This year is a clarifying moment for many people. We see how structural racism and state violence terrorize Black communities. We see how the COVID-19 pandemic is tearing through our communities, hitting people of color and those with the fewest resources hardest. And even with a Supreme Court decision that extends protections for DACA recipients, we know that anti-immigrant policies continue to prevent families from accessing essential health care for fear of arrest, detention and deportation.
As researchers, women of color and immigrants, we know that these crises are not separate threads, but part of the same tapestry of racism and xenophobia that have long shaped the health of people of color and immigrants.
The Trump administration has always been clear in its disdain for immigrants but has dug even deeper into its xenophobic agenda by unjustly blaming migrants for the COVID-19 pandemic, exploiting this public health crisis and effectively prompting a shutdown of the U.S. immigration system. It is no accident that immigrant communities—particularly immigrants of color—are among the hardest hit by this virus in the United States, and are also being denied many of the COVID-19 relief efforts that Congress is extending to other communities.
Among countless harms, new research shows that the bigoted pandemic response also impacts immigrants’ access to sexual and reproductive health care—a basic human right that should not be denied or delayed under any circumstance, including a pandemic.
Under normal non-pandemic circumstances, many noncitizens and their families already face barriers to obtaining essential sexual and reproductive healthcare, such as birth control, pregnancy-related care, and STI and reproductive cancer screening. This is largely due to bigoted rules that bar many immigrants from accessing public health insurance programs, such as Medicaid, based on legal status or how long they have lived in the United States.
Noncitizen immigrants also represent more than half of workers in industries most immediately devastated by COVID-19 mass lay-offs, including hotel, food and maintenance services. However, because of their documentation status, these workers have limited or no access to COVID-19 federal relief support, including unemployment benefits and existing public insurance programs. Without an income and health coverage, obtaining needed sexual and reproductive health services is difficult, if not impossible, for so many people.
The effects of hateful migration policies like the “Public Charge” and “Remain in Mexico” rules have only escalated during the pandemic and systematically curb or deny many immigrants’ access to any health care, much less reproductive services. At the same time, immigration enforcement raids at U.S. health facilities have continued. Noncitizen immigrants and their families who fear seeking health services may continue to forgo any care, for both COVID-19 treatment and their sexual and reproductive health needs.
On top of that, immigration enforcement through detention centers continues to jeopardize immigrants’ reproductive health and rights. In 2017 and 2018, some 28 women had miscarriages in U.S. Immigration and Customs Enforcement custody after being shackled across their arms, legs and stomach, and reports indicate that detained pregnant people are being shackled during labor and immediately after giving birth. These inhumane practices violate immigrants’ human rights and endanger their reproductive health.
As the health care system prioritizes COVID-19, the energy and resources of publicly funded family planning providers—who are often the main source of primary care for low-income and uninsured immigrant women—may be diverted to provide pandemic-related care. Some states have also exploited the pandemic to restrict access to abortion services, creating delays in receiving abortion care.
Crucial health care services, such as sexual and reproductive health care, must remain accessible to all populations, including immigrants, especially in a pandemic.
Congress must also repeal anti-immigrant policies that threaten the health and rights of immigrant communities, and enact legislation such as the Health Equity and Access under the Law (HEAL) for Immigrant Women and Families Act, which would expand immigrants’ ability to get health insurance and access sexual and reproductive health services now and after the pandemic. Further, all asylum seekers should be immediately released from detention and provided means to access sexual and reproductive health care as needed.
Xenophobia and racism have been described as an insidious byproduct of this pandemic, associated with politically motivated attempts to blame and stigmatize immigrant groups for the crisis. The simultaneous exclusion of immigrants from COVID-19 relief efforts, as well as sexual and reproductive health care in the U.S., violates a key public health commitment to leaving no one—especially those most excluded from health care systems—behind.
It is time we recognize that immigrants are not only our neighbors but an essential and integral part of our increasingly diverse communities and country. A unified approach to sexual and reproductive health for all—regardless of citizenship, national origin, race or wealth—is the only inclusive response to the COVID-19 pandemic that will safeguard the health and well-being of all.
Sheila Desai, DrPH is a senior research scientist with the Guttmacher Institute and Goleen Samari, Ph.D., MPH, MA is an assistant professor of population and family health at Columbia University, Mailman School of Public Health.