Skip to main content

Advertisement

Log in

Unaccompanied Children Migrating from Central America: Public Health Implications for Violence Prevention and Intervention

  • Injury Prevention (T Raybould, Section Editor)
  • Published:
Current Trauma Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Unaccompanied children (UC) migrating to the USA from the Central American countries of El Salvador, Guatemala, and Honduras are an underserved population at high risk for health, academic, and social problems. These children experience trauma, violence, and other risk factors that are shared among several types of interpersonal violence.

Recent Findings

The trauma and violence experienced by many unaccompanied children, and the subsequent implications for their healthy development into adulthood, indicate the critical need for a public health approach to prevention and intervention.

Summary

This paper provides an overview of the violence experienced by unaccompanied children along their migration journey, the implications of violence and trauma for the health and well-being of the children across their lifespan, prevention and intervention approaches for UC resettled in the USA, and suggestions for adapted interventions to best address the unique needs of this vulnerable population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. US Customs and Border Protection. United States Border Patrol Southwest Family Unit Subject and Unaccompanied Alien Children Apprehensions Fiscal Year 2016. 2016. https://www.cbp.gov/newsroom/stats/southwest-border-unaccompanied-children/fy-2016. Accessed 11 Nov 2016.

  2. US Department of Health and Human Services, Administration for Children and Families, Office of Refugee Resettlement. Children entering the United States unaccompanied: Guide to Terms. 2016. https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-guide-to-terms. Accessed 11 Nov 2016.

  3. Donato KM, Sisk B. Childrenʼs migration to the United States from Mexico and Central America: evidence from the Mexican and Latin American Migration Projects. Journal on Migration and Human Security. 2015;3(1):58.

    Article  Google Scholar 

  4. United Nations High Commission on Refugees. Children on the run: Unaccompanied children leaving Central America and Mexico and the need for international protection. Vienna: United Nations, 2016.

  5. Kennedy E. No childhood here: Why Central American children are fleeing their homes. Washington, DC: American Immigration Council. 2014.

  6. Carlson EG, Gallagher AM. Humanitarian protection for children fleeing gang-based violence in the Americas. Journal on Migration and Human Security. 2015;3:129–58.

  7. Hernandez D. Unaccompanied child migrants in “crisis”: new surge or case of arrested development? Harvard Journal of Hispanic Policy. 2014;27:11–7.

    CAS  Google Scholar 

  8. Murphey D. Moving beyond trauma: child migrants and refugees in the United States. Child Trends, Bethesda, MD. 2016.

  9. Chen A, Gill J. Unaccompanied children and the US immigration system: challenges and reforms. Journal of International Affairs. 2015;68(2).

  10. Gonzalez-Barrera A, Krogstad, JM, Lopez, MH. DHS: violence, poverty, is driving children to flee Central America to U.S. Pew Research Center 2014. http://www.pewresearch.org/fact-tank/2014/07/01/dhs-violence-poverty-is-driving-children-to-flee-central-america-to-u-s/.

  11. US Department of Health and Human Services, Administration for Children and Families, Office of Refugee Resettlement. Facts and data: General statistics. 2016. https://www.acf.hhs.gov/orr/about/ucs/facts-and-data. Accessed 14 Oct 2016.

  12. US Department of Health and Human Services, Administration for Children and Families, Office of Refugee Resettlement. Services Provided. 2016. https://www.acf.hhs.gov/orr/about/ucs/services-provided. Accessed 23 March 2017.

  13. Jones J, Podkul J. Forced from home: the lost boys and girls of Central America. New York, NY: Women Refugee Commission. 2012.

  14. Schapiro NA, Gutierrez JR, Gonzalez JL, Dai JS, Gutierrez I. Unaccompanied minors: breaking down barriers to health. J Adolesc Health. 2016;58(2):S21.

    Article  Google Scholar 

  15. UNICEF (United Nations Children's Fund). Hidden in Plain Sight – A Statistical Analysis of Violence against Children. New York: UNICEF, 2014.

  16. United Nations Office on Drugs and Crime. Global study on homicide 2013. Vienna: United Nations, 2014  Contract No.: Sales No. 14.IV.1.

  17. Jácome F. Trans-Mexican migration: a case of structural violence. Center for Latin American Studies, Georgetown University (undated, ca 2011). 2008.

  18. Vogt WA. Crossing Mexico: structural violence and the commodification of undocumented Central American migrants. Am Ethnol. 2013;40(4):764–80.

    Article  Google Scholar 

  19. Chavez L. The migration process for unaccompanied immigrant minors: children and adolescents migrating from Central America and Mexico to the United States [Dissertation]: Arizona State University 2016.

  20. United States Department of State. Trafficking in persons report, July 2015. 2015. https://www.state.gov/documents/organization/245365.pdf. Accessed 15 Nov 2016.

