I intimately see anti-immigrant sentiment played out in my day-to-day life – personally and professionally. My work over the past almost 20 years has focused on African immigrants and refugees in Massachusetts and nationally, specifically building community-led solutions for HIV/STD service delivery, research, training and advocacy. Too often African immigrants and refugees are lost under the racial category Black/African American and are invisible in the greater narrative on the criminalization of immigrants in the country and along the border. As a provider and activist, I constantly have to be on the alert; constantly ensuring that I can still say, “your insurance or health records are not shared with immigration authorities” or “no, you will not get followed, searched, detained or deported – public health care facilities are safe places.” There are many unknowns and many ways immigrants have been shown that they do not matter. The discourse is enough to ignite a level of fear that is thick and deep. It paralyzes all – undocumented and documented immigrants – from seeking their true right to health and basic needs. Fear reinforces the mistrust that immigrants have in the health care system, deters immigrants from accessing needed care, and even causes immigrants to refuse treatment or skip medical appointments. Being in constant fear takes a mental and emotional toll. In this environment fueled by xenophobic rhetoric, the health of immigrants and their families will worsen – use of prevention will decrease and chronic conditions will be neglected until they become emergencies, which in turn will heighten existing health inequities.
The negative social construction of immigrants in society is not foreign to the history of the US. Laws, overtime, have dictated who’s allowed to come and stay in the country, and to what extent they can exercise their human rights. The criminal [in]justice system and immigration enforcement machine are fused together, and today, immigrant communities are over policed, face unprecedented levels of surveillance, and are detained or deported at increasing rates. Black, LGBTQ and Muslim immigrant communities are disproportionately vulnerable to these acts of structural violence due to intersecting forms of oppression – racism, heterosexism, transphobia, and Islamophobia. Legal immigration and naturalization are under threat with the potential ban on asylum, elimination of DACA, DED and TPS, and passing of the public charge rule. These unjust bans, policies and practices rip families apart, are against human rights and critically put immigrants – individuals, families and communities – in real danger impacting their mental, physical and emotional health. This is not only threating the livelihood of immigrant families and communities, but also the needed work of organizers and health providers.
The wellbeing of immigrants should be placed within a ‘health as a human rights’ context. Article 25 of the United Nations’ Universal Declaration of Human Rights 1948 states that “Everyone has the right to a standard of living adequate for the health and well-being of himself [herself, themselves] and of his [her, their] family, including food, clothing, housing and medical care and necessary social services.” Embedded in this statement, as noted by the National Economic and Social Rights Initiative, is that “health care must be provided as a public good for all, financed publicly and equitably.” It doesn’t state only people with a certain nationality, skin tone, religion, accent or language have these rights. It states EVERYONE and ALL. This right, for immigrants, is under an unwavering attack in the US. It is important to note that the US does not uphold all United Nations’ human rights declarations, which speaks to the lack of and unwillingness to pass laws recognizing health and other rights and ensuring the implementation of those rights.
Fleeing persecution, the disruption of US foreign policy and civil war are only a few of the reasons for migration, as well as school, work and to simply visit the US and/or family. Immigrants come here with strengths of resiliency, hope, and colorful stories of diversity and purpose. Yes, immigrants contribute to the development and economic stability of the US, and are productive members of society. But, should that be the way we measure their value and access to rights? Immigrants – like all people – are more than their productivity. The humanity of immigrants is often forgotten or intentionally omitted in the national conversation. A ‘health as a human rights’ framework ensures that regardless of political agendas, immigrants and their families are entitled to being counted and visible, being respected as a community, and being in an environment that prioritizes living conditions to enable their wellness. Without fear. Without violence. Without arbitrary restrictions. Not commoditizing their humanity. This is their right.
As you know, CCPH works at the intersection of these issues while uplifting the voices, experiences, leadership and assets of communities most impacted by structural oppression. In addition to me, our current Board has several members that focus on immigrant health: Antonio Tovar-Aguilar, PhD at Farmworker Association of Florida works on the ground with Latino and Haitian farmworkers and rural low-income communities across Florida and South Georgia, and Rosemarie Hunter, Ph.D, LCSW at the University of Utah supports on-campus advocacy efforts and local community partners who do work in Latino behavioral health, affordable housing, and cultural and indigenous healing methods. Having academics and organizers on the Board committed to immigrant health and justice has propelled us to think more critically about how CCPH can support current immigrant-led organizations, nurture partnerships, and be more inclusive in advancing the voices of community. We are not only thinking about migrant justice issues domestically but also internationally whereas Board members have traveled for public health initiatives in various countries, such as Malawi, Thailand, Myanmar, Cuba, Uganda, Pakistan, and Malaysia. Collectively, we need to be vigilant in our efforts. With communities, public health professionals must actively condemn policies and practices, in society and our workplaces, that threatens establishing healthy conditions and environments in which immigrants live, work, study, pray and play. Locally grounded strategies of addressing and framing problems are effective and sustainable. The importance of sincere and deep community engagement in relation to developing culturally and linguistically appropriate health services and policies cannot be undervalued. This is often seen as integrating individuals who reflect the community (e.g., community health workers, cultural brokers) or partnering with a community organization or group. Regardless of the method, nurturing community -led initiatives is effective because communities know the complexities of the problem, know how their community functions, and known solutions to the issues. In doing our part to move this agenda forward, CCPH is convening an Immigrant Health Workgroup to think about and act on the implications for partnerships and policy. We also seek your feedback. Let us know your thoughts – are you ready to join us as we join others?
Chioma Nnaji, MPH, Med
Program Director, Multicultural AIDS Coalition
PhD Candidate, University of Massachusetts Boston, School for Global Inclusion and Social Development
For more information on Chioma’s work: