Proposed child immigration change poses new threat

Indefinite detention of undocumented immigrant children will exacerbate the risks to their health and safety, cautions the Michigan Chapter, American Academy of Pediatrics (MIAAP).

“President Donald Trump’s latest proposal to lift the current 20-day limit for children’s detention is another threat to their safety,” says Jared Burkhart, MIAAP executive director.  “It is a misguided effort to stem the number of families attempting to enter the U.S.  We urge the federal justice system to put children’s safety first as it considers the proposal and retain the current 20-day detention limit.”

MIAAP joins other advocates for children in denouncing the proposed regulation, suggesting that Mr. Trump and the administration are purposely treating families and children poorly in order to reduce the number of immigrants attempting to enter the country.

“If approved, the new rule would allow the administration to send families caught crossing the border illegally to family residential centers until their cases are decided, often taking many months,” Burkhart explains.  “Conditions in existing centers have been described as overcrowded and inhumane.” 

The 20-day detention limit has been in place since 2015, stemming from a 1997 class action lawsuit that argued the physical and emotional harm on children resulting from extended detention. 

MIAAP is a nonprofit, professional organization of more than 1,400 Michigan pediatricians, dedicated to optimal physical, mental and social health for all infants, children, adolescents and young adults.

MIAAP pediatricians want more restraints than new tobacco act provides

Michigan pediatricians believe the passage of the Youth Tobacco Act, signed today by Gov. Gretchen Whitmer does not go far enough to curb youth electronic cigarette use.

            “We are disappointed that this legislation puts electronic cigarettes into a separate class from other tobacco and nicotine products, given the highly addictive properties and other adverse health effects.” says Jared Burkhart, Executive Director, Michigan Chapter, American Academy of Pediatrics (MIAAP), “However, Gov. Whitmer’s action is encouraging.  We urge all elected officials to strengthen the new law by banning vape flavors, subjecting vape products to our clean air laws, and taxing all nicotine delivery products in an equitable way.  Electronic cigarettes and the associated nicotine addiction open a direct path to other forms of nicotine use, such as cigarettes, and should be regulated as strictly as other tobacco products.”

            Gov. Whitmer signed SB106 and HB 155 which will take effect in 90 days. 

            “We are urging the Legislature to continue its work on this issue, starting with classification as a tobacco product, consistent with the Federal Drug Administration (FDA) and Center for Disease Control (CDC).”  explains Dr. Sharon Swindell, President, MIAAP.  “E-cigarettes have become the most common nicotine product used by youth and, as a consequence, we have a new generation of youth addicted to nicotine—many of whom will go on to be cigarette smokers.”

            A 2018 survey showed 21 percent of high school students and 5 percent of middle school students used e-cigarettes, a dramatic increase in just one year.  Federal regulation ban e-cigarette sales to people under age 18.  Aggressive marketing campaign by e-cigarette manufacturers, many of which are owned by tobacco companies – entice young smokers with flavorings and advertising that appeals to youth. 

            Adolescents and young adults ages 14-30 who have used e-cigarettes are 3.6 times more likely to report using convention cigarettes later, according to recent studies.

 

MIAAP is a nonprofit, professional organization of more than 1,400 Michigan pediatricians, dedicated to the optimal physical, mental and social health for all infants, children, adolescents and young adults.

National Infant Immunization Week promotes need for vaccines

National Infant Immunization Week (NIIW) April 27 - May 4 coincides disturbingly with the second worst U.S. measles outbreak in 25 years, as the Centers for Disease Control (CDC), the Michigan Chapter/American Academy of Pediatrics (MIAAP) and other health professionals urge parents to vaccinate their children.

The 26th NIIW accentuates the need to educate parents about the dangers of preventable diseases which can be reduced or eliminated through vaccinations.  It encourages better communication between health care professionals and parents, and it aims to connect parents with providers who participate in Vaccines for Children, a federally-funded program that provides free immunization to families who otherwise could not afford it.  

