Before dawn, the quiet coastal community of Live Oak, California, exploded with noise. Sandy Beck, a teacher who has lived in the neighborhood for nearly 20 years, awoke to the thrum of helicopter blades. Outside, searchlights from the air swept the streets. Then the percussive blasts of flash-bang grenades echoed off the small ranch houses and low-slung apartments.

“It honestly felt like a war zone,” Beck said.

While she and her 16-year-old daughter huddled upstairs, other neighbors, silent in their darkened houses, listened to the thuds and cracks of federal agents breaking open front doors.

It was the day before Valentine’s Day in 2017, and this was California’s first immigration raid under the new president, Donald Trump.

By morning, raids across Santa Cruz County had ended in more than 20 arrests. The father of one student at Live Oak Elementary School, where Beck teaches third grade, was among those detained. The raids ushered in a new era for residents of the largely immigrant community of Live Oak – and forecast the experience to come for immigrants around the state.

Soon, the streets of Live Oak, a modest enclave only 2 miles across, were quiet again. But the new background noise – fear – was deafening.

Department of Homeland Security officials would defend the raids as targeting members of MS-13, an international street gang that the agency had been investigating for five years. A grand jury indicted 10 of those arrested that morning on extortion and drug charges; their prosecution is pending. But the sweep also netted bystanders with no criminal history, immigrants whose only offense, besides residing in the U.S. without permission, was being in the wrong place at the wrong time. The Department of Homeland Security told media outlets at the time that 10 of the 11 people arrested over only their immigration status were released quickly.

Nonetheless, the raids’ immediate effects rippled through immigrant communities in the Santa Cruz area like a bomb scare. Patients skipped appointments at a local health center. Parents who previously had flocked to school meetings suddenly evaporated, sensing they’d be safer if they stayed home. Children stuck close to the mother on yard duty at Live Oak Elementary instead of playing during recess. One 13-year-old boy insisted on accompanying his mother to her housecleaning job in nearby Scotts Valley – in case she got deported along the way.

Acute fear in Live Oak faded as the months went on, but more than a year later, everyday life is still not back to normal. A fresh wave of immigration arrests in the last days of February 2018, totaling more than 200 across Central and Northern California, dialed up the anxiety again – as does each fresh news report about enforcement and policy changes in the hard-line immigration atmosphere under Trump.

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Ask educators, doctors and activists who work with these families what defines their new reality, and you’ll hear the same word over and over: uncertainty.

“You think about it whenever you go out,” said Maria del Rocío, a mother of two and member of the parent leadership committee for Live Oak Elementary’s Cradle to Career program, speaking in Spanish. Del Rocío came to the U.S. from Mexico 13 years ago. Her children are U.S.-born citizens. “You could be crossing the street, and there’s immigration. They could be in the store where you go to get lunch. They could be anywhere.”

Physicians and researchers warn that some of the most significant changes are invisible. What we can’t conspicuously see – yet – is that chronic fear amounts to more than a mindset: It actually can erode families’ health. For children, it may even interrupt their development – and that of an entire generation.

“This is not just an immigration issue, but a public health issue,” said Duncan Lawrence, executive director of Stanford University’s Immigration Policy Lab, who has studied the effects of family immigration status on U.S.-born children’s mental health. “These children’s stress is likely to have impacts that are communitywide.”

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***

On a brisk Saturday morning in December, dozens of Mexican immigrants of all ages lined up along the asphalt outside the gym at Live Oak Elementary. Immigrants who work in housecleaning, landscaping and other service industries long have congregated in Live Oak, where rent is more affordable than in neighboring Santa Cruz and other beach communities.

Today, The Mexican Consulate had set up a one-day shop there, and people came from across the region to sort out passport issues and other government affairs. Any fear felt far away, as friends chatted in line and munched on cinnamon cookies from a nearby table.

Advocates from several community service organizations seized the moment. They walked up and down the lines, handing out manila envelopes that contained instructions for creating child care safety plans: legal documents that establish who will take custody of children if their parents are detained or deported.

Janet Solis, an immigration community coordinator for Building Healthy Communities, distributed the packets. The daughter of immigrants, Solis made a personal pitch in Spanish: “Ever since I was little, my dad always said to me, ‘If something happens to us, your mom and me, you’ll find the documents under the bed and you’ll go stay with your Uncle Hector.’ It’s like that, only more legal.”

