Although there have been many changes to community and family structure, and advances in scientific understanding of children's health and wellbeing, there has been little difference in how healthcare is delivered to children. The focus is often a deficit approach to acute situations. Halfon's Life Course Health Development Theory (LCHDT) focuses on a holistic approach to health and well-being. In the LCHDT, one's health is impacted by specific contexts during childhood that have a lasting impact. Key areas of family, community, schools, environment, and healthcare systems impart positive and negative experiences that affect children's health. Using the LCHDT as a guide, this consensus paper explores these five areas in the context of nursing practice roles and policy implications. With this approach, nurses lead and partner to build positive ecosystems for children and inform key policy actions to ensure change is a reality.

Unaccompanied immigrant children (UIC) are minors under 18 who arrive alone in the United States, often after experiencing cumulative trauma related to premigration adversity, family separation, and perilous journeys. These exposures increase risk for abuse, neglect, trafficking, and adverse physical and mental health outcomes. Trauma-informed care (TIC) offers an evidence-based, child-centered framework for nursing practice across the migration continuum by promoting safety, preventing retraumatization, and supporting continuity of care. Policies must prioritize children's best interests while equipping nurses, health professionals, and Customs and Border Protection personnel to deliver developmentally appropriate, compassionate care during screening, entry, release, and resettlement. An urgent, ethical, trauma-informed policy response is needed to safeguard UIC well-being. Providing TIC to UIC is both a moral imperative and a strategic investment in health equity and national well-being. The American Academy of Nursing supports integrating TIC across UIC services and minimizing detention to improve health outcomes.

Transgender, nonbinary, and gender expansive (TNGE) older adults face structural disparities in healthcare access and utilization. To examine perspectives on education, training, and desired qualities in healthcare delivery among TNGE older adults and identify opportunities for improvement. Between September 2021 and January 2022, semi-structured, individual interviews were conducted with 47 TNGE adults aged 65+ in the United States. Utilizing a thematic analysis approach, data were analyzed using NVivo software. Three themes emerged: (1) implicit bias and lack of TNGE-relevant healthprovider education, (2) healthcare professionals' empathy, compassion, and respect, and (3) challenges with disclosing TNGE identity. Respondents emphasized the need for more culturally responsive, age-friendly, and trauma-informed care education and training. These findings highlight the need for reforms in healthcare education and training to better serve TNGE older adults and to equip nursing and other healthcare workforces to respond effectively to TNGE identity disclosures.