BY MUHAMMAD SIDDIQ – As a country with nearly 30% of its population comprised of immigrants and their children, the United States is no stranger to controversy regarding immigration policy. Factors such as the income disparities between developing and developed countries have had people moving around for centuries. The policymakers of the nations receiving these people must weigh competing economic, security, and humanitarian interests resulting in constant political debate.  With the recent election season and the inauguration of President Donald Trump, it seems that the issue of immigration is at the forefront of political discussion in this country.

Immigration has always played an important role in American history. Prior to the Civil War and “era of rapid communications and transportation,” the United States encouraged open immigration to settle its land. Following the Civil War, several states began passing immigration laws, bringing national attention to the issue. In 1891, the Immigration Service was established to inspect and process immigrants seeking admission to the United States. The thirty years following the creation of the Immigration Service saw the creation of numerous immigration services such as Ellis Island in 1982. In 1924, following a period known as the “Great Wave,” when nearly 24 million immigrants arrived in the United States, Congress created the U.S. Border Patrol. A combination of immigration policy, World War II and the Great Depression resulted in very little immigration over the next couple decades. In the 1950s and 60s, the United States began trying to attract skilled immigrants to the United States. A formal agreement between the United States and Mexico in 1951 allowed the United States to permanently employ seasonal agricultural labor from Mexico as they had during World War II. It was during these decades that the sources of immigration shifted from mainly European countries to Asia and Latin America. In 1980, the United States passed the Refugee Act, finally creating a general policy governing the admission of refugees . As the ease of modern travel increased, the 1980s and 90s saw new challenges such as the increase of illegal immigration. Laws were created for the deportation of those found working illegally as well as allowing aliens to legalize their residence. Congress passed the Illegal Immigrant Reform in 1996 and Immigrant Responsibility Act which resulted in the hiring of more border patrol and Immigration and Naturalization Service agents (Center for Immigration Studies).  Immigration policy took another turn following the events of 9/11. Since then, American immigration law has been focused on border security and the removal of criminal aliens to protect the nation from terror.

Immigration policy today focuses on many of the same issues it has in the past: national security, economic concerns and humanitarian relief. With many Americans up in arms over illegal immigration and security concerns, President Donald Trump made immigration one of the cornerstones of his presidential campaign. Popular belief in today’s society is that immigrants are taking jobs from American citizens and that immigrants pose a security threat. President Trump’s controversial immigration plan presented several ideas to curb illegal immigration and protect national security. Trump’s plan included several controversial pieces including building a wall on the United States-Mexico border, cutting legal immigration significantly, hiring additional border patrol and Immigrations and Customs employees, and enforcing a travel ban that would block citizens of six predominantly Muslim countries from entering the United States. To no surprise, Trump’s immigration policy was met with heavy backlash and deemed by many as unconstitutional. Trump’s travel ban especially, has been deemed by many as discriminatory rather than an actual solution to potential security threats. Many view the idea to build a wall on the United States-Mexico border as a waste of energy and resources, even if Trump were to somehow make Mexico pay for it. Curbing legal immigration would have significant impact on certain industries and the economy as a whole. While President Trump has not been able to implement many of his ideas regarding immigration yet, he has certainly sparked significant debate over these issues.

Immigration policy has a huge impact on the growing science, technology, engineering, math and medical fields in the United States. STEM industries are responsible for many of the cutting-edge technologies that have greatly raised living standards in this country. These companies play a critical role in the nation’s economy and their role is only growing, with the Bureau of Labor Statistics projecting a 13 percent growth in STEM occupations by 2022.  STEM fields rely heavily on foreign born workers. In fact, twenty-five percent of high-tech companies founded between 1995 and 2005 have an immigrant founder. These high-tech companies are responsible for many of the U.S. patents in technologies such as medical devices and pharmaceuticals. Today, workers in STEM and healthcare fields make up nearly thirteen percent of the total U.S. workforce and this number is only increasing. Nearly twenty percent of these workers are foreign born. In healthcare fields specifically, about sixteen percent of workers are foreign born. Nearly thirty percent of the United States’ physicians and surgeons are foreign born. Without the aid of foreign born workers, it’s evident that the increasing demand for people in these rapidly evolving fields might not be met long term.  America’s health system specifically faces a delicate issue as it suffers a shortage of primary care physicians. An estimated 15,000 U.S. physicians are from the seven countries included in President Trump’s travel ban. With the average doctor seeing between 800 to 1,500 patients a year, a travel ban affecting 15,000 physicians could affect the health care of millions of Americans. By choosing to curb legal immigration and implementing a travel ban, President Trump would greatly limit the potential of these industries.

Immigrant patients also face a sleigh of issues. As of 2015, approximately 55% of immigrants in the United States had private health insurance compared to 69% of the U.S. born patients. Of the remaining immigrants, 29% had public insurance compared to 39% of native born patients and 22% were uninsured compared to 7% of the native-born patients. In recent years there has been an effort to increase health insurance coverage for immigrants. From 2013 to 2015, the immigrant uninsured rate fell from 32 percent to 22 percent. Despite the improvement in recent years, there is still a long way to go. Another issue preventing some immigrants from getting the healthcare that they need is fear. Many people in this country, both illegal and legal, are frightened by recent immigration policy and President Trump’s deportation intentions. Families are scared to see doctors and even pick up their prescriptions. Clinics that serve large immigrant populations have recently reported a downturn in appointments since President Trump took office. In a recent poll of providers by the Migrant Clinicians Network, two-thirds of respondents mentioned that they saw a reluctance among immigrant patients to seek health care. Many immigrant communities across the United States tend to suffer from health issues such as high rates of obesity, diabetes, liver disease, and high blood pressure. With such pertinent health issues prevalent in these communities, it’s important that immigrants have access to health providers without fear.

The large impact of immigration policy on science and medicine cannot be underestimated. Immigrants play a huge role in these growing fields that have a large effect on the United States economy and our quality of living. Viewing the political climate today and seeing how divided the American people are on issues such as immigration can often be frightening, but it’s important that we come together and remain optimistic. Our system of government gives a voice to many and as a result, many of the immigration policies that would negatively affect the medical field have not been passed. It is important that we remain informed and active during these times because as pre-med students we are the future and this will affect us.