The Escalating War on Immigrants Is a Public Health Crisis

Between 2017 and 2021, the presidential administration of Donald Trump implemented a range of exclusionary policies and tactics to restrict immigration and limit immigrant rights.^1,2 These policies and practices included declaring an emergency at US borders, drastically reducing and temporarily suspending refugee admission, trying to end birthright citizenship, restricting the practice of releasing immigrants held in detention while awaiting immigration proceedings, preventing asylum seekers from entering the United States, increasing scrutiny of work permits, targeting sanctuary cities, denying public benefits to immigrants, and expanding detentions and deportations.

At the very beginning of his second term, on January 20, 2025, Trump issued 10 executive orders that either reinstated immigration policies from his first term or introduced new exclusionary measures.³ The latest round of aggressively harmful policies includes seeking to end birthright citizenship, ending humanitarian programs, and limiting or ending funding for nongovernmental organizations that provide support to immigrants. In this editorial, we highlight specific economic and political actions whose only purpose is to restrict or prevent immigrants from accessing federal programs and health care services and call on the public health community to monitor and report on how these actions affect the health and well-being of immigrant communities.

PROTECTING THE HEALTH OF IMMIGRANTS

Aggressive immigration enforcement strategies will continue to exacerbate poor physical and mental health outcomes among immigrants and their families by increasing and perpetuating fear, discrimination, limited access to health care services,⁴ and family separation.⁵ Strategies to protect the health and well-being of immigrants must include upstream interventions that address entrenched power imbalances by improving access to public benefits that enable immigrants to live safe, healthy, and productive lives.

First, policies expanding the types of services provided in federally qualified health centers to provide health care access to immigrants, particularly undocumented immigrants, are needed.⁶ Similarly, immigration policies that continue to legitimize excluding immigrants from access to legal employment, education, and housing must be rescinded or scaled back, given their direct relationship to increasing health inequities in immigrant populations. Additionally, facilitating more pathways, rather than curtailing legitimate pathways, to attain legal status for immigrants residing in the United States is warranted to prevent family separation and disruption.

Second, current media discourse and misinformation about immigrants is perpetuating fear and stigmatization of this population, leading to poor mental health.⁷ Changing such discourses and narratives will improve mental health and facilitate the integration of immigrants into their communities. For example, inflammatory rhetoric and public misconceptions about immigration should be countered through evidence-based policies and public education efforts.⁸ Such efforts are increasingly necessary to reduce the dehumanizing narratives about recent immigrants in the public discourse⁹ and contribute to creating a more supportive environment for immigrants and, ultimately, affect health outcomes.

Finally, immigrant communities tend to informally engage in collective strategies to help navigate the effects of immigration policies. These strategies should be identified and fostered through partnerships with nonprofit organizations that advocate for immigrant populations and provide them with the information they need to navigate the system.¹⁰ Protecting immigrant health from the devastating policies being enacted under the second Trump administration will require multilayered and multifaceted approaches that include protecting access to health care, housing, food, education, and employment—key social determinants of health. In addition, campaigns to reverse and reduce fear and stigmatization and strengthen community-based initiatives and advocacy to empower immigrant communities are warranted.

CHARTING A RESEARCH AND POLICY AGENDA

To understand how these exclusionary policies affect the health and well-being of immigrants, their families, and their communities, we expect submissions to AJPH that examine how immigration policies—such as the proposed changes to the public charge rule, limiting access to health insurance coverage under the Affordable Care Act for Deferred Action for Childhood Arrivals recipients, preventing access to federally funded housing, and limiting access to Supplemental Nutrition Assistance Program benefits—will affect health outcomes. Furthermore, based on this information and knowledge, we call for evidence-based policy recommendations and potential interventions to reduce health inequities among immigrant populations, challenge misconceptions about immigration, promote evidence-based discourse, and explore community-based initiatives and partnerships to support immigrant populations.