Public health and one big border

At a meeting themed “Public Health Without Borders,” we need to look no further than a few miles south of the San Diego Convention Center to find a geographical border that illustrates a public health and human rights crisis.

At Monday afternoon’s session “Dying to Work: The Risks from Injury and Death on the Migrant’s Journey to Work in the United States,” Amy Liebman, of the Migrant Clinicians Network, said that despite a nearly ninefold increase in funding for the U.S. Customs and Border Patrol since 1993, the agency’s strategy of preventing illegal immigration through deterrence has failed.

This shift in the border patrol’s strategy in 1993 helped create an even more vulnerable population of immigrants coming to the United States by making it more treacherous to cross the border, but at the same time, not decreasing the prevalence of illegal immigration. The end effect was more migrants diverted into harsh, rugged areas such as the southern Arizona desert and an increase in the number of deaths and injuries.

Once migrants enter the United States and begin working, often in the construction, agriculture and meatpacking industries, their lives don’t get any easier. Liebman called them a “hyper-exploited” work force, vulnerable to safety violations in the workplace and at heightened risk of injury and mortality.

Liebman said we should immediately enforce workplace safety and minimum wage standards, create legal pathways for undocumented workers to stay, and create incentives for immigrants to return to their homelands.

Selena Ortiz and Christina Trimmer, of the University of Arizona’s Mel and Enid Zuckerman College of Public Health, stressed the need to frame immigration as a public health concern driven by economic, political and social factors. Policies addressing migrants from a public health and human rights perspective would be a departure from current immigration policy, but it’s a controversial issue that neither presidential candidate has touched, Ortiz noted.

Ortiz and Trimmer are very aware of the resistance, even among the public health community, to tackle this issue. In fact, they said faculty at their institution rejected their proposed position statement identifying migration as a preventable public health concern.

Such highly politicized debates are nothing new in public health, right? So what do you think?

— P.T.