Since 1965 the foreign-born population of the United States has swelled from 9.6 million or 5 percent of the population to 45 million or 14 percent in 2015. Today, about one-quarter of the U.S. population consists of immigrants or the children of immigrants. Given the sizable representation of immigrants in the U.S. population, their health is a major influence on the health of the population as a whole. On average, immigrants are healthier than native-born Americans. Yet, immigrants also are subject to the systematic marginalization and discrimination that often lead to the creation of health disparities. To explore the link between immigration and health disparities, the Roundtable on the Promotion of Health Equity held a workshop in Oakland, California, on November 28, 2017. This summary of that workshop highlights the presentations and discussions of the workshop.

Here is the first comprehensive cross-disciplinary work to examine the current health situation of our immigrants, successfully integrating the vast literature of diverse fields -- epidemiology, health services research, anthropology, law, medicine, social work, health promotion, and bioethics -- to explore the richness and diversity of the immigrant population from a culturally-sensitive perspective. This unequalled resource examines methodological issues, issues in clinical care and research, health and disease in specific immigrant populations, patterns of specific diseases in immigrant groups in the US, and conclusive insight towards the future. Complete with 73 illustrations, this singular book is the blueprint for where we must go in the future.

US-Mexico border region area has unique social, demographic and policy forces at work that shape the health of its residents as well as serves as a microcosm of migration health challenges facing an increasingly mobile and globalized world. This region reflects the largest migratory flow between any two nations in the world. Data from the Pew Research Center shows over the last 25 years there has never been lower than 140,000 annual immigrants from Mexico to the United States (with peaks over 700,000). This migratory route is extremely hazardous due to natural (e.g., arid and hot desert regions) and human made barriers as well as border enforcement practices tied to socio-political and geopolitical pressures. Also, reflecting the national interdependency of public health and human services needs, during the most recent five year period surveyed the migratory flow between the US and Mexico has equaled that of the flow of Mexico to the US--both around 1.4 million persons. Of particular public health concern, within the US-Mexico region of both nations there is among the highest disparities in income, education, infrastructure and access to health care--factors within the World Health Organization’s conceptualization of the Social Determinants of Health, and among the highest rates of chronic disease. For instance obesity and diabetes rates in this region are among the highest of those monitored in the world, with adult population estimates of the former over 40% and estimates in some population sub-groups for the latter over 20%. The publications reflected in this Research Topic, all reviewed from experts in the field, addressed many of the public health issues in the US Mexico Border Health Commission’s Healthy Border 2020 objectives. Those objectives-- broad public health goals used to guide a diverse range of government, research and community-based stakeholders--include Non Communicable Diseases (including adult and childhood obesity-related ones; cancer), Infectious Diseases (e.g., tuberculosis; HIV; emerging diseases--particularly mosquito borne illnesses), Maternal and Child Health, Mental Health Disorders, and Motor Vehicle Accidents. Other relevant public health issues affecting this region, for example environmental health, binational health services coordination (e.g., immunization), the impact of migration throughout the Americas and globally in this region, health issues related to the physical climate, access to quality health care, discrimination/mistreatment and well-being, acculturative/immigration stress, violence, substance use/abuse, oral health, respiratory disease, and well-being from a social determinants of health framework, are critical areas addressed in these publications or for future research. Each of these Research Topic publications presented applied solutions (e.g., new programs, technology or infrastructure) and/or public health policy recommendations relevant to each public health challenge addressed.

The U.S.-Mexico Border Region is among the poorest geographical areas in the United States. The region has been long characterized by dual development, poor infrastructure, weak schools, health disparities and low-wage employment. More recently, the region has been affected by the violence associated with a drug and crime war in Mexico. The premise of this book is that the U.S.-Mexico Border Region is subject to systematic oppression and that the so-called social pathologies that we see in the region are by-products of social and economic injustice in the form of labor exploitation, environmental racism, immigration militarism, institutional sexism and discrimination, health inequities, a political economy based on low-wage labor, and the globalization of labor and capital. The chapters address a variety of examples of injustice in the areas of environment, health disparity, migration unemployment, citizenship, women and gender violence, mental health, and drug violence. The book proposes a pathway to development.

