Immigrant Families – A New Report

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In the last two years, the immigration debate has become louder and arguably less civil. Political platforms and decisions based on fear have dominated the conversation, but behind the conversation are approximately 23 million people. The number includes those lawfully present as well as those who are undocumented. It includes around 12 million children who are legal citizens born in the United States, but whose parents are non-citizens.

How does the current climate affect the health and daily lives of these millions of people?

Kaiser Family Foundation wanted to find out more, and so began work with a research company to interview families in 8 cities in 4 states. They also interviewed pediatricians who work closely with immigrant families in these cities.

Their findings are significant and troubling. Among those findings are these:

  • Fears of deportation and overall uncertainty have increased in the last year. These fears extend to those who are here lawfully.

“I feel unsettled. Even though we already have the green card, if we do not apply for citizenship, I don’t think we can be at ease.” –Korean Parent, Chicago, Illinois

“Uncomfortable and unstable; we feel that in any moment a new rule could be issued leading to expelling us and sending us back.” –Arabic-speaking Parent, Anaheim, California

“There’s no stability. [The President] could write a tweet on Twitter tomorrow and turn things upside down.” –Arabic-speaking Parent, Anaheim, California

  • Children are facing increased fear that their parents will be deported and/or that they will end up having to uproot their lives and go to their parent’s countries.

“My children would come home from school and say that at school they were saying that all parents would be deported…” –Portuguese-speaking Parent, Chicago, Illinois

“All the children, even if they were born here, are fearful. They fear that anytime they’ll come back from school and won’t find their parents there.” –Latino Parent, Chicago, Illinois

“In Brownsville we have about 1,700 homeless children in the schools. Many of those children are homeless because of a parent that was deported or placed in detention.” –Pediatrician, Texas

  • Pediatricians and participants said that bullying and discrimination at work and at school has increased in the past year.

“They get bullied…told things like, ‘now you and your family will have to leave.’….And so, even though those kids don’t actually have to worry about their immigration status, I think obviously a child, they don’t know the details of how the system works.” –Pediatrician, Pennsylvania

“I work in landscaping, and we’re working and they see you working…and they just start yelling stuff at you…” –Latino Parent, Fresno, California

  • Families are making changes in their daily lives and routines base on fear.


“I am also concerned because if anything happens to us on the street, if we get assaulted or something, we won’t even be able to call the police because they will see we are immigrants.”      –Latino Parent, Boston, Massachusetts

“…but now around six or seven in the evening you won’t find anyone in [the neighborhood]… due to the fear we all feel about what is going to happen.” –Latino Parent, Chicago, Illinois

  • Increased fear in kids is resulting in behavioral issues, mental health problems, and psychosomatic symptoms.

“The kids who come in with concerns that you can kind of trace back to anxiety are usually the upper elementary age students, like the 3rd, 4th graders, to middle school students… 7th and 8th grade, who have nonspecific complaints like abnormal pain or headaches or decreased appetites… And then, in kids that are in the junior high to high school age range, it’s a little more overt: sadness, decreased appetite, not wanting to engage in usual activities, decreased in-school performance, those sorts of things.” –Pediatrician, Arkansas

  • Across the board, pediatricians are concerned with the long-term consequences of this environment.

“I think that we are going to have a generation of kids, who, especially in our immigrant homes, who are going to have more adverse childhood experiences than they would have. So, I think that we’re just setting up this generation of kids to have higher incidence of chronic disease, higher incidence of poor mental health, higher incidence of addiction…” –Pediatrician, California

“I think a huge worry is that children who have problems that are minor and fixable now… that, if those children go untreated, those could end up being bigger problems in the future that are going to be harder to treat and are really going to impact the child’s quality of life.” –Pediatrician, Pennsylvania

The health and well-being of immigrant and refugee communities is something I care deeply about. Yes, it is my daily work as a public health nurse, but it is more than that. It is something that is deeply embedded into who I am as a person. I have only benefitted from the many in my life who are immigrants and refugees, and it is troubling to me that there is documented fear and anxiety that is affecting the daily lives of those I care about.

