Twenty-one-year-old Andrea* couldn’t sleep that night last September when she heard about President Trump’s plans to end Deferred Action for Childhood Arrivals (DACA), a program that had protected her and other qualified undocumented youth from deportation and allowed them to work legally. She lay awake until 5 AM, filled with dread as she imagined building a new life in Mexico, a country she had left when she was only five years old.
But she worried most about her family being separated. Although her parents and brother are undocumented, her two youngest siblings, ages 11 and 15, were born here. “If we get sent back, what will happen to the kids?” she wondered. “Who will take care of them?"
Since then, Andrea, a student at the University of California, Berkeley, has struggled to fall asleep at night. The anxiety and sleep deprivation have taken their toll on her body, she says. Toward the end of last year, she came down with pneumonia. She’s gained 15 pounds, which she blames on stress-eating. “I’ll see something on the news, and I won’t feel like eating,” she says. “Then I’ll binge later.”
Recent developments in immigration policy, such as of Immigration and Customs Enforcement’s plans to conduct massive raids in the San Francisco Bay Area, where Andrea and her family live, and Congress’ failure thus far to reach an agreement to extend DACA, have only heightened her fears, as well as those of other members of immigrant communities.
Now, research suggests that, like in Andrea’s case, this fear may have real health consequences. A recent study of Latinas in the Salinas Valley, California, published in the Annals of Behavioral Medicine found an association between worrying about deportation and multiple risk factors for heart disease.
Research has emerged showing an association between fear of deportation with poorer mental health, but Jacqueline Torres, an assistant professor of epidemiology and biostatistics at the University of California, San Francisco, wanted to know whether it had a connection to physical health, too. A few studies hinted that it did, but were based on participants’ own ratings of their overall health. Torres wondered if she would see a link between worry about deportation and specific clinical risk factors, as measured directly by researchers.
To find out, she examined existing data on 545 mothers of primarily Mexican descent enrolled in a long-term study of children’s exposure to agricultural chemicals in the Salinas Valley, which is home to a large immigrant population. Since many of those helping to run the study had worked with the same women for several years, and also lived in the area, they'd heard about the impacts of deportation and fear of deportation had on families. So they asked the women how much worry deportation—of themselves, or their family or friends—caused them. They chose from three responses: not too much worry, a moderate amount of worry, or a lot of worry. The data set also included their health outcomes, such as their BMI, waist size, and blood pressure.
Around 49 percent of women reported a lot of worry about deportation. Compared with those who reported not too much worry, these women had significantly higher BMIs, larger waistlines, and a greater likelihood of being obese, putting them at increased risk for heart disease. They also had higher pulse pressures, a predictor for peripheral arterial disease and congestive heart failure. Women who reported a moderate amount of worry had a significantly greater likelihood of being overweight, and higher systolic blood pressure (the pressure in arteries when the heart contracts)—also associated with heart disease risk—than those who reported not too much worry.
The researchers saw these associations even after accounting for the women’s socioeconomic status, how long they had lived in the US, and other factors known to impact heart disease risk. They also controlled for whether the women had suffered from depression, since it’s not only correlated with increased heart disease risk, but might have also made them prone to worrying in general.
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Torres cautions that the findings were based on data collected from 2012 to 2014, during a surge in deportations under former President Obama; they don’t reflect levels of worry amid recent immigration policy changes. She says that since this worry has become more acute and widespread since Trump was elected—adding to immigrant communities’ already existing fears—its impact on heart disease risk factors may be greater and affect even more people.
Since the study included women born in the US, and didn’t ask participants to specify their immigration status out of concern for their safety and privacy, the findings suggest that worry about deportation has effects that ripple far beyond undocumented immigrants. These include people who have no potential of being deported but are woven into communities with people who do face the danger. “This kind of worry is impacting many members of communities, of which immigrants are a main part,” Torres says. “They are coworkers, church members, members of the PTA, schoolmates, neighbors.”
But while Torres’ team saw an association between worry about deportation and heart disease risk, additional studies are needed to establish a causal link. “I’m not ready to say to my patients that the risk of deportation is their number one risk for heart disease,” says Daniel Palazuelos, associate physician at Brigham and Women’s Hospital. Still, the findings “are another important piece of a larger body of research exploring how social inequity damages health,” he says. After all, past studies have correlated racial discrimination with accelerated aging in black men, for instance, and poverty with delays in brain development in children.
Such research hints at a few ways that worrying about deportation could affect heart disease risk, Torres and colleagues note in their paper. For instance, chronic stress from inequity has been associated with persistent, low-grade inflammation, which could increase the risk of heart disease.
Andrea isn’t surprised by Torres’ findings. Aside from her own health issues, the women she works with as a community organizer at a local church have complained about loss of sleep and appetite, trouble breathing, and panic attacks since Trump was elected. Many of them are undocumented. She tells me some of the kids in her community have begun cutting themselves.
Claudia Suarez, a 23-year-old undocumented immigrant from El Salvador, has suffered from multiple panic attacks since the election, including earlier this month after hearing about the administration’s decision to end temporary protected status for her and other Salvadoran immigrants, which had allowed them to live and work in the US. “My anxiety knows how to communicate with my body,” she says. “It’s gotten to the point that I’m so uncomfortable with existing.”
Palazuelos suggests that doctors working in immigrant communities ask their patients how shifts in immigration policy have affected their lives. “I think patients will appreciate that the physician is thinking about them as a whole person and not just a conglomeration of risk factors,” he says.
But fear of deportation might discourage undocumented immigrants from seeing a doctor at all.
Clinics serving immigrant communities have noticed a recent drop in appointments, and health advocates report lowered enrollment in federally subsidized health insurance even among legal immigrants, who worry their information may be used to track down undocumented family members. If these potentially at-risk individuals don’t seek medical care early on, “their risk for complications, disability ,and early mortality may increase,” says Carmen Isasi, an associate professor of epidemiology and population health at Albert Einstein College of Medicine.
Some local organizations, like the church where Andrea works, are trying to lower these risks outside of the healthcare system by offering workshops to help community members understand and manage their stress. She’s started applying the skills they teach, like talking about her fear with others. “I’ve learned to live with the fear in that it can’t define me,” she says.
In the meantime, the Trump administration continues to further burden a population already dealing with poverty, stress, and discrimination. “These families are struggling already,” Suarez says. “The political climate and policy changes going on are putting an already vulnerable population at higher risk of being even more vulnerable.”
*Source preferred not to use her full name since she is undocumented.