SAN DIEGO — Thousands of pediatric patients canceled or missed doctor appointments at a large pediatric referral center in the Midwest during a recent surge in U.S. Immigration and Customs Enforcement activity, according to new research presented during the American Academy of Pediatrics 2026 National Conference and Exhibition in San Diego.
In Chicago, the enforcement activity dubbed Operation Midway Blitz resulted from Presidential Executive Order 14161, enacted in January 2025. The study included all ambulatory appointments at the Midwest pediatric referral center between 2018 to 2025. The pediatric referral center is not named at the institution's request to protect patient and family privacy.
The authors of the abstract, "Immigrant Family Access to Pediatric Health Care after Executive Order 14161 and Operation Midway Blitz," will present their findings during the Oct. 2-6 conference at the San Diego Convention Center.
Of nearly 100,000 appointments scheduled after Operation Midway Blitz, researchers found increases in patient-canceled and no-show rates in all groups studied, though the rates of increase were significantly higher in Latine vs. non-Latine patients (4.2 vs. 1.5 percentage points). The increases also were higher in Spanish-speaking vs. non-Spanish-speaking patients and families (8.7 vs. 1.6 percentage points), and among patients living in high-immigration enforcement activity ZIP codes (5.1 vs. 2.2 percentage points).
Authors identified more than 1,258 missed appointments among the Latine group alone following the immigration enforcement crackdown.
"When families fear leaving home, children miss more than appointments—they miss opportunities for both life-saving and preventive care," said co-author Teresa "Tess" Trinka, MD, a pediatric resident. "Our findings highlight the downstream impact of immigration policy on pediatric healthcare utilization in Chicago."
Missed and canceled visits related to immigration enforcement may contribute to delays in preventive care and timely diagnosis and negatively impact both individual and community health. Non-English-speaking and Latine patients, and patients who live in neighborhoods targeted by immigration enforcement actions are significantly more likely to miss scheduled appointments, contributing to health care inequities, researchers said.
"I took care of a girl on the oncology service whose parent was unable to come visit her due to fears of being taken by ICE," said co-author Frances Ho, MD, a pediatric resident. "Her story stuck with me, and this project is a way to understand the scope of ICE's impact on patient care in the city of Chicago."
The researchers conclude that healthcare systems and policymakers must consider the unintended health consequences of immigration enforcement and implement strategies to ensure equitable access to care.
