How Politicizing Migration Harms Health

Politicians around the world are increasingly mobilizing anti-immigrant sentiment to garner support and votes-a trend that is especially evident as the US presidential election approaches.

While political rhetoric that stereotypes and scapegoats immigrants is well-documented, less attention has been given to the impact of these sentiments on immigrants themselves. In an article published today in the Journal of the American Medical Association (JAMA) and in a recently published book, Migration Stigma(MIT Press), scholars identify "migration stigma" as a pervasive and destructive force that links responses to immigration-such as prejudice and politics-to the health of immigrants.

"This concept of 'migration stigma' for the first time pulls together phenomena like the politicization of immigration and goes beyond how the native born think of immigrants to consider how it influences physical and mental health," said Lawrence Yang, professor and chair of the Department of Social and Behavioral Sciences at NYU School of Global Public Health, first author of the JAMA article, and lead editor of Migration Stigma.

The human cost

In the JAMA article, the authors write that being labeled as a migrant can set off a cascade of negative consequences: stereotyping, separation or "othering," discrimination, and loss of social status. In the context of power dynamics, these factors together result in stigma.

Stigma can take different forms, but all risk harming the health and mental health of immigrants. One form, structural stigma, occurs when groups are treated differently by laws or policies based on their status. For immigrants, this may mean worse access to education, housing, health care, and jobs-all of which are powerful social determinants of health, or social and structural factors that influence health outcomes.

Other forms of stigma may be less obvious. For instance, immigrants and their descendants who are attuned to the negative political environment and stereotypes people hold about immigrants may feel shame and internalize these negative beliefs.

Internalized stigma can increase stress, which may lead to a host of mental health issues, including anxiety, depression, and sleep disorders, and can even exacerbate post-traumatic stress disorder (PTSD) among migrants who endured traumatic journeys across borders. Moreover, internalized stigma-coupled with the fear of deportation-may deter immigrants from seeking medical attention and other services that ultimately improve their health and life opportunities, including jobs and education.

"New immigrants who are aware that the US is not the most hospitable place right now may respond to this negative environment by inadvertently avoiding opportunities to maintain their health," said Yang, who is also the founding director of the Global Mental Health and Stigma Program at the NYU School of Global Public Health.

Addressing migration stigma

"A new focus on the intersection of migration and stigma creates an opportunity to break the cycle of harmful policies and rhetoric that fuel stigma and hurt the health of immigrants and others," Yang said. And because stigma involves many factors-labeling, stereotyping, "othering," and loss of status-interventions to reduce stigma can work to address any of these linkages.

"For instance, we can introduce new narratives to change a label or address stereotyping, or can encourage policymakers to enact anti-discrimination laws to preserve access to health care and education," said Yang.

The authors also write in JAMA that to avoid stigmatizing migrant patients, health professionals can recognize that health and illness stem from social, political, and economic structures.

A new field of research

The concept of migration stigma grew out of an international forum, convened by the Ernst Stüngmann Foundation, that brought together scholars in the fields of stigma and migration to explore connections between the two.

"Although both fields examine the causes and consequences of prejudice and discrimination, until recently there was little formal collaboration between stigma and migration scholars," said Yang.

Through this process, the scholars coined the concept of migration stigma and launched this new field of research. Future areas of study include the impact of the migrant label on different life domains, whether the label extends beyond migrants themselves to other generations or associated racial or ethnic groups, and whether stigma has long-term health consequences.

"By examining how the seemingly disparate phenomena of anti-immigrant politics and individuals' health are related, we enhance the possibilities for researchers and clinicians to understand, and ideally, intervene to promote public health," the authors write in JAMA.

The JAMA article was co-authored by Bruce Link of UC Riverside and the Columbia Mailman School of Public Health and Maureen Eger of Umeå University and the Center for Right-Wing Studies at UC Berkeley. Eger and Link are also the co-editors of the book.

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Rachel Harrison

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