health disparity

New “Public Charge” Rule: How does it affect our patients’ families?

Texas is home to approximately 4.7 million immigrants (an estimated 17% of the state population), including approximately 317,000 immigrant children1. Of these immigrants, approximately 1.7 million are naturalized US citizens, nearly 1 million are eligible to become naturalized US citizens, and nearly 2 million are undocumented immigrants1,2. The number of US-born children in Texas who live with an undocumented family member is reported to be approximately 1 million, with approximately 500,000 children with an undocumented parent1,3. Obtaining permanent residency status is a lengthy process and a source of anxiety for many immigrants. Recent changes to the US Department of Homeland Security (DHS) rules regarding which public benefits count negatively towards obtaining permanent residency may impact these families and children. Pediatric healthcare providers should be prepared to help immigrant families understand how the use of public benefits could impact changing their immigration status.

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Child Health and Poverty – A Call to Action

It has been well described that poverty is associated with poor health, starting from time in the womb all the way into adulthood. Poor children have higher rates of infant mortality, low birth weight, food insecurity, and unintentional injuries. They also have a higher incidence and worse severity of chronic diseases such as asthma and obesity. As these children grow older, they are at higher risk of poor educational achievement, teen pregnancy, and inability to escape poverty. Finally, most poor children unfortunately grow into poor adults with higher rates of diabetes and cardiovascular disease, depression, substance abuse, and ultimately shorter life expectancy. Lately, a growing body of evidence has shown that toxic stress experienced by developing children fundamentally changes their biology – altering brain development, the immune system, hormones, and metabolism in ways that predispose to illness. As pediatricians, we should understand that addressing the effect of poverty on our patients’ health requires more than seeing families individually in the office. It will require our voices in broader social institutions. (more…)