A crisis in the shadows: public health outcomes and barriers to care for children of North Korean defectors in China

State policies that deny legal identity are the primary structural determinants of this public health crisis, systematically producing poor health outcomes. The analysis confirms that while the UN reporting system is limited in its enforcement capacity, it is crucial for documenting these violations. To mitigate harm, future health policy and advocacy should focus on the key recommendation of decoupling access to essential pediatric services from a child's legal or household registration status.