BACKGROUND: Children of immigrants are a fast-growing population. 88% of children with immigrant parents are US citizens, and many qualify for government-issued resources such as Supplemental Nutrition Assistance Program (SNAP) or Medicaid. OBJECTIVE: Our primary aim was to assess the utilization rates of Medicaid, SNAP, and Women Infants and Children (WIC) in children with 1 or more undocumented parent (UP) compared to children with no UP (with annual income levels of <$30,000). Secondary outcomes were immigration status concerns in children with 1 or more UP and comparison of food security and stress levels between children with 1 or more UP versus children with no UP. METHODS: This was a prospective cross-sectional study conducted at a quaternary care children’s hospital on the hospital medicine service. Primary caregivers of patients 0-18 years of age were given an 89-item self-report survey (available in English and Spanish). Foster parents or parents who did not speak either English or Spanish were excluded. Domains assessed included payor type, SNAP utilization, WIC utilization, food security, stress levels, and fear relating to immigration status. Food security was assessed using the 18-item US Household Food Security Survey Module developed by the US Food and Drug Administration. Stress level was assessed using the Perceived Stress Scale. We used chi-square and Fisher’s exact tests to assess differences in resource utilization between groups. The level of statistical significance was p < 0.05. RESULTS: This study represents preliminary data from 76 patients (out of 400 target sample size) enrolled from March 18th-March 29th, 2018 (75% response rate). Results are represented in Table 1 and Table 2. 18% of our sample (14 participants) reported that their child has 1 or more UP. 75% of participants reporting 1 or more UP had income levels of <$30,000 compared to 41% of participants reporting no UP (p=0.04). There was no statistically significant difference in utilization of public resources (WIC, SNAP, Medicaid) for families with annual income <$30,000 across both groups. Families with 1 or more UP had similar stress levels and food security levels. Of families with 1 or more UP, 29% reported discontinuing either Medicaid, SNAP, or WIC because of concerns for immigration problems. 71% reported worrying about whether a family member, friend, or themselves will be deported. CONCLUSIONS: Families with 1 or more UP have significantly higher levels of poverty. Our study lacked sufficient power to determine a statistically significant difference in resource utilization between families with 1 or more UP and families with no UP. However, several families with 1 or more UP reported not utilizing public resources because of fear that it will affect their immigration status. Continued efforts are needed to help this particularly vulnerable population.

Table 1

Comparison of Children with 1 or More Undocumented Parent vs Children with No Undocumented Parents

a Participants with reported income level <$30,000 (n=9 for children with 1 or more UP; n=19 for children with no UP) b Participants with reported income level <$30,000 with child less than age 5 (n=8 for children with 1 or more UP; n=9 for children with no UP)

Table 1

Comparison of Children with 1 or More Undocumented Parent vs Children with No Undocumented Parents

a Participants with reported income level <$30,000 (n=9 for children with 1 or more UP; n=19 for children with no UP) b Participants with reported income level <$30,000 with child less than age 5 (n=8 for children with 1 or more UP; n=9 for children with no UP)

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Table 2

Positive survey responses for families with 1 or more undocumented parent

Table 2

Positive survey responses for families with 1 or more undocumented parent

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