Despite a reversal of the Trump administration family separation policy, as of July 2018, more than 2000 children remain separated from their parents or legal guardians.1

In an article published in JAMA, Howard A. Zucker, MD, JD, and Danielle Greene, DrPH, of the New York State Department of Health, suggest that child-parent separation during an already tumultuous and emotionally strenuous event may exert greater long-term physical and mental health effects on children than is currently being discussed.2

Adverse childhood experiences (ACEs) have been consistently associated with adverse health effects throughout life. Child-parent separation represents at least 4 of the 10 ACE categories, including parental incarceration, emotional neglect, parental separation, and witnessing violence. In addition, pre-existing adverse experiences that catapulted the families’ into deciding to cross the border, including violence experienced in their home countries, add to the additional ACEs experienced by the detained children.

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The developing brain, when exposed to chronic stress, can experience impairments in the sympathetic-adrenomedullary system and hypothalamic-pituitary-adrenocortical axis. As a result, the body releases higher levels of cortisol and epinephrine, which reduces hippocampal volume and has an impact on stress modulation and emotion and memory processing. In addition, chronic exposure to stressors can weaken limbic system connections and increase the risk for anxiety and depression.

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Currently, there are few data available supporting the belief that the temporary separation of children from their parents can result in a real, negative, life-long impact on health. Expedited reunions of families represents the most appropriate step in preventing the potential for this effect. “It is in the best interests of these children, and society, to reconnect them with their parents and provide access to the services they may require as a consequence of their separation,” the investigators wrote.


  1. Kopan T, Shoichet CE. Only 54 children to be reunited by court deadline, but judge praises “progress.” CNN. Published July 9, 2018. Accessed August 27, 2018.
  2. Zucker HA, Greene D. Potential child health consequences of the federal policy separating immigrant children from their parents [published online July 19, 2018]. JAMA. doi:10.1001/jama.2018.10905