  21. Bhabha J, & Schmidt, S. Seeking asylum: unaccompanied and separated children and refugee protection in the US. 2006.

  22. Sultan A, O'sullivan K. Psychological disturbances in asylum seekers held in long term detention: a participant-observer account. Med J Aust. 2000;175(11–12):593–6.

    Google Scholar 

  23. Mares S, Jureidini J. Psychiatric assessment of children and families in immigration detention–clinical, administrative and ethical issues. Aust N Z J Public Health. 2004;28(6):520–6.

    Article  PubMed  Google Scholar 

  24. US Department of Health and Human Services, Administration for Children and Families, Office of Refugee Resettlement. Health and safety. 2016. https://www.acf.hhs.gov/orr/about/ucs/health-and-safety. Accessed 14 Oct 2016.

  25. TRAC Immigration. New data on unaccompanied children in immigration court 2014. http://trac.syr.edu/immigration/reports/359/. Accessed 3 Oct 2016.

  26. Rosenblum M. Unaccompanied child migration to the United States: the tension between protection and prevention. Migration Policy Institute 2015.

  27. Felitti VJ, Anda R, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14(4):245–58.

  28. Gilbert LK, Breiding M, Merrick MT, et al. Childhood adversity and adult chronic disease: an update from ten states and the District of Columbia, 2010. Am J Prev Med. 2015;48(3):245–9.

  29. Finkelhor DSA, Turner H, Hamby S. Improving the adverse childhood experiences study scale. JAMA Pediatr. 2013;167(1):70–5.

    Article  PubMed  Google Scholar 

  30. Cronholm PF, Forke CM, Wade R, et al. Adverse childhood experiences: expanding the concept of adversity. Am J Prev Med. 2015;49(3):354–61.

  31. Dube SR, Anda RF, Felitti VJ, Chapman D, Williamson DF, Giles WH. Childhood abuse, household dysfunction and the risk of attempted suicide throughout the life span: findings from adverse childhood experiences study. J Am Med Assoc. 2001;286:3089–96.

  32. Ports KA, Ford DC, Merrick MT. Adverse childhood experiences and adult sexual victimization. Child Abuse Negl. 2016;51:313–22.

  33. Whitfield CL, Anda RF, Dube SR, Felitti VJ. Violent childhood experiences and the risk of intimate partner violence in adults assessment in a large health maintenance organization. Journal of interpersonal violence. 2003;18(2):166–85.

    Article  Google Scholar 

  34. Remigio-Baker RA, Hayes DK, Reyes-Salvail F. Adverse childhood events and current depressive symptoms among women in Hawaii: 2010 BRFSS, Hawaii. Matern Child Health J. 2014;18(10):2300–8.

    Article  PubMed  Google Scholar 

  35. Shonkoff JP, Garner AS, Siegel BS, Dobbins MI, Earls MF, McGuinn L, et al. The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012;129(1):e232–e46.

    Article  PubMed  Google Scholar 

  36. Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, et al. Adverse childhood experiences and the risk of premature mortality. Am J Prev Med. 2009;37(5):389–96.

    Article  PubMed  Google Scholar 

  37. Anda RF, Fleisher VI, Felitti VJ, Edwards VJ, Whitfield CL, Dube SR, et al. Childhood abuse, household dysfunction, and indicators of impaired adult worker performance. The Permanente Journal. 2004;8(1):30.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Font SA, Maguire-Jack K. Pathways from childhood abuse and other adversities to adult health risks: the role of adult socioeconomic conditions. Child Abuse Negl. 2016;51:390–9.

    Article  PubMed  Google Scholar 

  39. Metzler M, Merrick MT, Klevens J, Ports KA, Ford DC. Adverse childhood experiences and life opportunities: time to shift the narrative? Children and youth services review. 2017;72:141-149.

  40. Schofield TJ, Lee RD, Merrick MT. Safe, stable, nurturing relationships as a moderator of intergenerational continuity of child maltreatment: a meta-analysis. J Adolesc Health. 2013;53(4):S32–S8.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Tyler JH, Lofstrom M. Finishing high school: alternative pathways and dropout recovery. Futur Child. 2009;19(1):77–103.

    Article  Google Scholar 

  42. Madruga CS, Laranjeira R, Caetano R, Ribeiro W, Zaleski M, Pinsky I, et al. Early life exposure to violence and substance misuse in adulthood—the first Brazilian national survey. Addict Behav. 2011;36(3):251–5.

    Article  PubMed  Google Scholar 

  43. Coêlho BM, Andrade LH, Borges G, Santana GL, Viana MC, Wang Y-P. Do childhood adversities predict suicidality? Findings from the general population of the metropolitan area of São Paulo, Brazil. PLoS One. 2016;11(5):e0155639.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Benjet C. Childhood adversities of populations living in low-income countries: prevalence, characteristics, and mental health consequences. Current opinion in psychiatry. 2010;23(4):356–62.

