What Is Happening to the Health of Our Children?

What is happening to our children’s health? We hear very little about the following three subjects:

1. Homelessness,
   
2. Healthcare sharing ministries, and
   
3. Resignation Syndrome.
   

1. Homelessness: Over 2.5 million children are homeless in America, with 1.5 million of these children being in public schools (https://www.nytimes.com/2020/02/03/us/Homeless-students-public-schools.html). In addition to parents with drug addiction and mental health problems, children are fleeing child abuse and neglect, which often results in homelessness. Many children are now becoming homeless due to climate change disasters such as floods, fires, or hurricanes. Parents are also losing jobs or experiencing income inequality, resulting in the inability to afford shelter, and they are turning to the streets – literally. Perhaps our stock market is doing well and unemployment rates are low, but we have to ask ourselves: Are people living better in America? These homeless young Americans are not only entering shelters, but many are “existing” in abandoned buildings or cars and then heading off to school. Of course, the effect of homelessness results in multiple, and sometimes complex, health issues. In addition to a lack of routine care and vaccinations, these children are suffering from respiratory diseases (as simple as bronchitis or as complex as TB), malnutrition, wound and skin infections, mental health problems, substance abuse issues, delayed development, and anxiety and trauma-related conditions (https://medlineplus.gov/homelesshealthconcerns.html).
2. Healthcare Sharing Ministries: With many people unable to afford traditional health insurance, families are seeking alternative coverage. Nonprofit Christian organizations have started programs called healthcare sharing ministries. The members come together and agree to pay a set monthly fee and share the cost of the group’s medical bills. They are popular among many Christians since the “cost sharing” fees are much less than health insurance premiums and members have the support (emotional, spiritual and sometimes, financial) of fellow church members. This approach might be beneficial for the healthy young adults, who share the organization’s belief system and are comfortable with a noninsurance solution; but for others, often children, there are glitches with the system  (https://www.healthmarkets.com/resources/supplemental-health-insurance/christian-healthcare/). In the U.S., many families are simply desperate, and they assume that a Christian organization would be reputable, especially when they see such advertising as,  “Just trust God.” The coverage varies depending on the health-sharing ministry. In some cases people have been misled or did not understand how little coverage they would receive, especially a member with a catastrophic illness (https://www.nytimes.com/2020/01/02/health/christian-health-care insurance.html?nl=todaysheadlines&emc=edit_th_200103?campaign_id=2&instance_id=14881&segment_id=20009&user_id=2881cad8f09d5d04d1ada80303b1628d&regi_id=913205490103https://www.google.com). Since these organizations have a tax-exempt status, they cannot be classified as insurance companies. This means the state governments and insurance commissions do not regulate them. The ministries can develop their own guidelines for coverage, which typically includes restrictions for preexisting conditions (even with common conditions such as diabetes, heart disease, or cancer), and there is cap on the overall coverage. A major drawback is that the ministries are not legally obligated to pay medical claims. Members must also partake in the religious aspects of the organization and accept the denial of services such as sterilization, contraception, genetic testing and abortions.
        Although these religious organizations are pro-life, they are not always willing to pay the bill to save a life, and this is happening with children. One Christian family in Illinois joined a healthcare sharing ministry since they could not afford traditional health insurance. They adopted two healthy children from Ethiopia, and as part of a well visit, the pediatrician recommended routine lab work for international adoptees. All results were within normal limits. However, the family discovered that this Christian-based ministry does not share in costs for “any physical condition, which the adopted child has prior to the adopted parent being legally responsible for the child’s expenses.” Basically, this translates to all conditions of an adopted child are considered pre-existing (https://www.buzzfeednews.com/article/lauraturner/christian-health-care). Fortunately the parents turned to the Medicaid program in Illinois to get health coverage, which ended up costing them a reasonable fee of $70 per month (an income-based tier). Although this approach was in opposition to the family’s typical religious philosophy, they were financially desperate and accepted this solution.
        In another case, an eight-year old boy suffered a brain aneurysm and was hospitalized for two months. The boy survived and is doing well, but his hospital bill far exceeded the $250,000 cap set by the healthcare sharing ministry, and the medical bill was not covered. Once again, the family turned to the plans offered with the Affordable Care Act (ACA) and fortunately this case qualified for Medicaid (the state-federal insurance program), which covered the boy’s entire medical bill (https://www.nytimes.com/2020/01/02/health/christian-health-care insurance.html?nl=todaysheadlines&emc=edit_th_200103?campaign_id=2&instance_id=14881&segment_id=20009&user_id=2881cad8f09d5d04d1ada80303b1628d&regi_id=913205490103https://www.google.com).
3. Resignation Syndrome – also known as traumatic withdrawal syndrome – is a dissociative syndrome, which includes a catatonic state that occurs with children, who have been traumatized as a result of a migration process (https://www.bbc.com/news/magazine-41748485). It was first identified in Sweden in the 1990s with the children of asylum-seekers, when they experienced complete withdrawal – ceasing to walk or talk, or open their eyes. They require life-sustaining treatment such as feeding tubes. Basically the care is much like a person in a comatose state. Typically they recover, but it often takes six months or more –some cases have lasted for years. The recovery starts once the child and family are in safe settings. Thus, the treatment is ironically simple: find a safe haven and resolve the resettlement issues. The etiology is not well understood, particularly since no research is available and the children, as refugees, are not followed after their recovery. Even more strange is that it appears to effect children from certain geographical and cultural areas: USSR, Balkans, Roma and Razidi (https://www.bbc.com/news/magazine-41748485). Unfortunately, there is a current case in Sweden with a little girl – a refugee from the USSR – who is still in a catatonic state after 20 months. In addition to this hardship of caring for an essentially comatose child, the family is facing deportation. Like other countries, Sweden is experiencing the resurgence of right=wing politics, which includes the anti-immigration sentiment.
   
   There is a book called “The Way Back.” This tells the story of Solsidan, a home for all kinds of troubled children, and their recovery. There are also short documentaries called “Life Overtakes Me” that can be viewed on Netflix –the stories of three families and their experiences with their children having resignation syndrome  (https://deadline.com/2019/12/life-overtakes-me-directors-kristine-samuelson-john-haptas-netflix-documentary-interview-1202814965/). One doctor describes the resignation syndrome of one young girl: “Your child is laying here like Snow White because everything is so terrible around her that this is a way of protection. She is just waiting for the situation to be better” (https://deadline.com/2019/12/life-overtakes-me-directors-kristine-samuelson-john-haptas-netflix-documentary-interview-1202814965/). Sadly these children have experienced dark and traumatic times, much like what we read about in scary fairy tales, but this is real life. The children require extensive medical care – totally dependent because of their comatose-like state.  Although previously only seen in Sweden, now resignation syndrome is being witnessed elsewhere, including Australia. Who knows where else we will discover this syndrome?

    
All three of these situations have a tremendous impact on our children’s health. As a society we have a moral imperative to re-examine our current policies in order to make changes and protect our children.

NOTE: A big thank you goes out to a friend who shared the story about resignation syndrome.

Charlotte Michos is a clinical nurse specialist who values personal-centered care and serves as a Healthcare Consultant in helping others make informed decisions. For more information, email her or call (845) 548-5980.