What might we do to change this? What might we do to help those whose anxiety is affecting their health and the health of their families? The answer is bigger than any one of us, but some of the things that can help are these:

  • Know the law* and be able to point people to the law. Some of the fear is based on rumor. It is important to squash rumors and to point people to laws.
  • Sensitive locations. Both ICE (Immigration and customs enforcement) and CBP (Customs and Border Patrol) consider hospitals and other health care facilities to be “sensitive locations.” Both agencies have issued memoranda that say that immigration enforcement actions are to be avoided at sensitive locations, including at hospitals and other health care facilities, unless urgent circumstances exist or the officers conducting the actions have prior approval from certain officials within the enforcement agencies.
  • Right to remain silent. While immigration enforcement at health care facilities is limited by the “sensitive locations” guidance, immigration agents may enter a public area of a health care facility without a warrant or the facility’s consent and may question any person present, but those people have the right to remain silent.
  • Reassure your patients. Educate and reassure patients that their health care information is protected by federal and state laws.

An appeal to those of us who are Christians:

Caution and compassion are not incompatible; instead it is reasonable to assume that they work well together.  The state is not the master of the church. If you are part of a faith community, none of this prohibits you and your faith community from reaching out to those who may be affected. They do not prohibit you from reaching out, in love, to refugees and immigrants in your midst. It is a lot easier to wear a sign and yell than it is to make a hot meal and take it to strangers, to check in with sick neighbors, to pray for those who are anxious and fearful. We must be willing to do more than react emotionally. We must be willing to put our loudly voiced news feeds into real action.

“The ability to love refugees well doesn’t require a certain party affiliation. It doesn’t require you to vote a certain way. But it does require us to show up, to step across “enemy” lines, and to choose love over fear.” from Preemptive Love

*See this document for more information.

Note: Communicating Across Boundaries has never been, and never will be, a political blog, but I see this not as a political issue, but as a human health care issue. The brief is much longer and more detailed than this blog post. This post is simply to raise awareness of the issues that result from an environment of fear and anxiety.


In 1982, I was living and working at a women and children’s hospital in Pakistan. I had gone on a tourist visa with intent to stay the year. I had arrived in September with a 3-month visa. My visa had expired but I had stayed on, hoping the proper papers would come and not thinking much about it.

And then in December, just two weeks before Christmas, I received a hand-written letter from the local police office telling me that I must leave the country in 24 hours.

Was this a joke?

My mom and I pored over the letter laughing. It was my father who said “I don’t think it’s a joke, I think it’s serious” and suddenly my world changed.

It was two weeks before Christmas and I could not eat or sleep. I had come to Pakistan in a bad place. I was with my family and in my home and I was gradually healing. I intended on staying in Pakistan at least a year. Now suddenly my plans were turned upside down. I had to leave. I was no longer living in the country with proper documentation and I had been asked to leave. Mercifully I was given until after Christmas to leave. Two weeks later I was deported. And although it happened many years ago, the memory of that event is alive. 

Well not technically ‘deported’ as in I wasn’t escorted to the border. I went on my own accord but it wasn’t willingly. And had I not left, I would have been escorted to the border.

Pakistan was my home. It was Pakistan I looked to when I was having a bad day in the United States. “In just a few months I’ll be going back” is what I said to myself all during the summer before I arrived. I couldn’t imagine that I would be made to leave, to pack up all my possessions and leave the place I loved most in the world; the place that  raised me from breast-feeding baby through bratty adolescence to adult woman.

I think of this event a lot when I think about those who were brought to the U.S in diapers, have known nothing else, yet have only recently had a path toward legal registration. I get that we have laws and rules, that borders can’t be a free for all — anywhere. I get that this is a complicated issue and there are no easy solutions. But the United States has been negligent in not working on immigration policy with urgency and putting laws into place at a federal level.

I believe the decision to allow those brought to the United States as children a way to apply for legal status so that they can stay and work without fear of deportation is a good start. This is just one piece of what should be a multifaceted approach – beyond that should be a means for their parents and grandparents to register and have legal status. It is estimated that over 12 million people (men,women, and children) are here without the proper documents. These are people who are working and have no way of becoming citizens, of coming out of the immigrant “closet”. If a solid plan existed, a plan that experts say should include paying taxes, registering, and learning English, then I would put money on most people coming forward. They are sick of living in the shadows, but the alternative of leaving what has become home seems incomprehensible. The Opportunity Agenda, a group with a mission of “building the national will to expand opportunity in America.” gives these recommendations to Congress around immigration and a “roadmap” to citizenship.

