Children of Immigrants and the COVID-19 Pandemic

The COVID-19 pandemic has had profound detrimental effects on children of immigrants. More than 75 percent of children dying from COVID-19 are minorities, echoing the disproportionate death rates among adults. The disproportionate representation of minority deaths may result from, among other things, mistrust of health services and the rise in children’s uninsured rates. Beginning in 2016, the uninsured rate among Latinx children with only foreign-born parents rose, resulting in roughly 515,000 more children who were uninsured in 2018 than in 2016. The parents’ undocumented status negatively affected their children’s development and wellbeing. In 2018, the uninsured rate for Latinx children with only foreign-born parents was 3.4 times higher than the rate for non-Latinx white children and 2.5 times higher than the rate among Latinx children with at least one U.S.-born parent.

Immigrant families faced higher rates of COVID-19 in their communities due to social disparities, such as wealth and education gaps. Other conditions that put immigrant families at higher risk include: overcrowded housing; lack of access to medical care, insurance, and sick leave; disparities in testing, infection, and hospitalization; food insecurity; pre-existing conditions; parents who are essential workers and cannot work from home; and unsafe working conditions, especially for migrant farmworkers. For immigrant families with members who were able to keep their job, many of them hold low-wage jobs considered essential, which don’t always offer employee-sponsored health care or paid sick leave. With an increased risk of exposure, lack of health insurance, and fear of accessing health care services, there are concerns that some immigrants might not seek testing or wait too long to receive care. Voice of San Diego, a nonprofit news organization, found that immigrants account for more than half of the people who died from COVID-19 in San Diego County in the first year of the pandemic, even though they make up 23 percent of San Diego County’s population.

Behind these shocking disparities are the ones left behind–orphans. According to the Centers for Disease Control and Prevention, more than 140,000 children under age 18 in the United States–from April 1, 2020 through June 30, 2021—lost a parent, custodial grandparent, or grandparent caregiver who provided the child’s home and basic needs. One U.S. child loses a parent or caregiver for every four COVID-19-associated deaths, a new modeling study published in Pediatrics reveals. Children of racial and ethnic minorities accounted for 65 percent of those who lost a primary caregiver.

American Indian/Alaska Native children were 4.5 times more likely to lose a parent or grandparent caregiver than white children, Black children were 2.4 times more likely, and Latinx children were 1.8 times more likely compared to white children. While the data were not separated by immigration status, we can expect that children of immigrants are disproportionately impacted since other data shows that immigrant families accounted for higher rates of the virus. The loss of a parent has adverse effects on children, including mental health problems, shorter schooling, lower self-esteem, sexual risk behaviors, and increased risk of substance abuse, suicide, violence, sexual abuse, and exploitation.

Child poverty rose between 2018 and 2020 for Black and Latinx children. A report reveals that Latinx child poverty rose from 2019 to 2020, during the COVID-19 pandemic, despite the unprecedented public investment in family-supportive policies. As with the rates of uninsured, the rates of increased poverty differ by parents’ citizenship statuses: 6.1 percentage points among Latinx children living in families headed by non-U.S. citizens (including both authorized and unauthorized immigrants); 4.9 percentage points among families headed by naturalized U.S. citizens; and 3.0 percentage points among families headed by U.S.-born citizens.

The increase is particularly troubling because the poverty rates among Latinx children were already high; in 2019 the poverty rate was 36.3 percent among families headed by non-U.S. citizens. The poverty rates are disproportionately high among immigrant families. Half of immigrant parents with children ages 0–4 are low-income, and 30 percent of them are working poor, employed with an annual family income of below 200 percent of the federal poverty level. Immigrant families are more likely to work a substantial number of hours more than families of children with U.S.-born parents; however, these families are more likely to have low incomes. The majority (54 percent) of immigrant parents of children ages 0–4 work in low-skilled jobs.

Unlike U.S.-born families, many immigrant families, who lost their job or had their hours reduced, did not qualify for most forms of federal aid, such as unemployment or recovery rebates, to help make up for the lost income. They also didn’t qualify for federal public benefit programs like Supplemental Nutrition Assistance Program (SNAP), regular Medicaid, Supplemental Security Income, or Temporary Assistance for Needy Families.

While U.S. citizen children in immigrant families can receive federal benefits if they meet the eligibility requirements, many families are afraid to access these or any other type of service due to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and the Public Charge Final Rule that went into effect on February 24, 2020. This rule expanded the criteria that the government can consider whether a green card and temporary visa applicant is likely to become primarily dependent on government assistance, making it more difficult for some immigrants to obtain lawful permanent residence if they access certain public benefits like food stamps and housing vouchers. Although the Biden administration restored the public charge rule to the status quo before the 2020 change, the public charge rule still applies to receipt of Temporary Assistance for Needy Families and Supplemental Security Income, programs that supplement families’ income and reduce poverty. The Immigration and Nationality Act requires officials to take into account whether a prospective immigrant could become a public charge, without explicitly defining the term. That is, the language around public charge remains vague and up to the discretion of officials. According to Shelby Gonzales, vice president for immigration policy at the Center on Budget and Policy Priorities, immigrant families continue to forgo critical resources.

Research indicates the “chilling” of such rules, whereby immigrant families avoided public programs out of fear of immigration-related consequences, were widespread even before implementation. One in five adults in immigrant families with children reported chilling effects on public benefit receipt in 2019. Families withdrew from benefits regarding food, housing, medical care, and disaster relief—all of which are critical to the wellbeing of their children. Immigration experts estimate millions of children in immigrant families could be affected, many of whom are U.S. citizens, including documented immigrants who withdraw from programs because of confusion about the new rules. Additionally, the local implementation of section 287(g) of the Immigration and Nationality Act and the Secure Communities program, which authorizes local law enforcement agencies to enforce federal immigration laws, produced profound mistrust of health services among Latinx persons, leading them to avoid health services and sacrifice their health and the health of their family members.

