193 - Children as Casualties: Healthcare Impacts of Immigration Enforcement

Publication Number: 2186.193

Katherine R.. Peeler, Harvard Medical School, Boston, MA, United States; Lindsey Green, Physicians for Human Rights, Plano, TX, United States; Mariyah Kapuswala, Michigan State University College of Human Medicine, Grand Rapids, MI, United States; Tessa F. Wilson, Physicians for Human Rights, New York, NY, United States

Background: In light of recent intensified immigration deportation activities, the removal of healthcare facilities from the list of “sensitive locations” where immigration enforcement was previously restricted, and emerging local directives that require healthcare providers to report patients’ documentation status, it is critical to assess the effects of these policies on health systems, providers, and the patients they serve. The increasingly hostile environment for immigrants in the US reverberates far beyond the immediate acts of detention and deportation. These policies disrupt the well-being of entire families and communities, including and especially children.

Objective: This study aimed to examine US clinicians’ accounts of the impact of Trump Administration policies on the immigrant communities they serve with respect to how these policies affect access to, and utilization of, healthcare services; physical and mental health conditions and outcomes; and the ability of healthcare providers and institutions to continue to deliver ethical care to their immigrant patients.

Design/Methods: A structured survey with closed- and open-ended questions was distributed online across the US to healthcare providers working in varied medical settings from March – August 2025. The survey focused on three key areas: immigrant patients’ changing willingness to seek care, observed shifts in patient health outcomes, and professional or institutional barriers or facilitators clinicians encountered in delivering medical care. Thematic analysis was performed.

Results: There were 691 clinician respondents from 30 states, the majority of whom had greater than 10 years' clinical experience. 60% reported a significant or moderate decrease in patient visits since the January 2025. The most frequent patient concerns included fear of deportation (85%), family separation (72%), and mental health or trauma impacts (63%). Major themes reported included: children arriving at emergency departments unaccompanied; children presenting with anxiety or fear of family separation as a primary stressor; children presenting with restricted physical activity, social isolation, and abnormal weight gain trajectories; and pediatric patients presenting at later disease stages with preventable complications and delayed diagnoses.

Conclusion(s): Findings demonstrate the broader public health effects of immigration enforcement policies on immigrant children. Pediatric providers are witnessing in real time the creation of a generation with preventable trauma, delayed diagnoses, foregone treatments, and compromised development.