Family Unity, Family Health

This week HIP released an HIA report and website highlighting an often overlooked aspect of the current heated debate on immigration policy reform. Family Unity, Family Health: How Family-Focused Immigration Reform Will Mean Better Health for Children and Families sets out to answer a question: how does immigration policy, specifically the threat of detention and deportation, influence the health and well-being of children and families?

Our conclusion is that the health and well-being of children who are citizens, but whose parents are undocumented, suffers needlessly because of harsh and inflexible immigration laws which, at any moment, threaten to tear their families apart.

Nationwide, an estimated 4.5 million children who are U.S. citizens live in families where one or more of their parents are undocumented. For this report, we examined more than 30 scientific studies from Harvard, University of Texas, Urban Institute and many others, and we also used data provided by government agencies. Our evidence overwhelmingly showed that current policies are harming the health and well-being of hundreds of thousands of children of undocumented immigrants, many of whom are U.S.-born.

We learned that between 1998 and 2012, detention and deportation policies affected at least 600,000 children who had a parent or guardian deported. If we look at this number differently, if deportations continue at current rates, just this year alone, more than 152,000 children who are citizens will have a parent taken away from them.

Other examples of what we can expect in the next year under that scenario:

• An estimated 43,000 children will suffer a deciline in physical health, and over 100,000 will show signs of withdrawals, a behavioral problem that leads to poor school performance

• Over 125,000 children will live in a food insufficient household, and may experience hunger or malnutrition

We supplemented our research with surveys and focus groups of people living in mixed-status families. Although it wasn’t a representative survey, we were able to confirm our findings and understand how the immigrant community experiences these policies on a day-to-day basis. Our survey data showed that undocumented parents are deeply aware of how their lack of legal status and the constant threat of detention or deportation affects their children.

•  Nearly 30% of undocumented parents reported that their children were afraid either all or most of the time, and nearly half reported that their children was anxious.

•  Furthermore, when we analyzed responses to a series of specific questions about stressful experiences, our findings showed that almost three-fourths of parents reported that a child had shown symptoms with post-traumatic stress disorder.

Interviews with physicians who work with immigrant communities also confirmed that many undocumented immigrants would not seek medical help for their children out of fear that their legal status will be detected. This was borne out in our survey as well: almost 40% of children of undocumented parents had not seen a doctor in the past year.

When the children of undocumented immigrants live daily with the effects of losing a parent, or anxiety about losing a parent, they are fearful that arrest, detention or deportation will tear their families apart. The trauma of actual separation – or simply just the fear of it – can really imprint on a young child’s brain. This can result in what researchers at Harvard call toxic stress response. 

It’s clear that effects of immigration policy matter not just to children’s health today, but pose risks to their health as adolescents and adults far into the future. As policymakers debate the specifics of immigration reform, a proposal that puts family unity first is the best opportunity to turn around the wide range of health harms we identified.

Lili Farhang

Lili Farhang


Lili Farhang joined Human Impact Partners in December 2009 and serves as one of its two Co-directors. Guided by her long-standing belief that health is a product of social, economic and political forces, Lili works with community organizations, government agencies, and others to re-conceptualize how health is understood and how we can collectively improve health by taking action in, for example, land use, transportation, housing, incarceration, and labor domains. As one of the first practitioners of health impact assessment in the U.S., she has extensive experience in the management, research, and community engagement aspects of HIA – for example, she led the first ever community-based HIA in the country and has since conducted over a dozen HIAs. She also provides training and technical assistance to aspiring practitioners, using her practical experience to guide how HIAs are conducted, how public engagement is incorporated, and ultimately, how research that is meaningful and responsive to community and stakeholder needs is generated. Lili received her Master's degree in Public Health from Columbia University and her Bachelor of Arts in Sociology and Women's Studies from Brandeis University.