Immigration Policy a Public Health Threat?

by Mandy Morgan May 8, 2025

What if the next major threat to public health wasn’t a virus—but a policy? Not something spread through the air, but through the pen of a president. Not a biological pathogen, but a political one—fueled by racism, cloaked in bureaucracy, and deadly in its consequences. That’s the argument emerging from a powerful new commentary that asks public health to confront a long-overlooked reality: immigration policy isn’t just a legal issue. It’s a public health emergency.

The Political Is Personal—and Biological

During Donald Trump’s first term as president, immigration policy was weaponized like never before. Sweeping executive orders made 11 million undocumented immigrants deportation priorities overnight. The so-called Muslim Ban stranded visa-holding families mid-flight. And changes to the “public charge” rule discouraged immigrants from using food assistance or even Medicaid—for fear of getting deported.

It wasn’t just politics. It was health. And the numbers are chilling.

Preterm births rose. Heart disease risk went up. Health care visits dropped. Anxiety, trauma, and discrimination became part of daily life for millions of immigrants—and for their U.S.-born children too. One chilling stat: hate crimes against Asian Americans rose 150% in major cities during Trump’s presidency, fueled in part by his repeated reference to COVID-19 as the “China virus” and “Kung Flu.”

Now, with Trump back in office, researchers warn: the second wave is here.

A Dangerous Continuation—and a Call to Action

Within weeks of returning to power in 2025, Trump reignited the same playbook: new bans on asylum seekers, renewed power for ICE raids in hospitals and churches, and executive orders halting refugee resettlement. The administration also erased diversity policies and launched efforts to dismantle entire public health programs under the banner of “equity bans.”

But this isn’t just about one administration. It’s about what happens when the systems meant to protect people are repurposed to exclude them—and when public health stays silent.

That’s why the authors turn to Critical Race Theory (CRT) for answers. CRT isn’t just an academic concept—it’s a set of tools to help us see how laws that claim to be “neutral” often hide deeply racialized consequences.

One powerful example: Trump’s claim that immigrants were abusing government benefits. In reality, many programs like food stamps or Medicaid were already restricted for undocumented immigrants. But that didn’t stop the fear campaign. As a result, thousands of eligible children were pulled from health programs they needed—as many as 260,000 lost Medicaid coverage.

The authors argue this wasn’t accidental. It’s part of what CRT calls “whiteness as entitlement.” When white Americans perceive resources as “theirs,” they’re more likely to support policies that restrict others’ access—even if everyone is paying into the same system.

Public Health Needs a New Compass

Historically, public health has focused on issues like disease prevention, vaccinations, and maternal health. But the study challenges professionals to zoom out and ask: Who has the power to shape health outcomes before we even show up?

Immigration policy—like housing, policing, and education—is a political determinant of health. It defines who gets care, who fears seeking it, and who is seen as worthy of public investment. That means silence is no longer neutral. It’s complicity.

The researchers call for a “critical public health” approach—one that’s unafraid to name white supremacy, to challenge systems of exclusion, and to see immigrant health not as a niche issue but as a central measure of national well-being.

They spotlight real-life models too. New York City’s ActionHealthNYC pilot, which helped undocumented residents get primary care, led to a 29% increase in access and 49% drop in emergency visits. California’s expansion of Medi-Cal to undocumented immigrants is another example: when you prioritize inclusion, everyone benefits.

What’s Next: Fight Back, or Fall Behind

The report closes with urgency. Public health professionals can’t afford to wait until harm is done. Agencies must assess how immigration policies shape health outcomes and speak out when those policies inflict harm. They must support inclusive initiatives, correct misinformation, and align with immigrant-led advocacy.

Because here’s the truth: the same policies that scapegoat immigrants often come with a second blow—defunding public health systems, censoring data, and banning equity initiatives. In other words, if they come for immigrants today, public health could be next.

Join the Conversation

• How does immigration policy show up in your community’s health outcomes?
• Should public health departments be more vocal about political determinants of health?
• What can local practitioners do when national policy seems out of reach?

Let’s talk about it—before silence becomes complicity.

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