Children who are immigrants or refugees have unique experiences, vulnerabilities, and health care needs. Many will have experienced trauma or exploitation prior to or during their migration or arrival to the United States. Additionally, these children and their families must assimilate into a new culture and health care belief system, which may be different from their home country. When providing care for this population, pediatricians must be sensitive to these issues.
In this issue of Pediatric Annals, we are pleased to present articles that emphasize different aspects of care for children who are immigrants or refugees. The articles provide the general pediatrician guidance on how to navigate specific clinical issues, including identifying human trafficking or a history of exploitation, understanding the forensic medical examination process, the importance of medical anthropology and cultural awareness, and lastly a pilot example of a successful local advocacy initiative that created a network of immigrant and refugee health care advocates.
In the article, “Human Trafficking of Children,” Drs. Dena Nazer and Jordan Greenbaum provide an overview of the typical clinical presentation of children who may be experiencing human trafficking with a focus on immigrant, refugee, and other underrecognized populations. The article uses a trauma-informed, rights-based approach to describe the initial medical evaluation and discusses ways in which health professionals can contribute to a multidisciplinary response to human trafficking.
In the article, “Forensic Medical Evaluation of Children Seeking Asylum: A Guide for Pediatricians,” Drs. Matthew G. Gartland, Roya Ijadi-Maghsoodi, Minal Giri, Sarah Messmer, and Katherine Peeler, Ashley Barkoudah, and Dr. Sural Shah review the importance of forensic medical examinations in asylum cases for immigrant and refugee children. They provide guidance to general pediatricians on age- and development-specific approaches to a forensic medical evaluation of children seeking asylum. Appropriate training and experience in conducting these medical examinations can strengthen a child's legal case and increase the likelihood of immigration relief. Additionally, they discuss the potential opportunities for collaboration with primary care pediatricians and community partners around asylum evaluations to build support for these children who have experienced trauma.
In their article, “Medical Anthropology in Pediatrics: Improving Disparities by Partnering with Families,” Drs. Nandini Mandlik and Deepak Kamat discuss how cultural health beliefs and practices can impact and create conflict between providers, patients, and their families. With a medical anthropology approach, they review three common pediatric concerns (fever-phobia, vaccine hesitancy, and co-sleeping), and discuss communication strategies providers can use to address these and other similar scenarios through a culturally aware lens. The authors emphasize building trust with their patients despite conflicting beliefs and working together with both the patient and the community to improve health.
In the last article, “An American Academy of Pediatrics State Chapter Initiative Advocating for Immigrant Children and Families,” Drs. Minal Giri, Melissa Palma, Deanna Behrens, Yessenia Castro-Caballero, Marielle Fricchione, Xochil Galeano, and Tim Herring and Mary Elsner detail a successful advocacy initiative that created a network of advocates focused on immigrant and refugee child health. Here, they highlight the importance of identifying and analyzing local demographic and policy concerns while providing the framework of how to build capacity, connect to local resources, and form key partnerships for an advocacy initiative.
Although the full scope of pediatric immigrant and refugee health is too vast to cover in this issue, we hope these articles provide informative recommendations and resources for general pediatricians who care for and advocate for the continued health and well-being of these children who are in vulnerable circumstances.