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

Publication ,  Journal Article
Mattingly, TJ; Kiser, L; Hill, S; Briggs, EC; Trunzo, CP; Zafari, Z; Betancourt, TS
Published in: J Trauma Stress
December 2020

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.

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Published In

J Trauma Stress

DOI

EISSN

1573-6598

Publication Date

December 2020

Volume

33

Issue

6

Start / End Page

873 / 881

Location

United States

Related Subject Headings

  • United States
  • Refugees
  • Psychological Trauma
  • Psychiatry
  • Mental Disorders
  • Male
  • Jails
  • Humans
  • Female
  • Family Separation
 

Citation

APA
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ICMJE
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Mattingly, T. J., Kiser, L., Hill, S., Briggs, E. C., Trunzo, C. P., Zafari, Z., & Betancourt, T. S. (2020). Unseen Costs: The Direct and Indirect Impact of U.S. Immigration Policies on Child and Adolescent Health and Well-Being. J Trauma Stress, 33(6), 873–881. https://doi.org/10.1002/jts.22576
Mattingly, T Joseph, Laurel Kiser, Sherika Hill, Ernestine C. Briggs, Carrie Purbeck Trunzo, Zafar Zafari, and Theresa S. Betancourt. “Unseen Costs: The Direct and Indirect Impact of U.S. Immigration Policies on Child and Adolescent Health and Well-Being.J Trauma Stress 33, no. 6 (December 2020): 873–81. https://doi.org/10.1002/jts.22576.
Mattingly TJ, Kiser L, Hill S, Briggs EC, Trunzo CP, Zafari Z, et al. Unseen Costs: The Direct and Indirect Impact of U.S. Immigration Policies on Child and Adolescent Health and Well-Being. J Trauma Stress. 2020 Dec;33(6):873–81.
Mattingly, T. Joseph, et al. “Unseen Costs: The Direct and Indirect Impact of U.S. Immigration Policies on Child and Adolescent Health and Well-Being.J Trauma Stress, vol. 33, no. 6, Dec. 2020, pp. 873–81. Pubmed, doi:10.1002/jts.22576.
Mattingly TJ, Kiser L, Hill S, Briggs EC, Trunzo CP, Zafari Z, Betancourt TS. Unseen Costs: The Direct and Indirect Impact of U.S. Immigration Policies on Child and Adolescent Health and Well-Being. J Trauma Stress. 2020 Dec;33(6):873–881.
Journal cover image

Published In

J Trauma Stress

DOI

EISSN

1573-6598

Publication Date

December 2020

Volume

33

Issue

6

Start / End Page

873 / 881

Location

United States

Related Subject Headings

  • United States
  • Refugees
  • Psychological Trauma
  • Psychiatry
  • Mental Disorders
  • Male
  • Jails
  • Humans
  • Female
  • Family Separation