Pediatric no-shows rose most among Latine patients after ICE operation

Pediatric ambulatory no-show and cancellation rates increased after a large-scale immigration enforcement operation in the Chicago area, with larger increases among Latine and Spanish-speaking patients, according to research presented at the American Academy of Pediatrics (AAP) 2026 National Conference & Exhibition in San Diego, California.¹^,² The analysis included 99,743 patients with appointments at a large Midwest pediatric referral center after Operation Midway Blitz.²

Executive Order 14161, enacted in January 2025, intensified immigration enforcement and coincided with increased Immigration and Customs Enforcement (ICE) activity, according to the abstract.² Operation Midway Blitz, on September 6, 2025, involved the arrest of thousands of immigrants living in the Chicago area.² The referral center is not named at the institution's request to protect patient and family privacy.¹

When families fear leaving home, children miss more than appointments—they miss opportunities for both life-saving and preventive care,” Teresa "Tess" Trinka, MD, a pediatric resident and study co-author, said in a press release. "Our findings highlight the downstream impact of immigration policy on pediatric healthcare utilization in Chicago," Trinka said.

No-show and cancellation rates rose after Chicago immigration enforcement

Researchers included all ambulatory appointments at the center between 2018 and 2025, excluding inpatient, emergency, telephone, and MyChart encounters.² For each patient with appointments after Operation Midway Blitz, investigators compared no-show and cancellation rates before and after the operation, using patients as their own controls.² A one-way analysis of variance identified which demographic variables predicted no-show and cancellation rates after the operation.²

Rates increased significantly across the cohort, but the size of the increase differed by ethnicity, language, and zip code.² Latine patients had a mean increase of 0.042 (95% CI, 0.037-0.047), compared with 0.015 (95% CI, 0.012-0.018) among non-Latine patients (P < .001).² The press release described these changes as increases of 4.2 and 1.5 percentage points, respectively.¹

Spanish-speaking patients showed a mean increase of 0.087 (95% CI, 0.078-0.096), compared with 0.016 (95% CI, 0.013-0.019) among non-Spanish speakers (P < .001).² Among patients living in zip codes with high ICE activity, the mean increase was 0.051 (95% CI, 0.036-0.066) vs 0.022 (95% CI, 0.019-0.025) in other zip codes (P = .0001).²

Language and ethnicity predicted missed pediatric appointments in adjusted analysis

In adjusted analysis, the post-operation period was associated with significant increases in no-show and cancellation rates among Spanish-speaking patients (0.055; P < .001; adjusted R² = 0.3112) and Latine patients (0.011; P < .001; adjusted R² = 0.3101).² English-speaking patients, by contrast, had a significant decrease after the operation (−0.0578; P < .001; adjusted R² = 0.3115).² According to the press release, investigators identified more than 1258 missed appointments among Latine patients alone after the enforcement activity.¹

The authors concluded patients who are non-English speaking, Latine, or living in areas with high ICE activity are more likely than their counterparts to miss appointments after citywide immigration enforcement.² They stated missed and canceled visits may contribute to delays in preventive care and timely diagnoses.¹^,²

"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," co-author Frances Ho, MD, a pediatric resident at Ann & Robert H. Lurie Children’s Hospital Department of Pediatrics and study co-author, said in a press release. "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 authors called on health care systems and policymakers to consider the unintended health consequences of immigration enforcement and to implement strategies supporting equitable access to care.²

The study was conducted at a single pediatric referral center, and the abstract did not report reasons for individual missed or canceled appointments.

References

1. American Academy of Pediatrics. Latine, Spanish-speaking patients missed pediatric appointments after immigration enforcement crackdown. Eurekalert. October 2, 2026. Accessed October 2, 2026. [URL NEEDED]

2. [LEAD AUTHOR]. Immigrant family access to pediatric health care after Executive Order 14161 and Operation Midway Blitz. Abstract presented at: American Academy of Pediatrics 2026 National Conference & Exhibition; October 2-6, 2026; San Diego, CA.