Dos manzanas por dia: Getting the Facts on Immigrant Health

click here to view the related article.

The article posted above is quasi advertisement, mostly propaganda.  The host of this site is claiming that illegal immigrants bring in a plethora of diseases into the United States.  I contacted some doctors at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, for a medical point of view.


The author of the report, Dr. Douglass, sounds like he has a political agenda, namely to decrease and/or stop the flow of illegal aliens into the US.  Putting the merits of that political/philosophical argument aside, there are some legitimate health issues that arise with both legal and illegal immigrants who enter the US. 

The Department of Family & Community Medicine at Jefferson has one of the best (and only) University Hospital based, residency-based, refugee health clinics in the entire country (another very good one at the University of Minnesota).  Dr. Marc Altshuler runs this program, attempting to help refugees, often times a group that are often poor, ill, in need and disadvantaged (although not always).


According to Dr. Altshuler,  there is no question that HIV, TB, and a variety of other infectious diseases, as well as a certain degree of substance abuse, occurs in disenfranchised populations, but this does not always mean these populations are to blame for a societal drain on our health care system. 


“There have been many proven studies showing that immigrants are not a drain on our healthcare system, and in the long run, their health care expenditures are lower than ours,” said Dr. Altshuler.


In a sense, however, the observations of Dr. Douglass sort of miss the entire point:  What kind of society do we wish to have?  Open?  Closed?  What does the answer to that question tell us about ourselves?  Can we not structure a health system that is compassionate, efficient and targets these health issues?  I think the Obama administration may be better equipped to deal with some of the fallout from these questions but we will see.


-Jules P.


Some interesting articles to read on Immigration and Health provided by Dr. Altshuler:


Mohanty SA, Woolhandler S, Himmelstein DU, et al.  “Health care expenditures of immigrants in the United States: a nationally representative analysis.” Am J Public Health. 2005 Aug;95(8):1431-8.


Singh GK, Siahpush M. All-cause and cause-specific mortality of immigrants and native born in the United States. Am J Public Health 2001; 91(3):392-399.


Adams et el. Healthcare challenges from the developing world: post-immigration refugee medicine BMJ 2004;328:1548-1552 (26 June), doi:10.1136/bmj.328.7455.1548


Dey AN, Lucas J. Physical and mental health characteristics of USS- and foreign-born adults: United States, 1998-2003.  Advance Data from Vital Health Statistics, 369.


Kandula NR, Kersey M, Lurie N. Assuring the health of immigrants: what the leading health indicators tell us.  Annual Review of Public Health 25: 357-376, 2004.


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