P3B102: Health Promotion by the Busload: Caring and Advocating for Newly Arrived Immigrant Families in NYC

Background: More than 50,000 immigrants have come to NYC in the past year after crossing the US-Mexico border. This new wave of immigrants primarily came from Venezuela (due to violence and government breakdown) and Ecuador (due to extreme poverty because of the COVID-19 Pandemic). Additional families immigrated from Africa and Haiti. Notoriously, the governor of Texas sent many busloads of these families to NYC last summer. The city government, including the mayor, the city health care system, (Department of Health and NYC Health and Hospitals-NYC H+H), and the city’s pediatricians and other health professionals stepped up to the plate to collaborate in helping these newest New Yorkers. This is the story of that effort regarding children, adolescents and families: the health and mental health issues that those children experienced and the response of the pediatric and broader health community.

Project Description: HOUSING: NYC provided shelter to these families. Many or most were housed in so called HERRCs (Humanitarian Emergency Rescue and Relief Centers). These are hotels, mostly in midtown Manhattan, that provide rooms, food, health care, legal services, school placements, and other help to these families. Thousands of families with thousands of children reside in HERRCs. The majority are located within a short distance of NYC H+H Bellevue Hospital, where many of the authors care for patients. Figure 1 shows parents at a HERRCs Hotel putting their children on school buses in the morning.
HEALTH AND MENTAL HEALTH PROBLEMS OF FAMILIES: In New York, all children and pregnant people are enrolled in public health insurance, regardless of immigration status. Many of the children and adolescents have mental health issues due to the trauma of leaving their home and traveling, often through danger, to come to the US. PTSD, depression, anxiety, trauma due to sexual assault, and adjustment reactions are commonly seen and cared for. Untreated dental caries are common. Children are frequently incompletely immunized and receive vaccines either at the HERRC or at health facilities like Bellevue. A varicella outbreak occurred in the HERRCs but has been under control due to case finding and vaccination programs. A number of parents have active TB and are being treated as outpatients or inpatients, and children are being referred for testing and possible therapy. Many families walked many miles through jungles and drank river water, leading to parasitic infections and E. Coli. All these children are screened for parasites and some have been admitted for diarrhea due to infectious agents. Children frequently have common chronic diseases, like seizure disorders, diabetes, and asthma, and may not have medication.

Discussion: NYC has always been a haven for immigrants and continues to be so.

Conclusion: Out country needs to welcome immigrant families the way NYC has shown us the way