019
Healing fractured minds,
hearts and bodies
While there are fewer unauthorized
immigrants in the U.S. workforce than
a decade ago, the latest studies by the
Pew Research Center found that about
3.9 million students in kindergarten
through 12th grade in the nation were
children of immigrants here illegally. So
now we have millions of children who, if
they read the news or hear adults speak
frankly, worry about growing up without
their parents or guardians.
The American Psychological Associa-
tion identified the long-term emotional
and behavioral outcomes of being the
child of an immigrant as post-traumatic
stress disorder. These children have dif-
ficulty forming relationships, experience
feelings of persecution, have distrust of
institutions and authority figures, and
act out in school.
The public charge rule finalized last
week ostensibly prevents immigrants
from seeking healthcare through public
programs, lest they risk jeopardizing their
chance at citizenship. So what will pro-
viders do to stem any negative impact? In
opposing the rule, providers cite regres-
sion in population health efforts.
As industry leaders continue to craft
their responses, I encourage you to think
long term and share your solutions with
us, through email and online comments
in related stories. lAURORA AGUILAR EditorP
erhaps it’s because my daughter starts kindergarten next week and her
father and I are trying to figure out ways to have one parent either drop
her off or pick her up. Maybe it’s the fact that I remember the relief of
seeing my mother’s face after a particularly hard day at school.But I wasn’t the only one moved by
the image of a little girl crying into her
hands after learning her parents were
among the over 680 people arrested
during her first day of school because
they illegally applied and were illegally
hired to work in the U.S.
In addition to feeling sorry for the
young girl, I started to worry about the
mark that and other incidents of sepa-
ration are doing to the psyches of young
people who will likely be Americans in
the future, the patients you will all face
at some point or another.
Many providers spoke out against a
rule finalized last week that will certain-
ly drive immigrants away from receiving
care. The Trump administration contin-
ues to criminalize immigration, meaning
many immigrant children will continue
to face unspeakable fear without much
access to affordable or comprehensive
healthcare. Providers will be left to deter-
mine their role in healing these fractured
minds, hearts and bodies. Countless
studies show how traumatic incidents in
childhood physically change the brain.
I didn’t need studies. I grew up in the
Pilsen neighborhood on the Lower West
Side of Chicago. There were a few kids
whose parents were in jail, a few others
whose parents or guardians had been
shot to death, still others who showedup to school with the physical marks
of trauma and others who witnessed it.
These kids were either more aggressive
or painfully withdrawn, resigned to liv-
ing their parents’ lives or under immense
pressure to chart a new course. Granted,
many kids show these behaviors as they
endure adolescence—trauma or not.
I can’t relate much to the adversity
that would lead someone to walk thou-
sands of miles to an unknown land with
few or no prospects, but I can relate to
the childhood fear of losing a parent.Before my mother learned she was
pregnant with me at 45, she thought she
was going through menopause. Around
6 years old, I began visiting my parent’s
bedroom nightly to check if they were
still alive. I worried about losing their love
and protection but also in that self-cen-
tered way children think, I panicked over
what would happen to me if they were
gone. If those memories shaped my psy-
che so distinctly, how much more would
the very real fear of coming home to an
empty house affect immigrant children?
Maybe that’s what resonated the most
when I saw that girl. “I need my dad ...
mommy,” the 11-year-old pleaded after
learning they’d been arrested. She was
reportedly reunited with her mother
shortly after a video of her went viral.