Advocacy organizations such as the San Francisco-based Immigrant Legal Resource Center are pushing these contingency plans nationwide, in states as dispersed as Georgia, Washington and Massachusetts. Many immigrant families include a mix of U.S. citizens, legal residents and those here without legal permission. Any given day feels like a roll of the dice: Parents are unsure whether a child’s “Dreamer” designation will hold, and children don’t know when a parent might be picked up by authorities.

Most immigrants have not personally witnessed a raid like the one in Live Oak, but seeing it on the news is enough to scare them. Immigration arrests surged after Trump took office, jumping 42 percent in the first eight months after his inauguration, compared with the same period the previous year. U.S. Immigration and Customs Enforcement also has abandoned the Obama-era practice of focusing deportation efforts on immigrants with criminal histories. Instead, any person in the U.S. without legal permission who crosses paths with the federal government – including those showing up for scheduled meetings with ICE or green card interviews with their U.S.-citizen spouses – now could be a target for deportation.

To add to the instability, families have experienced a seesaw of shifting policies on so-called “Dreamers” – those who were brought to the U.S. illegally as children but have been granted temporary protection from deportation under the Deferred Action for Childhood Arrivals program. And they have heard the president make public statements that cast immigrants as enemies.

“The predators and criminal aliens who poison our communities with drugs and prey on innocent young people – these beautiful, beautiful, innocent young people – will find no safe haven anywhere in our country,” Trump told a rally in Youngstown, Ohio, in July. “And you’ve seen the stories about some of these animals.”

The resulting anxiety reaches every corner of the immigrant community – and beyond.

“Now anytime I hear a helicopter or a plane after dark, I’m on alert,” said Sandy Beck, the Live Oak teacher. She is a U.S. citizen who grew up in Virginia, and yet, she added, “the heart starts racing. I’m looking around. And I shouldn’t be, because I’m not being targeted, but these people who I work with every day – I don’t know who’s at risk.”

Many of those feeling the fear are not immigrants themselves, but U.S.-born children living with immigrant parents who lack legal status. As of 2014, there were about 4.7 million of these children across the country, the Pew Research Center estimated. In California, about 1 million children in public school, or 16 percent of those enrolled, have a parent without legal status.

At Live Oak Elementary, some of those children show up in the office of counselor Brad Edwards. They exhibit signs of anxiety, he said, including hypervigilance about their parents’ whereabouts, distraction in class, trouble sleeping, shortness of breath and panic attacks. Students tell him: “I don’t want my dad to go to work.” Or: “He was 10 minutes late when he got home and I thought someone got him.” Or: “I don’t want my mom to go out. She has to tell me where she is all the time.”

In his 14 years of counseling children and young adults, including five in Los Angeles public schools, this is the first time Edwards remembers politics so overtly entering his office. Some students have had such serious symptoms that their pediatricians took notice and referred their families to Edwards for counseling. Some, including U.S.-born citizens, are asking their parents to move the family to Mexico so they won’t have to worry about being separated. While many students cried and clung to their parents right after the raids, the majority since have calmed down – at least outwardly.

Edwards suspects they are still quietly carrying the same anxiety, but “there’s no way of knowing,” he said.

***

Hard data on the effects of this kind of chronic stress are hard to come by. It’s too early in Trump’s presidency to see any health effects reflected in large sets of government statistics. Plus, researchers find it difficult to survey and study a population that often wants to remain unseen.

Yet in January 2017, when Trump issued an executive order that turned undocumented immigrants without criminal records into targets for deportation, the American Academy of Pediatrics sounded the alarm.

“When children are scared, it can impact their health and development,” the academy wrote in a public statement. “Indeed, fear and stress, particularly prolonged exposure to serious stress – known as toxic stress – can harm the developing brain and negatively impact short- and long-term health.”

Numerous studies, many sponsored by the U.S. Centers for Disease Control and Prevention, have established that serious and chronic stress in childhood alters children’s biology and makes them more likely to have troubles such as poor work performance, substance abuse, depression and heart and lung disease later in life.

The health effects of childhood stress can take years to appear, but one large new study used an unusual measurement tool and found a clear connection to immigration policy.

Researchers from Stanford University’s Immigration Policy Lab wanted to know how children’s health changes when their undocumented parents are protected from possible deportation. So they looked at health care data on more than 8,600 children born in Oregon to more than 5,600 mothers who most likely lacked legal status between 2003 and 2015. The researchers compared the health of children whose mothers were younger than 31 on June 15, 2012 – the cutoff to qualify for the Deferred Action for Childhood Arrivals program – with the health of kids with older mothers.