"Children today should not have to experience measles,” says Dr. Matthew Hornik, MIAAP president-elect.  "The disease had been eliminated, not only in the US but in the entire Western Hemisphere.  Now, the many cases erupting in parts of Michigan mean we must redouble our efforts and educate parents who are either unaware of the importance of vaccinations or are misinformed about their efficacy.”

The call to vaccinate is especially urgent this year, as 704 measles cases in 22 states – including 43 in Michigan – have been reported and linked to unvaccinated individuals (Source: CDC).  Measles is a highly contagious disease that can lead to serious complications in children and even death.

Measles was declared eliminated in the U.S. in 2000 only to reappear in recent years.  While no fatalities from measles have been reported in the U.S. this year or last year, 35 people in European Union countries died of the disease in 2018, according to the European Centre for Disease Prevention and Control.

                National Infant Immunization Week is part of World Immunization Week (WIW), an initiative begun in 1994 by the World Health Organization (WHO) to highlight the positive impact of vaccination on infants and children and to promote immunization achievements.  More than 180 countries and territories will promote immunization, equity in vaccine use and universal access to vaccination services across borders.

Still, the WHO includes “vaccine hesitancy” among the top 10 global health threats in 2019.  The current U.S. measles outbreak is on track to eclipse the 644 identified cases in 2014, more than half of which occurred among unvaccinated communities in Ohio exposed to a virus brought from the Philippines.

Michigan requires mandatory vaccinations for children in public schools, but parents can obtain a nonmedical waiver which exempts their children.  In some areas of Michigan, 1 in 10 students are granted a waiver and the number could be growing.

 “Infants are one of the most vulnerable populations when a life-threatening disease like measles occurs,’ explains Dr. Sharon Swindell, MIAAP president.  “In the case of measles, an infant depends on community protection for this highly contagious disease, since the measles vaccine is not routinely given until 12 months of age.  It is also important to remember that there are individuals, young and old, who have compromised immune systems and cannot receive certain vaccines.  These individuals also depend on community protection.  Vaccines save lives.     

            MIAAP is a nonprofit, professional organization of more than 1,400 Michigan pediatricians, dedicated to the optimal physical, mental and social health for all infants, children, adolescents and young adults.

Measles cases in Michigan are on the rise

           LANSING, Mich. (WILX) - The threat is real and doctors are getting more concerned about the spread of measles in Michigan, especially in Ingham County.

There have been 14 new cases confirmed in the Detroit area, making the total to 22 cases in all.

According to doctors, Ingham County's vaccination rate is low. In fact, experts say it's low enough that the disease could establish itself there. Because the vaccine has been around for nearly 70 years, many people don't remember how widespread and dangerous measles used to be.

"The best way to protect yourself is to get vaccinated." Dr. Jonathan Gold said. Dr. Gold is a professor at MSU and a part of the Fellow of the American Academy of Pediatrics.

Measles was eliminated in the United States in 2000, but lower vaccine rates and more foreign visitors are giving it a foot-hold again. Before the vaccine came out in the 1960s, measles killed upwards of seven million children around the world every year.

"People would be afraid. They would be afraid of their children's lives when there was a measles epidemic. It's not an exaggeration to say that there were life-threatening sort of concerns," Dr. Gold said.

Dr. Gold says doctors are also on the lookout here in Mid-Michigan. Especially with Ingham County being one of the lesser-vaccinated counties in the state.

"Most experts say you really want to have close to 90 percent or more of the people in the community who are vaccinated and if you have that there is very little risk that measles will be able to grab hold of the community. And we're below 80."

So even though measles hasn't crept into the area, that doesn't mean we are in the clear. Doctors say it's not only important to get the shot to protect yourself, but also those who are unable to get vaccinated due to medical concerns.

"I don't want to spread panic....but I just want people to be thoughtful about making sure that they get their kids vaccinated. The true benefit of vaccination is when an entire community is vaccinated," Dr. Gold said.

According to the Center for Disease Control, 2019 is on track to have the most cases of measles in the U.S. since 1992.

