Unseen Costs: The Direct and Indirect Impact of U.S. Immigration Policies on Child and Adolescent Health and Well-Being
Date
2020Journal
Journal of Traumatic StressPublisher
John Wiley and Sons Inc.Type
Article
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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
ChildAdolescent
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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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/10713/13581ae974a485f413a2113503eed53cd6c53
10.1002/jts.22576