The difference was dramatic. After protections for “Dreamers” began in 2012, the health of children whose mothers faced less threat of deportation swiftly improved. Specifically, the diagnoses of adjustment and anxiety disorders among these children dropped by half. The researchers underscore that such a diagnosis is no light matter.

“We’re talking about extremes,” behavior that interferes with children’s normal function and development, said Fernando Mendoza, a study co-author and pediatrics professor at Stanford’s Lucile Packard Children’s Hospital. Such behavior could include increased recklessness, sleeplessness, lashing out at classmates or an inability to complete schoolwork.

Duncan Lawrence, the lab director and an author of the study, was surprised by the magnitude of the impact.

“It’s not just a small change; it’s dramatic,” he said. “And there’s a huge cost associated with these childhood mental health issues.”

***

Parents, meanwhile, are trying to reassure their children while quietly coping with their own worries. At the Mexican Consulate event at Live Oak Elementary, the atmosphere was casual and communal until advocates started talking about contingency plans for children in case of parents’ deportation. Most people fell silent.

Adriana Hernandez of Santa Cruz, whose son came with her to work after the February 1017 ICE raids, asked a question: “I have a daughter who’s 20 and a son who’s 13. Can she take care of him?” The advocates said yes.

So far, local service organizations have trained at least 70 volunteers to help people create child care safety plans, which parents are urged to keep in a designated place in their home and share with the people they’ve selected to help. Ten families in the Santa Cruz area have completed them. Now other local schools, finding their students’ parents fearful, are asking for formal presentations on how to make these plans, too.

At Live Oak that morning, some parents were putting in place another kind of contingency plan: a safety net in Mexico for their children. A consular service called Registro Civil allows Mexican nationals to register their U.S.-born children as Mexicans, which qualifies them for public services if they move to Mexico.

Registrations through Registro Civil have skyrocketed under Trump. The Mexican Consulate in San Jose, which ran the Live Oak event, saw its annual registrants double from 644 to 1,300 between 2016 and 2017. At the larger consular operation in Fresno, annual registrations more than quadrupled, from about 780 to more than 3,700.

Psychologists warn that parents’ fear also tends to affect their children’s well-being – and not only because their kids can sense it.

In spring 2008, homeland security officials conducted a massive raid at an Iowa meatpacking plant. Hundreds of federal agents swept in and arrested nearly 400 immigrant workers, almost all of them Latino, as helicopters hovered overhead. Afterward, researchers from the University of Michigan found that Latina mothers across Iowa who were pregnant at the time of the raid had a higher risk of giving birth to low-weight babies. Low birth weight has known links to mothers’ stress, and it puts a baby at risk of long-term health and academic problems.

Additionally, parents afraid to take part in society miss opportunities to involve their children in day care, nutrition programs and other activities and services that might benefit them.

In January 2017, just after Trump’s inauguration, a draft executive order leaked to the press revealed that he was considering targeting even legal immigrants for deportation if they use public benefits such as food stamps and Medicaid.

Sandra Hernandez is co-chairwoman of the parent leadership committee of Live Oak Elementary’s Cradle to Career Initiative, a program that helps parents provide their children the essential ingredients for health and learning, including good nutrition. Yet her own family stopped accepting food stamps when Trump took office.

“When the president said he was going to start focusing more on people who get this type of assistance, my husband said, ‘That’s it, we’re going to stop getting it,’ ” Hernandez said in Spanish.

Hernandez, who came to the U.S. from Mexico City 12 years ago, runs the Cradle to Career meetings with a steady calm. Her husband works as a restaurant cook and volunteers at the school, making pancakes for fundraisers. The family used to receive $300 a month in credits through the CalFresh program to help feed their two U.S.-born sons, ages 6 and 9. Now, Hernandez watches for grocery sales and stretches her budget for the 15 days between her husband’s paychecks.

“We have to balance between buying food and buying things like clothes for the children,” she said.

It’s a concern the Santa Cruz County Human Services Department has heard repeatedly from immigrant residents, with fewer noncitizens applying for food aid and welfare benefits. Emily Balli, the department’s deputy director, suspects that both fear and cost of living in the area factor into the decline.