Symptoms of measles include a rash, fever, cough, pink eye, and a runny nose. Contact your health care provider if you think you've been exposed for more signs and symptoms and a list of locations that the disease may have been contracted.

Michigan doctors using Oakland County measles outbreak as a teachable moment

Michigan doctors hope to use the measles outbreak in Oakland County to encourage parents to get more children vaccinated.

Michigan ranks near the middle of the pack among states for measles vaccination rates.

Dr. Matt Hornik is the president-elect of the Michigan Chapter of the American Academy of Pediatrics. He says they're stepping up their efforts to educate parents and state lawmakers.

“The goal is to try to increase our prevalence in the community as well and to try to fight back and push back against the anti-vax population that has been so vocal,” says Hornik.

Hornik says they hope to use what has worked in other states to increase childhood vaccination rates in Michigan. 

Health officials have confirmed eight cases of measles in Oakland County.

Measles outbreak underscores need for vaccinations

            Measles, the highly contagious virus that has been well contained until recent years, is back in Michigan, and vulnerable populations are again at risk.  The state’s vaccination rate, which was on the decline for several years, needs to increase in order to contain preventable infections, says Michigan Chapter, American Academy of Pediatrics. 

            “We are urging parents to educate themselves about the risks of not vaccinating their children,” says Dr. Matt Hornik, MIAAP president-elect.  “The decision not to protect your child has far-reaching effects beyond your own families.  We are seeing evidence now of preventable outbreaks that are putting other children and families in harm’s way.  Measles are among life-threatening diseases, like whooping cough and mumps, that are preventable.”

            Pregnant women and people who have illnesses that compromise their immune systems and people who are taking medications that weaken their immune systems are at highest risk.  Those who have not been vaccinated and think they could be exposed to the virus can limit the likelihood of contracting the disease by getting the vaccination within 72 hours of exposure.  Those born in 1957 or earlier are considered immune from measles.

            Measles symptoms – high fever, cough, runny nose, red watery eyes -- usually appear seven to 14 days after a person is infected, or as long as 21 days later.  After respiratory symptoms begin, tiny white spots are often visible on the gums, roof of the mouth and inside the cheeks. A raised, blotchy rash usually starts on the face before spreading to the trunk, arms and legs.

            Michigan’s childhood immunization rate ranks at 43rd in the United States.  Michigan accounts for 19 of the 228 measles cases in the nationwide outbreak.  Michigan requires mandatory vaccinations for children in the public school system, but parents are able to obtain a waiver which exempts the student from the requirements.  In some areas of Michigan, 1 in 10 students are granted a waiver, and the number could be growing.

            The World Health Organization includes “vaccine hesitancy” among the top 10 global health threats in 2019. 

MIAAP supports the “I Vaccinate” campaign, headed by the Michigan Department of Health & Human Services, an information campaign raising awareness of the importance of vaccines and the role they play in preventing deadly diseases.

MIAAP has called on Gov. Gretchen Whitmer and the Michigan Legislature to promote vaccinations as part of its vision for healthy children and secure families. 

“Investing in our children should be the highest priority for the Legislature and the new administration,” says Jared Burkhart, MIAAP executive director, “child health and well-being must be elevated and maintained as a priority in our state”.

MIAAP is a nonprofit, professional organization of more than 1,400 Michigan pediatricians, dedicated to the optimal physical, mental and social health for all infants, children, adolescents and young adults.

Lowering home heat OK for most children, say pediatric experts

In light of Consumers’ Energy’s request that residents lower their thermostats to at least 65 degrees, the Michigan Chapter of American Academy of Pediatrics (MIAAP) expects that some parents may have concerns for the safety of their children.

            “Children above one year of age are safe in homes kept at 65 degrees,” says Dr. Sharon Swindell, MIAAP president.  “To keep them comfortable, we recommend parents add one additional layer to their children’s clothing than they would wear themselves to be comfortable.  Babies, less than one year of age, however, should be kept in a room that is 68-72 degrees, since babies can lose heat more easily and should not be over bundled during sleep.”