In Fevered Measures, John Mckiernan-González examines public health campaigns along the Texas-Mexico border between 1848 and 1942 and reveals the changing medical and political frameworks U.S. health authorities used when facing the threat of epidemic disease. The medical borders created by these officials changed with each contagion and sometimes varied from the existing national borders. Federal officers sought to distinguish Mexican citizens from U.S. citizens, a process troubled by the deeply interconnected nature of border communities. Mckiernan-González uncovers forgotten or ignored cases in which Mexicans, Mexican Americans, African Americans, and other groups were subject to—and sometimes agents of—quarantines, inspections, detentions, and forced-treatment regimens. These cases illustrate the ways that medical encounters shaped border identities before and after the Mexican Revolution. Mckiernan-González also maintains that the threat of disease provided a venue to destabilize identity at the border, enacted processes of racialization, and re-legitimized the power of U.S. policymakers. He demonstrates how this complex history continues to shape and frame contemporary perceptions of the Latino body today.

Stemming from four years of ethnographic research, media analysis of over 750 national news articles published in the 2010s, and decades of the author’s professional and personal immersion in the Rio Grande Valley of south Texas, Rhetoric and Reality illuminates a place at the heart of our national conversation: the U.S.-Mexico border. K. Jill Fleuriet contrasts the rhetoric of national political and media discourse with that of local border leaders in economics, health care, politics, education, law enforcement, philanthropy, and activism. As she deconstructs the common narrative of a border in need of external intervention to control corruption, poverty, sickness, and violence, Fleuriet engagingly illustrates the range of regional organizing, local development strategies, and community responses in the borderlands that ultimately situate the Rio Grande Valley as the “true North” of the U.S. national compass—where the Valley goes, the rest of the country soon will follow. Rhetoric and Reality asks us to question our own assumptions, especially about those areas that drive national decisions about resource allocation, economic development and national security. “Rhetoric and Reality is an important ethnographic study of the deeply misunderstood, increasingly vilified, Rio Grande Valley located on the Texas-Mexico border. Fleuriet presents a balanced counter-narrative that that shows the region as one of growth, innovation, complexity, and rich with meaning. Rhetoric and Reality is an excellent example of place-based, reflexive scholarship appropriate for use in courses on border theory, applied anthropology, and research methods. Written clearly and crisply with a wide readership in mind, Rhetoric and Reality is mandatory reading for those wanting to better understand the US-Mexico border region and the people who live there.” --Margaret A. Graham, Professor and Chair, The University of Texas Rio Grande Valley, USA “This is an important book, as it describes life in the Rio Grande Valley rather than ‘on the border.’ The notion of ‘the border’ as an open range in need of external help is challenged, as the author illustrates the wide range of leadership and programmatic change occurring in the Rio Grande Valley.” --Roberto R. Alvarez, Professor Emeritus of Ethnic Studies, University of California, San Diego, USA

We build border walls to keep danger out. But do we understand the danger posed by walls themselves? East Germans were the first to give the crisis a name: Mauerkrankheit, or “wall disease.” The afflicted—everyday citizens living on both sides of the Berlin wall—displayed some combination of depression, anxiety, excitability, suicidal ideation, and paranoia. The Berlin Wall is no more, but today there are at least seventy policed borders like it. What are they doing to our minds? Jessica Wapner investigates, following a trail of psychological harm around the world. In Brownsville, Texas, the hotly contested US-Mexico border wall instills more feelings of fear than of safety. And in eastern Europe, a Georgian grandfather pines for his homeland—cut off from his daughters, his baker, and his bank by the arbitrary path of a razor-wire fence built in 2013. Even in borderlands riven by conflict, the same walls that once offered relief become enduring reminders of trauma and helplessness. Our brains, Wapner writes, devote “border cells” to where we can and cannot go safely—so, a wall that goes up in our town also goes up in our minds. Weaving together interviews with those living up against walls and expert testimonies from geographers, scientists, psychologists, and other specialists, she explores the growing epidemic of wall disease—and illuminates how neither those “outside” nor “inside” are immune.