When my husband and his family members fled Liberia in West Africa in the 1980s and ’90s following a series of political conflicts, they came to a country that provided them with many opportunities for education, safety, health and security. However, all members of the family did not realize this dream.
During my father-in-law’s flight from Liberia following a military coup, he experienced considerable physical and psychological hardships. He marched out of Liberia on foot under the threat assassination from soldiers in the new government regime. Although he made it alive to a neighboring African country and was fortunate to secure refuge in America, he arrived to a country that knew nothing about his personal and professional history.
{mosads}The only work he could find was a security guard position — far different from the high-level security position he held in Liberia. Shortly after arriving, he developed depression and was diagnosed with diabetes. At age 64, he died alone in his home from a sudden heart attack.
Unfortunately, my family’s story is not isolated. For decades, my colleagues in public health have tracked disparities in health outcomes between immigrants and U.S.-born citizens.
One of the earliest examples from the 1960s is a study comparing Japanese men living in Nagasaki, Japan to Japanese American men living in Honolulu, Hawaii or San Francisco, California. Rates of heart disease were lowest in Japan and remained low in Honolulu. But once Japanese were on the mainland in San Francisco, their disease rates were similar to white men. Investigators concluded that “racial” differences in heart disease were not due to genes. Rather, they were due to the U.S. environment — ready availability of fatty, sugary and processed foods; cars for transportation rather than walking and bicycling; and occupations that involve more sitting than active labor.
These patterns are borne out in multiple immigrant groups in America and in relation to multiple diseases and ailments. A startling and recent example is the tragic deaths of two children from Central America in December while in a U.S. detention center at our southern border. While we debate issues of safety from immigrants, those same immigrants face threats to their health and higher death rates in the near- and long-term than their U.S.-born counterparts.
It is true that some immigrants come to the U.S. in need of health care. Medical officials surmise that those young children from Central America may have contracted the viruses that led to their deaths during the journey to the border. Others, like my father-in-law and possibly those children from Central America, left situations in their home countries characterized by political unrest, gang violence or crime that posed more immediate threats to their lives than our “environment.”
{mossecondads}These scenarios are all true, and we have little control over their influence on the health outcomes of immigrants. What we can control are the narratives we choose to embrace about immigrants in our country. If we choose to believe that immigrants pose a threat to our health and safety, then we ignore the oftentimes terrible circumstances in their own countries that brought them here. If we choose to believe that America is a meritocracy where each individual can pave his/her own destiny, then we ignore the long reach of anti-immigrant sentiments and the “-isms” (racism, classicism) that present a more substantial barrier to upward mobility than any border wall.
Instead, we should choose to extend our humanity to immigrants and the other vulnerable among us by using the tools we have to create an environment that promotes and protects health.
Only by shifting our narrative from protecting ourselves from immigrants to protecting immigrants can we fulfill the promise of life and liberty imprinted on our most prominent symbol of immigration: “Give me your tired, your poor, Your huddled masses yearning to breathe free. . .”
Mercedes Carnethon, Ph.D. is the Mary Harris Thompson professor of Preventive Medicine and chief of the Division of Epidemiology at the Feinberg School of Medicine at Northwestern University, and a public voices Fellow with the OpEd Project.