Research suggests that family separation has immediate and long-term negative impacts on children’s health. There are a few rare instances when family separation is beneficial to the child, such as cases of extreme abuse in which it would be physically unsafe for the child to remain in the household with their parent. There are other instances when family separation is unavoidable, such as during a natural disaster, as we see with tsunamis, earthquakes, or large fires. Barring such crises, it is paramount to avoid family separation whenever possible.
How does family separation impact children’s health?
In some regards, the impact of family separation depends on the circumstances and mechanism of the separation. However, there also seems to be underlying aspects of family separation that are universal. These aspects span circumstance, culture, geography, and even children’s age.
When children become separated from their families, the parent-child bond is disrupted. The disruption in the parent-child bond, as understood through Bowlby and Ainsworth’s attachment theory, can harm children’s psychological health. Children can become less flexible, open, and adaptable to the world around them.
In physiologic terms, the impact of family separation can be understood as creating a toxic stress. We all face challenges in our day-to-day lives. For some individuals, adversity is extreme and repeated. For children facing situations that create repeated adversity in childhood, we call these factors adverse childhood experiences (ACEs). Family separation due to ACEs (for example parental incarceration, parent divorce, or parent death) are strong ACEs that create a toxic stress response in a child’s body. Without loving, trusted caregivers, the toxic stress intensifies, leaving a child’s body in a continual state of “fight or flight” stress response. The impact is upregulation of stress hormones, which worsens emotional health and can increase risk of physical illness, such as autoimmune disease or even heart attack later in life.
In terms of diagnoses, family separation creates a profound trauma on children’s lives. Many children develop depression, anxiety, or post-traumatic stress disorder. Given the mechanism of toxic stress described above, family separation may impact children’s risk of medical conditions into adulthood as well, such as by increasing the risk of stress-related illnesses including heart disease or heart attacks.
The best way to mitigate the impacts of family separation is to avoid family separation whenever possible. When family separation does occur, children should be reunited with their families as quickly as possible (when safe to do so). When reunion does occur, the reunion and long-term reunification process needs to be supported. Also, during separation, when children are suffering the stress of the separation, the setting the child is in should be developmentally appropriate. Children should be allowed to communicate with their parents and receive frequent updates and clear expectations regarding reunion. That is because UNCERTAINTY around reunion—children wondering if, when, or ever they will reunite with their parents—can be gruelling. The ambiguity of children not knowing whether or when they will reunite with their families intensifies the separation. The impact of the separation is worse when children have less understanding or control over what is happening.
Data suggests that the impacts of family separation on children’s health have universal features, are intense, and are likely life-long. To promote a healthy society and healthy children (and future adults), family separation should be prevented when possible. Children’s health and well-being are at stake.
Liz Barnert, MD, MPH, and MS; Pediatrician & Assistant Professor at UCLA