  • Provide safe, legal means for migration through points of entry.
  • Eliminate the existing three and ten-year bars to admissibility.
  • Increase the number of employment-based immigrant visas to reflect market demand for sought-after skills and experience.
  • Allow individuals outside of the United States to meet certain criteria to submit and process their applications at the U.S. Consulate in their country of residence.
  • Enact laws that create a system which allows individuals already residing in the United States, including undocumented persons, members of multi-status families, refugees, and asylees, to apply for permanent residence by registering, learning English, and continuing to pay taxes*

I am hopeful that a comprehensive new policy will be a priority – a bipartisan priority. But until then I enjoy telling my deportation story. The astonished “How could a white person be deported?” that I get every time I tell it is a point of connection, for all of those who I have told know someone who is here without authorization.  In their world, it is inconceivable that a white person would not have the proper papers to stay in a place. It is brown people who get deported; brown people who are undocumented. English: Statue of Liberty Gaeilge: Dealbh na ... May 2013 bring about better policy and may the United States continue with a common sense approach to the words inscribed on that statue of hope for many –Lady Liberty:

Give me your tired, your poor, Your huddled masses yearning to breathe free, The wretched refuse of your teeming shore. Send these, the homeless, tempest-tost to me, I lift my lamp beside the golden door!

“I saw the Statue of Liberty. And I said to myself, ‘Lady, you’re such a beautiful! You opened your arms and you get all the foreigners here. Give me a chance to prove that I am worth it, to do something, to be someone in America.’ And always that statue was on my mind.” Immigrant from Greece (Wikipedia)

I know many immigrants read Communicating Across Boundaries and I value your voice.

What are your thoughts? You may differ profoundly from what I have voiced and that’s okay. Join in the conversation through the comments.

* articles

Changing our Immigrant Lexicon

“We have to watch who we hire” said the woman. “We can’t have a bunch of illegals hired or else we’ll be liable”

And I saw red. The color I have seen every time I hear someone use the term “illegals” for the past decade.

“By becoming judge, jury and executioner, you dehumanize the individual and generate animosity toward them.” Charles Garcia

It doesn’t take a reader much time in Communicating Across Boundaries to recognize that I work and identify with many immigrants. I live in an immigrant neighborhood, I have conversations daily with immigrants, and I am most at home when in a group of immigrants. I look similar to those of the majority population but my worldview has a different shape to it – I am an invisible immigrant.

And with this comes a desire for fairness and a strong sense of advocacy for immigrant communities.

I am convinced that fairness and advocacy includes examining our lexicon when it comes to immigrants and immigration. We all know the power of words; they shape us daily. And we have used the word “illegals” referring to people long enough. They are not illegals. They are undocumented people; people without the proper papers and documents required by a government. They may have committed illegal acts but a person cannot be illegal.

The word illegal alien holds even more offense. While I understand the word ‘alien’ to have been in wide use since Biblical times, in combining the two words we paint a picture of an unlawful creature from Mars.

I am not arguing the importance and merits of a solid immigration policy; what I am arguing is the terms and words that go into that policy. Because words make all the difference in our attitudes and decisions to treat people as human beings or as “other”.

In an excellent piece posted on CNN Opinion Charles Garcia goes as far as to call the words “illegal alien” or “illegal immigrant” racial slurs.

“When you label someone an “illegal alien” or “illegal immigrant” or just plain “illegal,” you are effectively saying the individual, as opposed to the actions the person has taken, is unlawful. The terms imply the very existence of an unauthorized migrant in America is criminal.” (Why ‘Illegal Immigrant’ is a Slur, CNN Opinion, July 6)

His points are well made. Significant he says is that the Supreme Court, in handing down their decision on immigration, did not use this biased language except in quoting other sources.

Dehumanizing those men, women and children who are in this country without proper documentation does nothing to help promote good policy and everything to create an angry “us” vs. “them” dialogue.

It’s time to change the lexicon and take out words that make creating fair policy even harder. So next time someone uses the word ‘illegals’ I challenge you to say to them “You mean people without proper documentation of their right to be here?”

And through changing our lexicon, may we be changed and pray for wisdom and humanity to be at the heart of the discussion.