    Article  PubMed  Google Scholar 

  45. Fortson B, Klevens J, Merrick M, Gilbert L, Alexander S. Preventing child abuse and neglect: a technical package for policy, norm, and programmatic activities. Atlanta, GA: Centers for Disease Control and Prevention. 2016.

  46. Hillis SD, Mercy JA, Saul J, Gleckel J, Abad N, Kress H. THRIVES: a global technical package to prevent violence against children: Centers for Disease Control and Prevention; 2015.

  47. World Health Organization. INSPIRE: seven strategies for ending violence against children. Geneva, Switzerland; 2016.

  48. Centers for Disease Control and Prevention. Essentials for childhood: Steps to create safe, stable, and nurturing relationships. Atlanta, GA; 2013.

  49. US Department of Health and Human Services, Administration for Children and Families, Office of Refugee Resettlement. Children entering the United States unaccompanied: Section 3. 2015. https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied. Accessed 14 Oct 2016.

  50. United States Congress. Trafficking Victims Protection Reauthorization Act of 2005. 109th Congress 1st Session; 2005. https://www.govtrack.us/congress/bills/109/hr972. Accessed 1 Nov 2016.

  51. Roth BJ, Grace BL. Falling through the cracks: the paradox of post-release services for unaccompanied child migrants. Child Youth Serv Rev. 2015;58:244–52.

    Article  Google Scholar 

  52. Lustig SL, Kia-Keating M, Knight WG, Geltman P, Ellis H, Kinzie JD, et al. Review of child and adolescent refugee mental health. Journal of the American Academy of Child & Adolescent Psychiatry. 2004;43(1):24–36.

    Article  Google Scholar 

  53. Huemer J, Karnik NS, Voelkl-Kernstock S, Granditsch E, Dervic K, Friedrich MH, et al. Mental health issues in unaccompanied refugee minors. Child and adolescent psychiatry and mental health. 2009;3(1):1.

    Article  Google Scholar 

  54. Lummert N. Assisting unaccompanied youth to integrate. Forced Migration Review. 2012;40:31.

    Google Scholar 

  55. Kataoka SH, Stein BD, Jaycox LH, Wong M, Escudero P, Tu W, et al. A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child & Adolescent Psychiatry. 2003;42(3):311–8.

    Article  Google Scholar 

  56. Avellar S, Paulsell D, Sama-Miller E, Grosso PD, Akers L, Kleinman R. Home visiting evidence of effectiveness review: executive summary. Mathematica Policy Research, 2015.

  57. Bernal G, Jiménez-Chafey MI, Domenech Rodríguez MM. Cultural adaptation of treatments: a resource for considering culture in evidence-based practice. Professional Psychology: Research and Practice. 2009;40(4):361.

    Article  Google Scholar 

  58. Chávez LM, Canino G. Toolkit on translating and adapting instruments. http://www hsri org/files/uploads/publications/PN54_Translating_and_Adapting pdf. 2005. hsri org/files/uploads/publications/PN54_Translating_and_Adapting pdf. 2005.

  59. Community Toolbox.  Section 4: Adapting community interventions for different cultures and communities. 2016. http://ctb.ku.edu/en/table-of-contents/analyze/choose-and-adapt-community-interventions/cultural-adaptation/main. Accessed 11 Nov 2016.

  60. Family Violence Prevention Fund. Culture Handbook 2005. https://www.futureswithoutviolence.org/userfiles/file/ImmigrantWomen/Culture%20Handbook.pdf. Accessed 14 Oct 2016.

  61. Council on Community Pediatrics. Immigrant Child Health Toolkit. 2016. https://www.aap.org/en-us/about-the-aap/Committees-Councils-Sections/Council-on-Community-Pediatrics/Pages/Immigrant-Child-Health-Toolkit.aspx. Accessed 14 Oct 2016.

  62. Sangalang CC, Ngouy S, Lau AS. Using community-based participatory research to identify health issues for Cambodian American youth. Family & community health. 2015;38(1):55–65.

    Article  Google Scholar 

  63. Hipp, T. N. & Cook, S. L. (2017). Rape and sexual assault on campus, in diverse populations, and in the spotlight. In C. M. Renzetti, J. L. Edleson, & R. K. Bergen (Eds.), Sourcebook on Violence Against Women (Chapter 4). Thousand Oaks, CA: SAGE.

  64. Ungar M. Resilience, trauma, context, and culture. Trauma, Violence, & Abuse. 2013;14(3):255–66.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lianne Fuino Estefan.

Ethics declarations

Conflict of Interest

Drs. Estefan, Ports, and Hipp declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the author.

CDC Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Additional information

This article is part of the Topical Collection on Injury Prevention

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Estefan, L.F., Ports, K.A. & Hipp, T. Unaccompanied Children Migrating from Central America: Public Health Implications for Violence Prevention and Intervention. Curr Trauma Rep 3, 97–103 (2017). https://doi.org/10.1007/s40719-017-0082-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40719-017-0082-2

Keywords

Navigation