Editor’s Note: Edith Bracho-Sanchez is a primary care pediatrician, director of pediatric telemedicine and assistant professor of pediatrics at Columbia University Irving Medical Center. She hosts the podcast “The Stuff that Matters for Kids’ Health” from Columbia Children’s Health.

CNN
 — 

Latino children who live in states with harsher laws that apply to immigrants and systemic prejudice against them are more likely to experience mental health or chronic physical health conditions, according to a new study.

For the study, published Tuesday in the journal Pediatrics, researchers used nationally representative data of 17,855 Latino children, ages 3 to 17, from the National Survey of Children’s Health conducted between 2016 and 2020. Caregivers were polled on three areas of children’s health: health difficulties in the past year; chronic physical conditions diagnosed by a medical provider, such as asthma, diabetes or a heart condition; and current mental health conditions also diagnosed by a medical provider. Health scores were then compared with each state’s “inequities” score, which considered exclusionary state policies toward immigrants and attitudes toward Latino communities.

Latino children who lived in states with higher inequities had higher odds of one or more physical health conditions and two or more mental health conditions, even after accounting for individual experiences of discrimination and socioeconomic status. States with higher inequity scores included Alaska, Alabama and Nebraska, while California scored the lowest.

Latino children, who make up a quarter of children in the United States, are known to fare worse than non-Latino White children when it comes to common health conditions like respiratory illnesses and obesity. Systemic inequities are thought to affect the health of children by causing chronic stress and by depriving them of the resources needed to support healthy development. These inequities include prejudicial attitudes and rhetoric directed toward racial or ethnic minorities, as well as laws designed to exclude individuals from obtaining health services, private sector employment, housing and education.

Before this study, there was little research on the impact of larger social and systemic factors on the health of Latino children, said Dr. Natalie Slopen, lead study researcher and assistant professor in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.

“Our hope is that these findings can inform future studies to identify macro-level approaches to address health inequities,” Slopen said.

To pediatrician Dr. Ilan Shapiro, the results of the study were not surprising. “I have seen this play out everywhere I’ve practiced medicine: Illinois, Florida, now California,” said Shapiro, the chief health correspondent and medical affairs officer at Altamed, a California-based community health network.

Children in Latino communities with a true safety net around them see their health improve, and those without it see it suffer, he added. This safety net includes access to medical services in the form of community health clinics, as well as access to healthy and affordable food and housing, Shapiro said.

The survey did not ask caregivers about their personal experiences with these inequities. Instead, it measured inequities at the state level and correlated them with health scores.

“This places the findings within the realm of public policy with a call to action to address state mandates that directly affect individual children,” said Dr. Nathalia Jimenez, professor and vice chair for equity, diversity and inclusion in the Department of Anesthesiology and Pain Medicine at the University of Washington School of Medicine, in a commentary also published Tuesday in Pediatrics. 

The study, Shapiro points out, was conducted before the Covid-19 pandemic, which was known to further cut access to critical services for the Latino community. “I suspect if we did the same study today, we’d see an even bigger impact on the health of Latino children,” he said.

The future of any country is on the shoulders of its children, Shapiro said.

“Not acting on this information is like having a positive screening test for cancer, knowing what the treatment is but not doing anything with it,” he added. “We have a choice, and we need to choose to create better systems.”

 To Jimenez, policies affecting a quarter of children in the US have real implications for the health of the whole country.

“At the societal level, this study provides further evidence that immigrant policy is health policy,” she said.