P3.K203: Child health as an intermediary to whole immigrant family’s socio-legal needs

Background: Both United States (U.S.) born and foreign-born children to immigrant parents face an array of social complexities that can affect the health of the whole family. The threat of deportation, trauma from migration, and need to financially and emotionally support the family places a strain on the immigrant parent to child relationship. Difficulties in accessing systems that could address these social disparities, specifically the U.S. legal system, alongside mistrust have kept families from progressing following migration. A medical referral to a trauma-informed, bicultural, multidisciplinary clinic for the child may provide a clear pathway for the whole family to receive socio-legal care.

Methods: Patients were referred to the multidisciplinary clinic by local providers, emergency rooms, and hospitals if found to be a child in an immigrant family and aged one month-18 years. These patients (n=205) were administered Intake during the first in-person appointment with a clinic coordinator from 2022-2024. Guardians or those aged 16+ provided answers on the patient birth country, legal status, and family legal status. All patients then received a combination of medical, psychological, legal care and/or case management consultation by each respective provider, which corroborated the Intake data. After their appointment, the patients were documented to have accepted or declined legal services. Data was collected in Qualtrics (Qualtrics 2024, Provo, UT) with analyses conducted in R Statistical Software (v4.3.1; R Core Team 2023).

Results: Of the 32 U.S. born patients, 28 accepted legal services (87.50%) and of the 173 foreign-born patients, 156 accepted legal services (90.17%). Patients born in the U.S. were approximately 0.763 as likely to accept legal services compared to patients who were not born in the U.S. (Odds Ratio [OR] = 0.763, p-value > 0.05, 95% confidence interval [CI] = 0.239-2.436). From the 205 patients, information regarding the family legal case status of 8 patients was unable to be collected and were omitted; subsequent analysis included 197 patients. The result of Fisher’s exact testing (p-value = 0.034) indicates a significant association between acceptance of legal service and if a patient’s family was also included on the patient’s legal case.

Conclusion: No statistically significant difference was observed in whether U.S. born or foreign-born patients accepted legal services. This contrasts the general assumption that U.S. born children would not need legal services. In addition, the association between acceptance of legal service and the patient’s family inclusion on their legal case further indicates how a pediatric visit for one child may begin to support the entire family. The data observed shows how a multidisciplinary clinic can continue to bridge care to immigrant parents in need of legal counsel and improve the wellbeing of the whole family.