A Children’s Defense Fund-Texas report found that between December 2017 and April 2019, Texas experienced a precipitous drop in enrollment in benefit programs: SNAP lost 520,000 of its enrollees, a drop of 13.5 percent. Women, Infants and Children (WIC) lost 155,726 enrollees, or 18.8 percent of its caseload. Immigrant families across Texas began to withdraw their citizen and lawfully-present children from Medicaid and Children's Health Insurance Program (CHIP) in addition to food assistance. VELA, which provides assistance, support, and training to families who have children with disabilities in Austin, Texas, found that 80 percent fewer VELA families were enrolled in SNAP, between 2019 and 2018. Foundation Communities, an organization in Austin that offers health insurance enrollment assistance (among other programs) revealed that in 2018 during the open enrollment for the Affordable Care Act health insurance marketplace, they had seen a 16.9 percent reduction in immigrant clients, compared with only a 5.4 percent reduction in nonimmigrant clients, from their 2017 open enrollment numbers. Epiphany Community Health Outreach Services, a non-profit organization in Houston that connects low-income, largely immigrant clients with health, social and educational resources, saw a 42 percent reduction in Children’s Medicaid enrollments, a 42 percent reduction in adult Medicaid and CHIP-Perinatal services, and a 37 percent decrease in SNAP enrollments, between 2016 and 2019.

Nationally, 11.4 percent of immigrants with children reported that they or a family member avoided a nutrition program (SNAP or WIC) in 2019. In terms of access to health care, more than 1 in 4 children of immigrants did not have health insurance in 2019 (25.5 percent compared to 5.1 percent of native-born citizen children). Despite a federal directive ordering states not to withhold childcare subsidies from U.S. citizen children with undocumented parents, some are, at a minimum, tacitly unhelpful or unwelcoming. The state of Utah, for instance, asked applicants whether they are legally permitted to work in the United States when the state was pressured to stop checking citizenship to decide who gets benefits. By extension, Utah effectively found a way to continuing to deny children of immigrants, U.S. citizens, access to federal safety net programs like Medicare, SNAP, and CHIP. And though the government has specified that COVID-19-related care will not be used as part of public charge considerations, immigrants are not seeking medical care related to the COVID-19 out of fear of consequences for their immigration applications or fear of deportation, according to immigrant advocates and medical personnel.

The recent increase in uninsured and poverty rates leaves children especially vulnerable during the pandemic. It is particularly concerning that the uptick was limited to the one of the groups hardest hit by COVID-19, Latinx children with foreign-born parents. The social safety-net programs effectively penalize the 3.5 million children who have mixed-status families. Unemployment benefits require sufficient formal earnings as an eligibility criterion, which may be difficult to meet for many Latinx workers in low-wage or seasonal jobs. Additionally, many programs impose immigration restrictions by requiring Social Security numbers for all family members or by banning public assistance to most non-citizens through the 1996 welfare reform law. Responding to the pandemic’s impact on immigrant families, one year after, recent Economic Impact (stimulus) Payments and the temporary Child Tax Credit expansion have allowed immigrant families to access benefits for their U.S. citizen children by making individuals and children, rather than the family, the basis of eligibility. The ability of this change to reduce the adversity faced by immigrant families in poverty requires increasing awareness and combating distrust of government in their communities.

In addition to the barriers to access nutrition and health programs, immigrant parents do not have criteria, such as high formal education and English-proficiency, to financially advance and help their children with school. Immigrant parents of children ages 0 to 4 are four times less likely to hold a high school diploma or equivalent than their U.S.-born counterparts. Although they represent only one-quarter of the total population of parents, 57 percent of parents of children ages 0–4 without a high school diploma were immigrants. Significant shares of immigrant parents had less than a ninth-grade education: 15 percent of those with children ages 0–4 compared to 1 percent of U.S.-born parents.

About half of immigrant parents of young and elementary-school age children are English learners. Many immigrant parents experience the compounded impacts of poverty, low education, and being English learners. One-third of immigrant parents of young children were both low income and English learners. Low-income immigrant parents are three times more likely to lack a high school diploma/equivalent than low-income native-born parents. Because mobility in the United States usually requires education prerequisites of high school diploma/equivalent and English proficiencies, many immigrant parents with young children become stuck in low-wage jobs that offer little room for autonomy and advancement.

While the majority of immigrant parents are employed, parents not in the labor force tend to have a low level of education attainment, which heightens their isolation and alienation in the United States. Zahra Hasmi, a 41-year-old from Afghanistan who has lived in the United States for three years, is illiterate in all languages and describes helplessness in many aspects of her life. Her five-year-old daughter recently started school when Zahra learned about the school from a friend. She does not know the name of the school nor if it’s kindergarten or preschool. In fact, she is also unsure of her daughter’s age—she presented her daughter’s green card to the school and trusts that the school will place her daughter in an appropriate class. In addition to her illiteracy, for the majority of her motherhood, her biggest concern has been whether her children will return home alive or dead.

Murders of her family dominate her mind and determined many of her life events. After her father and uncle were burned alive in front of her, she married a man who worked for the U.S. embassy. She doesn't know how old she was when she got married; she only knows that marriage might help her stay alive. Four of her cousins were also burned alive in their house; her mother still carries a bullet left by a member of the Taliban. She bookends the interview with questions on how to help her family escape Afghanistan, suggesting feelings of responsibility and guilt. Zahra’s uncertainty, feelings of helplessness, witnessing of atrocities against her family members, and prolonged sadness have a cumulative effect on the family and the parent-child relationship.