“Do no harm.” Upon entering medical school, my classmates and I uttered these words with pride and joy, unaware of the deeper meaning behind them. While it may sound cliché, many of us choose to become doctors because we have a strong desire to help others in some capacity. The esteemed title M.D. fortunately allows us to wear many different hats in serving our communities. Medical doctors have expanded their scope beyond traditional clinical duties to explore fields such as research, economics, and politics. While I always pictured myself treating patients in a clinic, one thing has become clear as day to me as a student doctor: One of the most important roles we can take on is that of an advocate.
The impact of immigration policy on health
The current U.S. presidential administration has left little to the imagination regarding their thoughts on immigration. A top priority of their candidacy was to detain and deport undocumented civilians while using them as a scapegoat for many of the issues we see in this country today. By doing so, they have created an environment of fear and hostility, specifically towards the Latinx community. While the Latinx community has been persecuted for decades, President Trump has reversed an alarming number of policies that aim to leave them defenseless and vulnerable in public settings. Notably, Immigration and Customs Enforcement (ICE) agents are now permitted to enter and make arrests without a warrant at “sensitive” areas, including schools, churches, and health care facilities. As an aspiring pediatrician, I wanted to better understand the implications of these changes on my future patients.
It is crucial to understand how immigration policies influence family dynamics in the Latinx community. Many Latinx children are U.S. naturalized citizens yet have at least one undocumented parent. Researchers suggest that this complex family dynamic can profoundly disrupt a child’s development in numerous ways. As immigration enforcement intensifies, children tend to limit their exposure to areas of social gatherings, such as extracurricular activities, in fear of losing a parent to deportation.
With the expansion of ICE jurisdiction, Latinx youth may miss critical developmental opportunities, such as school and health care appointments, due to increased fear of family separation. Instability in social experiences and education can result in a false sense of security and well-being. Yearly maintenance care and physicals are a crucial part of child development to ensure proper growth and prevention of treatable diseases. Delays in seeking medical care may result in disease progression to the point of debilitation. Additionally, low educational attainment secondary to chronic school absences is a well-known social determinant of health, which can further exacerbate health care disparities in the Latinx community.
Stress and adverse childhood experiences
Another way in which the increase in targeted immigration control may affect Latinx youth is through the ample stress associated with having family members of mixed status. Children exposed to parental deportation had significantly worse health status and behavioral problems than children in stable familial environments. In line with these findings, a previous study introduced a new category of adverse childhood experiences (ACEs) which recognizes the unique challenges faced by migrant children. ACEs are events that occur from the ages of 0 to 18 that produce a potentially toxic stress response. These experiences have been linked to poorer physical and mental health outcomes in adulthood, underscoring the potential long-term impact of immigration-related stress on Latinx youth.
The role of medical students
Although it will be years before I’m a practicing pediatrician, the work that my peers and I have done in medical school reminds me that we have the power to create a safer and more supportive future for families and children in the Latinx community. Firstly, medical students can play an active role in their communities by volunteering for organizations directed towards the needs of underserved populations to promote education, economic stability, and welfare within these communities.
Moreover, students can leverage their connections within medical school, collaborating with practicing physicians and utilizing school-based resources to promote the health of medically underserved communities. At the Medical College of Georgia in Augusta, Georgia, numerous student-run clinics aim to serve patients of low socioeconomic status, with one notably being Clinica Latina. Although medical students have a limited scope of practice, we can orchestrate behind-the-scenes aspects of patient care to ensure that these clinics are adequately staffed and available to those in need.
Lastly, medical students can create initiatives or programs that provide youth with a network of mentorship and valuable life skills to mitigate the impact of ACEs. At our medical school, a club known as Resilient Teens focuses on promoting resilience skills among at-risk youth in 14 rural counties in Georgia. By meeting with students for weeks at a time, we provide them with companionship and guidance while also opening the door to the possibility of pursuing a career in medicine and beyond.
I wrote this piece to highlight the struggles of a marginalized community and to offer fellow medical students and people who want to pursue medicine practical steps to help counteract the harm caused by rising xenophobia, especially toward the Latinx community. As a young medical trainee, it is disheartening to watch the current government implement policies that undermine what should be a safe and supportive health care system. A physician’s duty to “do no harm” extends far beyond a medical setting. It is a commitment to use every tool at our disposal to help build a brighter, healthier future for the next generation.
Adam Zbib is a medical student.
