Operation Midway Blitz
Latino Spanish-speaking patients missed pediatric appointments after immigration enforcement crackdown
Hundreds of patients missed their appointments in communities where Latine workers were targeted by federal authorities
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.
Media Contact:
Gregg Montalto, MD, MPH, at gmontalto@luriechildrens.org.
The authors are scheduled to present the research, which is below, from 1:46 – 11 am PT on Sunday, Oct. 4, 2026, for the Council on Health Equity at the Marriott.
In addition, authors will be among highlighted abstract authors will give brief presentations and be available for interviews during a “Soundbite Session” from noon- 1 pm PT Sunday, Oct. 4, in the conference center Press Office, 14A.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/
Submission Type: Council on Health Equity
Abstract Title: Immigrant Family Access to Pediatric Health Care after Executive Order 14161 and Operation Midway Blitz
Frances Ho
Chicago, IL, United States
Background: A surge of immigration enforcement practices have been associated with patients’ increased fear of deportation attending their health care appointments.1-4 In January 2025, Executive Order 14161 was enacted, intensifying immigration enforcement and coinciding with an increase in Immigration and Customs Enforcement (ICE) activity. One example was Operation Midway Blitz (OMB) on September 6, 2025, which was the arrest of thousands of immigrants living in the Chicago area. This study determines whether there were more no-show/canceled ambulatory pediatric appointments following OMB.
Methods: This study included all ambulatory appointments at a large pediatric referral center in the Midwest between 2018 to 2025. Inpatient, emergency, telephone, and MyChart encounters were excluded. Demographic information was collected. For each of the appointments after OMB, the patients were used as their own controls to compare their rate of no-show/cancellations before and after OMB with a two-sided t-test. A one-way analysis of variance determined which demographic variables were predictive of no-show/cancellation rates after OMB.
Results: Among 99,743 patients with appointments after OMB, their no-show/cancellation rates increased significantly following OMB. However, the magnitude of increase differed by ethnicity, language, and zip code status. Latine patients had a greater increase in no-show rates compared to non-Latine patients (mean change 0.042, 95% CI [0.037, 0.047] vs 0.015, 95% CI [0.012, 0.018]; p < 0.00005). Similarly, Spanish-speaking patients demonstrated a larger increase in no-show rates compared to non-Spanish speakers (mean change 0.087, 95% CI [0.078, 0.096] vs. 0.016, 95% CI [0.013, 0.019]; p < 0.00005). Patients residing in zip codes with high ICE activity also showed a greater increase in no-show rates compared to those residing in other zip codes (0.051, 95% CI [0.036, 0.066] vs 0.022, 95% CI [0.019, 0.025]; p = 0.0001). When controlling for other variables, the post-OMB period saw a significant increase in no-show/cancellation rates among Spanish speaking (0.055, p < 0.0005, adjusted R2 = 0.3112) and patients identifying as Latine (0.011, p < 0.0005, adjusted R2 = 0.3101)(Table 3). In contrast, English-speaking patients had a significant decrease in no-show/cancellation rates post-OMB (-0.0578, p < 0.0005, adjusted R2 = 0.3115).
Conclusion: Immigration enforcement practices disrupt access to pediatric ambulatory healthcare. More no show/canceled appointments after immigration enforcement contribute to delays in preventive care and timely diagnoses.4 Patients who are non-English speaking, Latine, or who live in high-ICE activity areas are more likely to miss health care appointments compared to their counterparts after citywide immigration enforcement. Healthcare systems and policymakers must consider these unintended health consequences of immigration enforcement and implement strategies to ensure equitable access to care.
Table 1. Changes in Clinic No-Show Rates Pre- vs. Post-Midway Blitz (Two-sided t-test)
Table 2. Predictive Variables for Increased Clinic No-Show Rates Pre- vs. Post Midway Blitz (ANOVA)
Controlling for active zip, age, insurance type, clinic type, clinic location, and the number of post-Midway Blitz no-shows/cancellations
Subject of Research
People
Article Title
Immigrant Family Access to Pediatric Health Care after Executive Order 14161 and Operation Midway Blitz
Article Publication Date
2-Oct-2026
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