Systems, Structures, and Support: Using a Socioecological Framework to Improve Health Equity for Children in Immigrant Families

Children in immigrant families (CIF) represent one in four children in the United States and face disproportionate health risks shaped by immigration policy, structural racism, trauma, and barriers to care. Using a socioecological framework, this article reviews the current state of pediatric immigrant health and outlines opportunities for pediatricians to advance equity at the individual, organizational, and structural levels. Clinicians can follow expert clinical care guidelines, practice trauma-informed care and safe documentation practices, and partner with qualified medical interpreters. Health systems can create safe spaces for immigrant families and collaborate with researchers to promote community-led cohort building while protecting patients from identification. Finally, pediatricians play a vital role in advocating for inclusive insurance coverage and equitable health policies. Advancing care for CIF requires coordinated efforts across all levels of influence to ensure that every child, regardless of birthplace or legal status, receives care grounded in dignity, trust, and justice.