King County doctor: Family separation policy has health consequences

While many voice moral arguments against family separation immigration policies, one Western Washington doctor points out that science also opposes the practice.

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“There are physical and mental effects that we both see in the acute setting, but also long-term,” Dr. Danny Low told Seattle’s Morning News. “Strictly speaking, from a medical perspective, there are also huge consequences that we are seeing at the border.”

Dr. Low is a family medicine physician at Swedish Medical Center’s Cherry Hill location. He’s on the board of the King County Medical Society where he is introducing a resolution stating that the county medical society opposes family separation immigration policies. The resolution argues that the practice of separating families is “designed in a manner that increases poor health outcomes for children.”

If approved, the resolution will be forwarded to the Washington State Medical Association and will be included in that organization’s legislative portfolio in January 2019.

Health effects of family separation

Dr. Low’s argument centers on “adverse childhood events” — incidents and environmental factors that increase poor health conditions in children up to the age of 18. The more adverse childhood events add up, the greater the health risks. Being separated from parents is one factor, which leads to social neglect, and then physical neglect. That’s three adverse childhood events right there, Low points out.

“When these happen more and more frequently what we see is increased likelihood of having heart disease, pulmonary disease, liver disease and even increased early mortality,” Dr. Low said.

While family separation has happened for years, even before the Trump administration, the practice has ramped up in recent months. Shefali Luthra with Kaiser Health News reports that since October 2017, there have been 70 children younger than the age of 1 who have been summoned to go through immigration court without a parent.

“What we are seeing now, though, is we have a lot more kids that are considered unaccompanied because of family separation,” Luthra said. “They go through these immigration courts operated by the Department of Justice.”

“It’s pretty wild,” she added. “We spoke to a lawyer who said this kid started crying in court, in 2014 so this has been going on for a while … and the judge said ‘Can you take this child out of the courtroom?’ And the lawyer said, ‘This child is the next case you are hearing.’”

KCMS resolution

If the resolution is approved, it will be added to other medical statements across the country which also oppose the immigration policy, Low said, such as the American College of Physicians, the American Academy of Pediatrics, as well as the American Psychiatric Association.

Dr. Low’s proposed resolution reads:

WHEREAS Adverse Childhood Events (ACEs) refer to categories of abuse, neglect and household/family challenges that children experience during the first 18 years of life, and

WHEREAS experiencing ACEs has repeatedly revealed a dose-response relationship between ACEs and negative health and well-being outcomes across the life course, and

WHEREAS experiencing an increasing number of ACEs has specifically been shown to increase the risk for autoimmune disease, alcoholism, chronic obstructive pulmonary disease, depression, , early death, illicit drug use, ischemic heart disease, liver disease, poor work performance, intimate partner violence, sexually transmitted diseases, smoking, , suicide attempts, and unintended pregnancies, and

WHEREAS current immigration practices that allow for the separation of families result in children experiencing at least 3 ACEs – parental separation, emotional neglect and physical neglect from parents who are forcibly separated from their children; and

WHEREAS studies of detained immigrant children have shown that children often subsequently suffer negative physical and emotional symptoms from detention, including anxiety, depression and posttraumatic stress disorder, and

WHEREAS conditions in U.S. detention facilities reportedly have included forcing children to sleep on cement floors, use open toilets, and receive insufficient food and water, leading to ill and malnourished children, and

WHEREAS such immigration practices are therefore designed in a manner that increase poor health outcomes for children; be it

RESOLVED that the Washington State Medical Association support policy that promote unification of families at the border, and be it further

RESOLVED that the Washington State Medical Association oppose policy that detains immigrant children in detention facilities, and be it further

RESOLVED that the Washington State Medical Association support local and state-level immigration policy that prevents non-criminal, undocumented immigrants in Washington State from being separated from their family, and be it further

RESOLVED that the Washington State Medical Association oppose the enforcement of immigration policy on undocumented immigrants that impose increased ACEs.

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