Psychologist Kalina Brabeck has found that such strain can affect children’s academic performance, too. She and colleagues at Rhode Island College and Boston College studied nearly 180 families with Latin American immigrant parents and U.S.-born children. They found that children whose parents lacked legal status to stay in the U.S. tended to do significantly worse on tests in reading, spelling and math. Their scores on certain tests stayed higher, however, if their parents used social services for the family – the same kinds of services that families such as the Hernandezes now are abandoning.

Beyond avoiding social services, immigrants without authorization to be in the U.S. also tend to be socially isolated and vulnerable to exploitative work conditions, which means they often aren’t able to pour the same resources and energy into their children as others can. Hirokazu Yoshikawa, a psychologist at New York University, has found the effects can last a lifetime.

“We know that having a parent without papers does represent a risk to children’s development from birth up to adulthood,” he said.

During Barack Obama’s presidency, Yoshikawa studied infants born in the U.S. to to immigrants from Mexico, China and the Dominican Republic, as well as African Americans, and compared those whose families did and did not have papers.

As early as age 2, the children of parents without legal status showed deficits in cognitive skills, which put them at an academic disadvantage before they even entered school. As these young citizens grow, Yoshikawa said, they are likely to suffer lower academic achievement, behavior problems, anxiety and depression in adolescence, and lower levels of educational attainment by adulthood.

Under a new president and a far harsher climate for immigrants, he added, “there would be very solid evidence to suggest that now these effects are solidly worse.”

In California under Trump, The Children’s Partnership – a research and policy organization – found evidence that kids in immigrant families are indeed at risk of social deprivation. The organization last fall surveyed 150 doctors, nurses and counselors at health centers across the state about trends in immigrants’ health since the 2016 presidential election.

Over 70 percent said they were seeing more children with symptoms of depression, such as sadness, sleep troubles and withdrawal from their usual activities. Almost the same proportion reported that immigrant families were increasingly expressing fear about bringing their children to school, the park or recreational events. Two-thirds saw an increase in families’ concerns about enrolling in public assistance programs such as Medi-Cal or CalFresh food assistance, even if they were eligible.

“It’s not only about immigrants,” said Stanford’s Fernando Mendoza. “It’s about kids who are U.S. citizens, who are the future of California.”

In the Live Oak schools, the tension is hitting in one additional, surprising place: classroom volunteers. California law requires certain school volunteers to be fingerprinted, and neither immigrant parents nor school officials can be sure those fingerprints won’t somehow be used to identify them as undocumented.

“We don’t want to encourage people to be fingerprinted right now,” said Live Oak School District Superintendent Tamra Taylor. So the district’s family coordinator is trying to keep parents involved by identifying tasks that don’t require the volunteer to be alone with children – and thus don’t require fingerprinting.

“It’s something I’ve never experienced as a superintendent,” Taylor said, “just nothing like it ever.”

***

These days in Live Oak, parents go to work and children go to school. People attend meetings and parties. Sandra Hernandez and her fellow Cradle to Career parent leaders are planning their year-end celebration, complete with awards, dinner, structured discussions on child development and Zumba.

On the surface, everyday life continues. But deeper down, something has shifted.

“Last year, when the president was inaugurated, I got depressed because I worried that if I went out, I’d be arrested,” Hernandez said.

For more than a month, she didn’t want to leave her home. Her husband and friends finally persuaded her “not to live in fear,” she said, and “this is why I’m really involved in school. It distracts me. Plus, I like helping people.”

Now, along with her cellphone, Hernandez carries a small red card detailing her rights and what to say if she is approached by any law enforcement agents. She tries not to let her sons see the TV news, so as not to alarm them. If the family were to have to move to Mexico, she worries about how her sons, who don’t speak Spanish well, would fare in school.

Live Oak Elementary is where Hernandez feels most secure. By policy, ICE does not conduct sweeps at sensitive locations such as schools and churches.

It’s the walk to and from school that unnerves her.

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Editor’s note: The Center for Investigative Reporting, a nonprofit, receives funding from The California Endowment, which supports our coverage of stories affecting Californians. Building Healthy Communities, where Janet Solis works, also receives funding from the endowment. However, all editorial decisions are made independently; donors receive no preferential coverage and do not influence the direction or findings of our reporting. This story was edited by Amy Pyle and copy edited by Nadia Wynter and Nikki Frick. Grace Rubenstein can be reached at grace@gracerubenstein.com. Follow her on Twitter: @GraceRubie.