Elsevier

Advances in Pediatrics

Volume 66, August 2019, Pages 87-110
Advances in Pediatrics

Health Considerations for Immigrant and Refugee Children

https://doi.org/10.1016/j.yapd.2019.04.003Get rights and content

Section snippets

Key points

  • Immigrant and refugee children are at increased risk for physical, developmental, and behavioral health challenges.

  • Health considerations for immigrant and refugee children should be framed within an ecological context that includes considerations of family, community, and sociocultural influences.

  • It is important to understand the migration history of an immigrant child (or the history of their family), which provides context for infectious disease screening and exposure risk (including trauma).

Migration history

The experience of migration includes social and physical exposures and public health risk factors that can guide initial screening, management, and treatment of recently immigrated children and families. Therefore, it is imperative for providers to incorporate a migration history (Box 2) into the routine collection of a patient’s historical data. For example, children may travel through areas that have different patterns of endemic infectious diseases than the country of origin; a family also

Physical health

The recommendations for screening, presumptive treatment, and testing in this section primarily apply to newly immigrated children; however, the history is applicable to all generations of immigrant children.

The World Health Organization (WHO) Alma-Ata agreement was updated approximately 20 years ago to include the provision of primary health care as a human right [12]. Despite this, many individuals around the world remain without routine access to primary care [13]. For children, this may

Developmental health

One in 6 children in the United States is reported to have 1 or more developmental delays or disabilities [50]. Although there are no reliable and representative data on the global prevalence of childhood developmental disabilities, research indicates that hundreds of millions of children worldwide are not meeting their developmental potential and may not have access to interventions that could positively alter their developmental trajectories [51], [52].

Although they come from widely varying

Behavioral/mental health

An immigrant child’s behavioral/mental health is also strongly influenced by experiences and exposures. Behaviors provide valuable insight into an immigrant child’s overall well-being and family functioning. In younger children, close attention to eating, sleeping, and toileting patterns may reveal underlying psychological stressors. In older children, it often is helpful to elicit additional information about school engagement/performance and peer interactions.

Overall, immigrant children are

Early childhood education

Research highlights the immediate and long-term benefits of high-quality early childhood education programs (ECEPs) for all children [62]. These programs are particularly valuable for children of immigrant status, given their increased developmental and behavioral risks. ECEPs establish a solid foundation for school readiness through promotion of healthy physical, cognitive, socioemotional, and language development [63], [64]. ECEPs also build literacy skills by providing language instruction

Summary

Health considerations for immigrant and refugee children are vast, diverse, and complex. Thoughtful attention to the physical, developmental, educational, and behavioral health of immigrant children demands a broader appreciation for their experiences, exposures, and roles within their families, communities, and society. Supporting immigrant and refugee children requires intentional, interdisciplinary partnerships across social, educational, legal, political, and health care systems [73], with

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    Disclosure Statement: Dr. Dawson-Hahn is the recipient of the Seattle Children's Center for Diversity and Health Equity Mentored Scholars Award.

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