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Immigrant Children’s Illnesses and Access To Health Care

by Sasha Nyary, May 13, 2004
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The eight-year-old had had chronic stomach pains for several weeks when his mother came up to Sandra Romain in Cambria Heights asking for help. The mother, undocumented and unable to speak English, had taken her son to the doctor, but left when she heard how high the fee would be. She had been feeding her son a home remedy of a certain Haitian tea, but he was still sick.

Romain, who was passing out flyers about health care for the Haitian Americans United Progress, told the mother that her boy was eligible for free health care. She helped the mother apply for a program known as Child Health Plus B.

Last year, people like Romain helped almost 95,000 immigrant children to sign up for this program, an example of what is called facilitated enrollment. But Governor George Pataki has proposed eliminating $10 million of funding for facilitated enrollment.

The city’s children will be hurt by this.

Undocumented immigrants have few choices for public health insurance in New York. But any immigrant child can enroll in Child Health Plus B, regardless of their status, and this covers many medical costs. Legal immigrants can use the more comprehensive Child Health Plus A, Medicaid or the state’s Family Health Plus.

What The Facilitators Do

The enrollment facilitators have set up shop in about 40 community-based organizations and 12 government agencies around the city. This group of diverse, multi-lingual people demystifies the process, answers questions, and dispels false rumors about the dangers of signing up for health care. They help the applicants fill out and gather the necessary forms, which they then send along to Medicaid or an HMO. Thousands are helped with the renewal process. An estimated 70 percent of adults enrolled in Health Family Plus in New York City came in through these facilitators (in PDF format). Losing this program will result in tens of thousands of immigrant children in New York City being without health insurance.

Why The Facilitators Are Needed

Overall, foreign-born children suffer from more illnesses than native-born children, according to a recent report (in PDF format). The city’s immigrants tend to be poor, especially recent arrivals. A third of children with immigrant parents live in families that have difficulty affording food.

Poor living conditions often lead to big problems for children:

Lead Poisoning

Children born in other countries make up 14 percent of the city’s child population but account for 22 percent of the lead poisoning. Lead poisoning disproportionately affects the Haitian and South Asian immigrant communities. Children born in Haiti are just three percent of the city’s population but account for 27 percent of all foreign-born children with lead poisoning. Children from India, Pakistan and Bangladesh are less than nine percent but account for 23 percent.

Asthma

Similarly, communities with high immigrant populations where the primary language is not English have extremely high rates of asthma. Haitians in Jamaica and Flatbush, and Dominicans and Latinos in Bushwick have very high rates of asthma. East Harlem, which is primarily Spanish-speaking, has the highest rates in the city. Rat and roach infestations, mold and dust mites are all linked to asthma.

Pesticides

Pesticides both legal and illegal are big problem for New York’s immigrant children. Children absorb more pesticides than adults because of their proximity to the ground and their still-developing bodies and brains. Pesticides have been shown to lead to lower birth rates and learning and behavioral problems. The insect and rodent infestations often present in poor housing means a higher use of pesticides, which have higher rates of use in New York City than in upstate agriculture. Illegal pesticides imported from China and the Dominican are widely sold in immigrant neighborhoods.

Obesity

Obesity is a particular problem for Hispanic children, who have by far the highest rate of pediatric obesity in the city. Almost one-third of Hispanic children between the ages of six and eleven are obese, compared with 16 percent of white children and 23 percent of black children. Diabetes, high blood pressure, and asthma can result from obesity, which usually follows children into their adulthoods, and increases the chances they will have obese children.

Immigrant parents are often working long hours and can’t monitor their children’s eating habits well. Low-income families can’t afford organized sports programs and poor neighborhoods often have poor or no playgrounds and parks, so children spend their time watching TV or playing video games. Culturally, many immigrant families come from countries with significant food shortages, so they urge food on their children as a way to show love.

Sasha Nyary, formerly on the staff of Life Magazine and the mother of a public school student, edits the newsletter of The Fifth Avenue Committee, a community-based organization.

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