Child health and housing security are closely intertwined, and children without homes are more likely to suffer from chronic disease, hunger, and malnutrition than are children with homes. Homeless children and youth often have significant psychosocial development issues, and their education is frequently interrupted. Given the overall effects that homelessness can have on a child’s health and potential, it is important for pediatricians to recognize the factors that lead to homelessness, understand the ways that homelessness and its causes can lead to poor health outcomes, and when possible, help children and families mitigate some of the effects of homelessness. Through practice change, partnership with community resources, awareness, and advocacy, pediatricians can help optimize the health and well-being of children affected by homelessness.

This policy statement, which recognizes the large changes in immigrant status since publication of the 2005 statement “Providing Care for Immigrant, Homeless, and Migrant Children,” focuses on strategies to support the health of immigrant children, infants, adolescents, and young adults. Homeless children will be addressed in a forthcoming separate statement (“Providing Care for Children and Adolescents Facing Homelessness and Housing Insecurity”). While recognizing the diversity across and within immigrant, migrant, and border populations, this statement provides a basic framework for serving and advocating for all immigrant children, with a particular focus on low-income and vulnerable populations. Recommendations include actions needed within and outside the health care system, including expansion of access to high-quality medical homes with culturally and linguistically effective care as well as education and literacy programs. The statement recognizes the unique and special role that pediatricians can play in the lives of immigrant children and families. Recommendations for policies that support immigrant child health are included.

This policy statement provides a framework for the pediatrician' s role in promoting the health and well-being of all children in the context of their families and communities. It offers pediatricians a definition of community pediatrics, emphasizes the importance of recognizing social determinants of health, and delineates the need to partner with public health to address population-based child health issues. It also recognizes the importance of pediatric involvement in child advocacy at local, state, and federal levels to ensure all children have access to a high-quality medical home and to eliminate child health disparities. This statement provides a set of specific recommendations that underscore the critical nature of this dimension of pediatric practice, teaching, and research. Pediatrics 2013;131:623-628Environmental and social factors contribute significantly to the health and well-being of children in the contexts of families, schools, and communities. Over the past decade, the Institute of Medicine recognized and quantified the effects of external factors on early brain development and the health of children in 2 seminal reports, Neurons to Neighborhoods 1 in 2000 and Children' s Health, the Nation' s Wealth 2 in 2004. As understanding of the mechanisms and impact of biological, behavioral, cultural, social, and physical environments on healthy development deepens and expands, the long-standing role of pediatricians in promoting the physical, mental, and social health and well-being of all children must also evolve. 3 The field of pediatrics must address the problems facing children in the 21st century by influencing these critical determinants of child health and well-being. 4 To do so, pediatricians must successfully merge their traditional clinical skills with public health, population-based approaches to practice, and advocacy.

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