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    Unseen Costs: The Direct and Indirect Impact of U.S. Immigration Policies on Child and Adolescent Health and Well-Being

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    Author
    Mattingly, T.J. II
    Kiser, L.
    Hill, S.
    Briggs, E.C.
    Trunzo, C.P.
    Zafari, Z.
    Betancourt, T.S.
    Date
    2020
    Journal
    Journal of Traumatic Stress
    Publisher
    John Wiley and Sons Inc.
    Type
    Article
    
    Metadata
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    See at
    https://doi.org/10.1002/jts.22576
    Abstract
    Shifts in migration and border control policies may increase the likelihood of trauma exposure related to child-parent separation and result in costs to the health system and society. In the present study, we estimated direct and indirect costs per child as well as overall cohort costs of border control policies on migrant children and adolescents who were separated from their parents, detained, and placed in the custody of the United States following the implementation of the 2018 Zero Tolerance Policy. Economic modeling techniques, including a Markov process and Monte Carlo simulation, based on data from the National Child Traumatic Stress Network's Core Data Set (N = 458 migrant youth) and published studies were used to estimate economic costs associated with three immigration policies: No Detention, Family Detention, and Zero Tolerance. Clinical evaluation data on mental health symptoms and disorders were used to estimate the initial health state and risks associated with additional trauma exposure for each scenario. The total direct and indirect costs per child were conservatively estimated at $33,008, $33,790, and $34,544 after 5 years for No Detention, Family Detention, and Zero Tolerance, respectively. From a health system perspective, annual estimated spending increases ranged from $1.5 million to $14.9 million for Family Detention and $2.8 million to $29.3 million for Zero Tolerance compared to baseline spending under the No Detention scenario. Border control policies that increase the likelihood of child and adolescent trauma exposure are not only morally troubling but may also create additional economic concerns in the form of direct health care costs and indirect societal costs. Copyright 2020 The Authors.
    Keyword
    Child
    Adolescent
    United States
    Emigration and Immigration
    Markov Chains
    Mental Health
    Transients and Migrants
    Monte Carlo Method
    Health Care Costs
    Delivery of Health Care
    Probability
    Cohort Studies
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    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85089373338&doi=10.1002%2fjts.22576&partnerID=40&md5=a6cfa79a130c28dc895b4433cf917c65; http://hdl.handle.net/10713/13581
    ae974a485f413a2113503eed53cd6c53
    10.1002/jts.22576
    Scopus Count
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