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Open letter: Isolating children at border is harmful

Pictured: Louis Appel, MD, MPH performs a routine well child check up with a young girl and her mother.

June 11 letter to the editor, “Texas border a flashpoint in humanitarian crisis.”

To the Editor:

As a pediatrician at People’s Community Clinic, I am greatly alarmed by the long term adverse health consequences of forcibly separating children from parents at the border as described by the letter writer.

Research shows that traumatic events in childhood—even in infancy—are associated with poor health outcomes later in life. Chronic, unmitigated stress activation in the body—known as toxic stress— increases risks for everything from depression to heart disease. Parental support and nurturing–precisely what the family separation policy deprives children of–  are the critical protective factors.

Families arriving at our border have already experienced profound trauma, from violence in their home countries to the hardships of their journey. Inhumane detention practices here inflict further harm. Separating children from their parents in the name of deterrence is an unconscionable injury to children at a time when they need their parents the most. It must stop!


Louis Appel, MD, MPH
Chief Medical Officer, People’s Community Clinic


Louis Appel, MD, MPH serves as Chief Medical Officer and Director of Pediatrics at People’s Community Clinic in Austin, Texas. Dr. Appel provides primary pediatric care at the Clinic in addition to overseeing the clinical programs. At the clinic he has championed projects on lactation support, group pediatric well child checks, postpartum depression screening, childhood obesity prevention focused on the prenatal and immediate postpartum periods, and promotion of parent-infant bonding. To learn more about Dr. Appel and other clinicians at People’s Community Clinic, click here.