Throughout his political career, the current President has defined himself in large part by his antipathy towards immigrants; from hisdisparaging remarksabout Mexican immigrants (and judges) at the start of his presidential campaign, to his administration’sban on immigrants from several majority-Muslim countries. Leaving aside the callousness of such statements and actions, they have drowned out a conversation that we should be having about the health of immigrants.
Immigration is neither a new issue, nor an exclusively local one. In 2017, there were more than250 million immigrants living worldwide, and about 2.4 million migrate across national borders each year. It is estimated that more than750 million people live within their country of birth but in a different region, having migrated within national borders. Economic, political, and social forces drive migration. Migrants who are forced to leave their country due to war or persecution become refugees; there were 65 million refugees worldwide at the end of 2017.
Themigration experience itself affects health, particularly for vulnerable populations, but the “healthy immigrant” effect suggests that those who are healthier immigrate in the first place—migration after all is an arduous process. More importantly from the point of view of a host country, conditions experienced by migrants in their new countries are strongly determinative of health. For instance,legal status in the host country is associated with access to a broad range of health services and resultant better health.A study in Denmark found that refugees were disadvantaged in terms of some cardiovascular disease outcomes and equal or better off than a Danish-born comparison group in others, but family-reunified immigrants had significantly lower incidence of stroke, cardiovascular disease, and myocardial infarction across the board.
Aggressive anti-immigration tactics are notably unhealthy. Policies at our borders traumatize families and mental health care is the greatest unmet health need. In-country, there are spillover effects. Federal raids can affect the birth-weight of babies born to US-born Latina women followingimmigration authority raidsin search of undocumented Latinos.
Creating the conditions for immigrants to stay healthy helps us all. A recent measles outbreak in Minnesota was fueled bylow vaccination ratesin refugees who often mistrust providers and fear discrimination and deportation. Rather than shouting about the imagined evils of immigration, we should be doing all we can as a country to maximize healthy immigrants.
Contrary to the current administration’s narrative, migrants are not trying to take resources away from Americans—they are simply trying to create a life for themselves and their children that was not possible at home. Study after study shows thatimmigrants increase productivity. We should be celebrating such effort.
Warmly,
Michael Stein & Sandro Galea