            Consumers’ Energy’s request that its customers conserve energy came following a fire at a Macomb County compressor station which provides natural gas to customers. 

            MIAAP is a nonprofit, professional organization of more than 1,000 Michigan pediatricians, dedicated to the optimal physical, mental and social health for all infants, children, adolescents and young adults.

Children’s health advocates release “Blueprint for Michigan Children”

Calling on Gov. Gretchen Whitmer and the Michigan Legislature to adopt a comprehensive vision for healthy children and secure families, the Michigan Chapter of American Academy of Pediatrics (MIAAP) has released a “Blueprint for Children” (miaap.org/blueprint), spelling out public policy recommendations to improve the lives of Michigan children.

“Investing in our children should be the highest priority for the Legislature and the new administration,” says Jared Burkhart, MIAAP executive director. 

Mental health services, trauma-informed care and evidence-based suicide prevention standards are high on the list of MIAAP’s priorities for legislative action to promote healthy children. 

“All children require access to high-quality pediatric-specific health care, so they can thrive throughout their life span,” says Dr. Sharon Swindell, MIAAP president.   “A healthy child is more likely to attend school, learn and become a productive adult. Thanks to the Medicaid expansion in 2014, 97 percent of Michigan children now have health insurance.  We cannot go backward on that critical achievement, which has helped to significantly improve health outcomes for our children. 

Because the percentage of children born into poverty in Michigan has steadily increased over the past 40 years -- now approaching 50 percent -- MIAAP is calling for improved access to affordable housing, an increase in the minimum wage and paid parental time off for family illnesses and prenatal and postnatal periods. 

“From workplace supports to healthy food access, we need to advance efforts to ensure that parents give their children the best foundation for the future,” Burkhart says.  “We need to eliminate child poverty and communities of concentrated poverty.”

Noting that a child’s Zip code, rather than his or her genetic code, is the greatest predictor of life outcomes, MIAAP calls for measures to provide access to safe and affordable drinking water and lead-free homes, protect children from gun violence and change the tobacco age to 21.  

Affordable, accessible, high quality child care, early literacy programs and greater support for public school systems also make MIAAP’s list for action by governmental leaders.

“Child health and well-being must be elevated and maintained as a priority in our state,” Burkhart stresses.  “We are asking that state agencies implement a ‘children in all policies’ approach to decision-making.”

The Blueprint for Children has been endorsed by Michigan League for Public Policy, Michigan Environmental Council and major Michigan children’s hospitals.

MIAAP is a nonprofit, professional organization of more than 1,000 Michigan pediatricians, dedicated to the optimal physical, mental and social health for all infants, children, adolescents and young adults.

Statement on Passing of Dr. Natalia Tanner

Dr. Natalia Tanner Cain, known for breaking down barriers in the field of medicine as a second-generation African-American physician, died on July 14, 2018 in Southfield, Mich. She was 96.

Dr. Tanner was the first African-American to serve as the president of Michigan Chapter of the American Academy of Pediatrics (MIAAP) and the first African-American woman to become a Fellow of the American Academy of Pediatrics (AAP). She practiced medicine in the Detroit area for decades and was also a professor at Wayne State University School of Medicine. Still, the road to Dr. Tanner’s success was not easy and she faced discrimination head-on along the way.

She was featured in the August 2011 AAP News magazine and said she was initially denied an appointment at Children’s Hospital of Michigan because of her skin color. Later, she became the first African-American board-certified pediatrician on staff there. She also struggled to get her AAP membership transferred from Illinois to Michigan when she moved to Detroit in the 50s. Dr. Tanner became president of the MIAAP in 1983.

Current MIAAP President Teresa Holtrop, MD, FAAP, said she feels honored to have known Dr. Tanner. 

