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Systems, Structures, and Support: Using a Socioecological Framework to Improve Health Equity for Children in
Nicole E Hickman1, Emma L Anselin2, Elizabeth Dawson-Hahn3,4
1Department of Pediatrics, University of California San Diego School of Medicine, Rady Children's Hospital, San Diego, California.
Pediatric Annals
|May 1, 2026
Summary
Children in immigrant families (CIF) face significant health risks. Pediatricians can improve care by addressing individual, organizational, and structural factors to ensure equitable health outcomes for all children.
Area of Science:
- Pediatric Health
- Health Equity
- Immigrant Health
Background:
- Children in immigrant families (CIF) are a significant population in the U.S., facing unique health disparities.
- These disparities are influenced by immigration policies, structural racism, trauma, and access to care barriers.
Purpose of the Study:
- To review the current state of pediatric immigrant health.
- To outline strategies for pediatricians to advance health equity for CIF at multiple levels.
Main Methods:
- Utilized a socioecological framework to analyze challenges and opportunities.
- Reviewed existing literature and clinical guidelines on pediatric immigrant health.
Main Results:
- Identified key areas for intervention: clinical practice, health systems, and policy advocacy.
- Highlighted the importance of trauma-informed care, safe documentation, and medical interpreters.
- Emphasized the role of health systems in creating safe environments and fostering community partnerships.
Conclusions:
- Advancing care for CIF requires a multi-level, coordinated approach.
- Pediatricians are crucial in advocating for equitable insurance coverage and health policies.
- Ensuring dignity, trust, and justice in care is paramount for all children, irrespective of background.
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