Health effects of anti-immigrant rhetoric

WHEN public figures indulge in anti-immigrant rhetoric, it’s not too hard to imagine this might cause psychological harm in the groups being denigrated.

But could the health effects go further, even affecting future generations?

A recent article in JAMA investigated the association between preterm births in Latina women in the US and that country’s 2016 presidential election.

After controlling for temporal and demographic variables, the researchers found there were significantly more preterm births to Latina women over the period than would have been expected if the election had not occurred.

In all, 1342 more baby boys were born preterm than expected and 995 more baby girls, an increase of 3.6% and 3.2% respectively.

The increase was most pronounced for babies who were either conceived or in the second trimester of gestation around the time of the election.

“Although the present study does not identify mechanisms underlying our findings, a growing body of evidence suggests that the circumstances surrounding the 2016 presidential election led to increased levels of psychosocial stress and anxiety among US immigrants and their co-ethnic family and community members,” the authors wrote.

Previous research had shown uncertainty and fear about immigration policy were associated with poorer self-rated health, cardiometabolic risk factors and inflammation, all of which could contribute to risk of preterm birth, they said.

Immigration-related rhetoric might also affect women’s health behaviour, including the likelihood of them accessing adequate prenatal care.

More research was needed into “how the threat of punitive immigration laws and enforcement negatively affect population health outcomes, especially for pregnant women and their children”, the authors wrote.

The US immigration regime is very different to Australia’s of course, but the potential for anti-immigrant, or racist, rhetoric to cause adverse health effects, even intergenerational harm, might be common to both societies.

When Home Affairs Minister Peter Dutton claimed last year Melburnians were afraid to go out to dinner because of “African gangs”, it prompted widespread mockery on social media, with thousands of people posting pictures of their meals and of crowded restaurants using the hashtag #MelbourneBitesBack.

The consequences of Dutton’s comments were doubtless more far-reaching for African Australians than they were for most of the wits of Instagram, although I’m not aware of any research into specific health effects.

As is the case in the US, we know immigrant communities in Australia can experience higher rates of poor obstetric and other health outcomes than the general population.

What we don’t know is whether such preexisting risk might be aggravated by inflammatory public discourse around questions of immigration and race.

A response to the JAMA article from two US doctors, a paediatrician and a neonatologist, says it raises questions about the association between sociopolitical events and population health, including “the ways in which individual and institutional racism and discrimination affect biology and physiology”.

Might the election have been associated with other adverse health outcomes such as cardiovascular events, these doctors ask.

“If changes in birth outcomes were associated with a sociopolitical event such as the 2016 election, it stands to reason that other pediatric and adult outcomes might … have been affected,” they argue, noting that, while broader health effects of events such as earthquakes have been studied, this has not been the case for political events.

One thing we do know is that words have the potential to cause harm, particularly in vulnerable communities.

The 2337 babies who may have been born preterm as a result of anti-immigrant rhetoric in the US deserved better.

Jane McCredie is a Sydney-based health and science reporter.

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.