“Years ago, she told me about her plans to write a book about her experiences as a pediatrician, recounting the challenges she faced as a ‘first’ in several arenas. A couple of years ago I ran into her again at one of our conferences and asked her whether she had ever written the book. At the time, she admitted that she hadn’t yet and I urged to her to put her experiences on paper,” Dr. Holtrop said. “I really hope that she did so, because her life was quite extraordinary. She was inspiring in her indomitable spirit.  Well into her 90s she continued to attend weekly grand rounds at Children’s Hospital of Michigan as well as the MIAAP’s Annual Conference, a sign of her inquisitive mind and energy. We have a lot to learn from her example.”

The AAP News article credits Dr. Tanner with lobbying the Michigan Legislature for the successful passage of car seat legislation and for initiating collaboration between the AAP and the National Medical Association, the largest and oldest national organization representing African-American physicians.

Dr. Tanner received numerous awards as a practitioner, professor and advocate, and has been recognized for her many firsts. Read more about Dr. Tanner’s life and legacy at on.freep.com/2vp0IfV.

Funeral Service Details:

Public Viewing for family and friends: Friday, August 3, 2018, 10 a.m. to 4 p.m., Swanson Funeral Home West, 14751 W. McNichols Rd., Detroit, Michigan.

 Omega Omega Ceremony: Friday, August 3, 2018, Performed by the Delta Sigma Theta Sorority, 6 p.m to 7 p.m., Plymouth United Church of Christ, 600 East Warren Ave., Detroit, Michigan.

 Services: Saturday, August 4, 2018, Family Hour from 10 a.m. to 11 a.m.; Funeral at 11 a.m., Plymouth United Church of Christ, 600 East Warren Ave., Detroit, Michigan.

 In lieu of flowers, the family will be establishing a scholarship memorial fund.

 

 

Opinion: Learn the lessons of the past to help children in our care

It is common to hear ‘History repeats itself’ and unfortunately I see it happening in the area of immigration. After separating many children from their parents at our nation’s borders the government seems to be solely focused on reunification. While that is an important part of the process it will never make families whole. Children separated from their parents not only face a mental health crisis now but will for years to come. This is an area where the past can help us understand present conditions.

In 1923, the German-French border was being contested and as a result my mother, who was 3 at the time, was separated from her parents. She and her two young siblings were sent to live with family in Germany. It was several months before the three siblings saw either parent again. While the family eventually grew to include seven children, the oldest three—those who lived through that traumatic separation event—all suffered from lifelong major depression and two committed suicide.

I was 12 when my mother died. She was a well-respected physician in her adopted community in Michigan, yet was unable to obtain adequate mental health support. The mental health struggles and suicides of my mother, aunt and uncle reverberated through the next generation, affecting me, my siblings and cousins.

Many years later, medical studies would help us to understand how damaging Adverse Childhood Experiences (ACE) really are. The ACE studies provide a scientific explanation of the biological mechanisms behind why the three oldest of seven siblings ended up suffering so strikingly while none of the others did. Experiencing severe traumatic stress at a young age does not just go away. It physically prunes the connections in the emotional centers of the brain needed to form strong attachments and develop empathy as an adult. Traumatized children are much more likely to grow into adults with mental health issues. Certain genes turn on or off, increasing the likelihood of physical health issues, including hypertension, heart disease, and stroke.

It is physically nauseating for me as a pediatrician, and a daughter, to listen to the news reports of the ongoing separations of asylum-seeking children from their parents, and the trauma we are currently putting young families through in the United States. Many of these families are fleeing significant violence in their homeland. To inflict separation on top of that is creating unnecessary physical and mental stress on young children who cannot fully comprehend the situation they are placed in.

Just as we expect parents to be responsible for the health and welfare of their children, we as Americans should also demand our government to be responsible for the health and welfare of the children in OUR care. Humanity requires us to ask if these actions are how other humans should be treated. As Americans, we would never require that a child be sexually abused or watch his mother be beaten but we are creating toxic stress in another form by not addressing the long term needs of these children. I encourage everyone to remember the lessons of our families’ pasts, and to face the future with these children and their families and not turn away.

Teresa Holtrop, M.D., is the president of the Michigan Chapter of the American Academy of Pediatrics and executive/medical director of the Wayne Children's Health Access Program.