Health watch: The children of immigrants

 

One in five U.S. children lives in an immigrant family -- they are the fastest-growing segment of the nation’s children. As a result, says migrant health advocate and researcher Mary Lou de Leon Siantz, “it is on their shoulders that a lot of the economic success of the U.S. rests.” (Siantz discusses migrant health issues in this Georgetown University interview.)

 

The well-being of these children is influenced by several factors. One in three Latino children lives in poverty, said de Leon Siantz, and they are less likely to have health insurance than any other ethnic group. The 1996 federal welfare revisions denied many legal immigrants access to public health insurance benefits such as SCHIP and Medicaid during their first five years of U.S. residency. (Search for two federal bills that address those restrictions, S 1104 or HR 287.) Even immigrant families who have gained legal rights to government care may not use those benefits, she noted.

 

Language barriers, and the use of unqualified interpreters, continue to complicate efforts by health care providers and burden patients, said Heng Lam Foong, program director for PALS for Health, the only nonprofit language translation service in Southern California. She recalled several examples where, in violation of federal privacy and interpretation requirements found in HIPPA and Title VI, children and unqualified strangers interpreted health information for adult patients who couldn't speak English. (See her organization’s article on that subject.) She described a case where a 10^th grade boy was incapable of interpreting during his mother’s gynecological exam, so painter who had been working in the hallway was called in by the doctor to interpret for the woman.

 

“Many people think that it’s simple enough to read English or convey information in health care settings,” Foong said. “Not everyone who is bilingual can effectively interpret. In health care, you need to be highly fluent in English and medical English,” and have that same fluency in the patient’s native language.

 

Panelists detailed several ideas that could lead to stories:

 

• Most hospitals receive funding from the federal government, but how do they comply with Title VI, which requires language assistance for those with limited English skills?

 

• Who’s providing dental care to immigrants, and how are they paid? Dental caries are disproportionately higher among these children, said de Leon Siantz, and “one of the very first things to go is dental health.”

 

• Latino girls are among the heaviest U.S. children, in part because nervous parents think they are safest inside the house, de Leon Siantz said. While medical professionals may suggest a diet, and more expensive fresh food, she asked: “How are you going to logically negotiate with a parent to buy and produce foods for one child” when they can’t afford that for their other children?

 

• As with many low-income populations, Latinos in particular face food insecurity, meaning some may go without to feed the family. One in three Latino households has insufficient access to enough food. Who gets to eat when the money runs out?