Dr Julie Linton Addresses Disparities in Pediatric Care for Immigrant Children in the US

Julie Linton, MD, FAAP, immediate past chair of the American Academy of Pediatrics (AAP) Council on Immigrant Child and Family Health, addressed disparities within health care services impacting immigrant populations in the United States. Linton discussed cultural differences, different types of immigration status, and how access to care can vary based on the state in which these patients are living.

The American Thoracic Society 2024 international conference included a keynote series where Linton and other expert speakers highlighted disparities and discussed ways to improve access to care for immigrant populations.

Transcript

What are the biggest challenges immigrant children face in accessing quality pediatric care in the US? How do these challenges differ based on the child's immigration status, country of origin, or socioeconomic background?

That's really a huge question. Before jumping in, I just want to quickly make sure we're talking about the same population I think you're asking about, which is immigrant children. The broader term of children in immigrant families refers to children who they themselves, or at least 1 parent, were born outside of the United States, and the specific population of immigrant children are children who they themselves were born outside of the United States. Those children may comprise a number of immigration statuses—that could include anything from being a US citizen who's already been naturalized, or it could include some types of humanitarian visa programs such as refugee status or having asylum status. It could include being part of a family who's come for work-related or family unification, or for some children, it could include being undocumented.

And all these different statuses, their eligibility for health coverage will vary. It will vary based on federal law. For instance, undocumented people are excluded from federal Medicaid, excluded from purchasing into the ACA [Affordable Care Act]. However, there are some states that cover children with state-sponsored Medicaid, including states like California, where we are today, as well as New York and Illinois, the District of Columbia, and I think there's 9 other states. You can actually find that information, if you're interested in knowing whether your state does or doesn't offer that coverage, on the National Immigration Law Center website. There's some maps there that are really helpful.

In terms of other factors, country of origin is relevant only in how it relates to immigration status. Certain countries, for instance, are eligible for Temporary Protected Status, meaning that if somebody is coming from Haiti, or Venezuela right now, under the current presidential administration, those families may be eligible for Temporary Protected Status, which would mean that they're eligible to buy into the Affordable Care Act and they're also, in some states, eligible to actually get state-funded Medicaid if those states took up a piece of legislation called the CHIPRA [Children's Health Insurance Program Reauthorization Act] option. Again, that map I mentioned will show you that from the National Immigration Law Center.

In terms of socioeconomic status, that really depends on the state eligibility for Medicaid in terms of how high of a poverty level that somebody could qualify for is one of the big pieces. Then there's other factors around socioeconomic status and other demographic factors that may make it more or less easy for somebody to enroll—language access, transportation, other things that can make it easier or more difficult for somebody to access services.