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Bradley J. Bradford, MD

Correspondence: Requests for reprints should be sent to Bradley J. Bradford, MD, Department of Pediatrics, Mercy Children’s Medical Center, Mercy Hospital of Pittsburgh, 1400 Locust St, Pittsburgh, Pa 15219 (e-mail: bbradford{at}mercy.pmhs.org).

I am writing in response to the February 2003 report from Entzel et al., "The Health Status of Newly Arrived Refugee Children in Miami–Dade County, Florida."¹ This report provided important information to add to our expanding knowledge regarding the health risks faced by new Americans. Florida, particularly, has experienced the arrival of many children born outside the United States, each of whose origin and circumstances dictate a special sensitivity to emergent and chronic health concerns.

This report raises several interesting questions for those responsible for dealing with these health concerns. First, it is noteworthy that in this legally documented population of children, predominantly from Cuba, lead levels were markedly elevated. It would be important to know specifics regarding those elevated lead levels, and equally so, the potential environmental exposures that were involved. Much experience has shown that in other populations of new—often not legally documented—Americans, especially from the Caribbean and Latin America, lead levels are even higher than described and are a serious problem.

Second, the absence of tuberculosis and hepatitis B in this population is unusual. I wonder whether any appropriate screening for HIV was performed and whether perhaps this population’s low infectivity reflects an aberration and not the norm. Finally, and of most value, is the fact that behavioral and neurodevelopmental concerns are a major unrecognized issue in many of these new American children. This I have gleaned from personal experience.

These are the issues that, along with strict medical screening, must be addressed to appropriately care for what is often an economically, socially, and medically fragile population of children. For these children to become successfully integrated into the United States, and for them to succeed in school, public health appraisal must extend beyond a medical perspective.

Reference

1. Entzel PP, Fleming LE, Trepka MJ, Squicciarini D. The health status of newly arrived refugee children in Miami–Dade County, Florida. Am J Public Health.2003;93:286–288.[Free Full Text]

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This Article Extract Full Text (PDF) Submit a response View responses Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bradford, B. J. Search for Related Content PubMed PubMed Citation Articles by Bradford, B. J. Related Collections Other Child and Adolescent Health Immigration