CP18 - The Surge of Central American Immigrant Families: A View from the Trenches and Ideas Toward Caring for the Entire Family

Poster Type: Research

Category: Expanding Access to Care and Other Services

Research Objectives: Since FY13, the proportion of Central American immigrant families crossing the Southwest border relative to unaccompanied children has increased substantially. A retrospective chart review was undertaken to evaluate the need for a redesigned immigrant intake appointment with emphasis on the entire family unit given the recent (2019-20) surge in immigrants.

Study Design/Methods: The surge of Central American immigrants to the US in 2014 brought many new minors (typically teenagers) to Zufall Health Center (ZHC). Based upon their experiences, ZHC clinicians adapted procedures to better serve this population. At that time, the EMR was modified to include questions regarding family structure, country of origin, mode of travel, and new living arrangements. Using this information, the cohort of newly-arrived minors who visited ZHC medical for the first time during FY2019 was then reviewed. The information gathered was evaluated to determine how changing immigration patterns might influence the provision of comprehensive, family-based care at ZHC.

Principal Findings and Quantitative/Qualitative Results: 365 new immigrants, from Honduras, Guatemala, and El Salvador, were seen at one ZHC site (Morristown, NJ) during FY19. Of those with known accompaniment status during immigration (n=286), 82% were accompanied by a family member or friend. This demonstrates a change from Zufall’s 2014 experience, in which a majority of new child immigrants were unaccompanied. The guarantor of 28% of these new patients was previously or became a Zufall patient during the evaluation period. The first appointment of all patients peaked in September 2019, in line with the calendar school year.

Conclusions on Impact on Health Centers: Recent trends in Central American child immigration indicate a shift from unaccompanied children (typically teenagers) to family units (frequently with younger children), suggesting a need to redesign the current approach to care. Though recently arrived children are required to visit a healthcare provider to receive school-related physical examinations, the needs and health status – including mental health – of the entire family should be evaluated proactively to ensure the well-being of the family unit. Connections of families to case management, legal, and behavioral services could help mitigate trauma during the immigration experience and address socioeconomic determinants impacting health during the integration process.

Author(s):

Douglas Bishop, MD, Family Medicine Physician, Zufall Health Center

Peter Rentzepis, AmeriCorps Member, Zufall Health Center

Ritesh Karsalia, AmeriCorps Member, Zufall Health Center

Rina Ramirez, MD, FACP, Chief Medical Officer, Zufall Health Center