Refugee Children Use ERs Less for Minor Illness
Refugee and immigrant children are less likely to use emergency departments for minor illnesses compared to their non-immigrant peers, new research finds. The study suggests potential barriers to primary care access or different health-seeking behaviors within these communities. This dynamic is crucial for providers to understand when delivering family and maternal health care.
The initial study followed 458,597 children in Ontario, Canada, and found that for the first four years after arrival, refugee and immigrant children had more primary care visits and fewer non-urgent emergency room visits for minor illnesses compared to their peers born in Ontario. This suggests that settlement services, which often include healthcare navigation support, may play a positive role in how newcomer families access care. This pattern of healthcare use challenges the misconception that newcomers overuse emergency services. However, the study also noted a shift after two years, with a decrease in primary care visits and a slight increase in ER use among refugee children. This change may be linked to a reduction in financial support and the difficulties families face in accessing primary care during standard work hours. Barriers such as language differences, financial constraints, and a lack of familiarity with the healthcare system can significantly impact how immigrant and refugee families seek care. In Virginia, organizations like Commonwealth Catholic Charities and the Virginia Department of Social Services' Refugee Resettlement Program work to help newcomers navigate these complex systems. For expectant mothers, these challenges intersect with a growing demand for midwifery care, especially in a state facing significant maternity care shortages. Recent legislation in Virginia aims to expand the role of midwives. As of July 1, 2025, House Bill 1904 allows certified nurse-midwives to provide newborn nursery care without a physician immediately available, a move expected to help keep labor and delivery units open in rural areas. Furthermore, House Bill 1923, also effective in July 2025, mandates 100% reimbursement parity for all midwife types from both private insurers and Medicaid. This addresses long-standing pay disparities and aims to make midwifery a more sustainable career path, which is critical given the projected 26% job growth for nurse-midwives in Virginia through 2032. The Virginia Affiliate of the American College of Nurse-Midwives has been a key advocate for these changes, working to increase access to midwifery care, especially in underserved communities. Their efforts, along with a broader state focus on maternal health equity, are crucial in a state where 36% of counties are considered "maternity care deserts." Digital health innovations are emerging as a vital tool to bridge these care gaps. Telehealth, remote patient monitoring, and AI-driven diagnostics can connect pregnant individuals in remote or underserved areas with specialized care. For non-English speaking families, multilingual telehealth platforms and translation apps are becoming increasingly important for effective communication and care. These technological advancements, combined with expanded practice authority for midwives and a focus on culturally competent care, are shaping the future of maternal health in Virginia. This evolving landscape presents both opportunities and challenges for future nurse-midwives dedicated to serving diverse populations, including immigrant and refugee families.
