March 23, 2017

CONTACT: Karen Teber /

EMBARGOED FOR RELEASE: Thursday, March 23, 2017; 11:00am ET

WASHINGTON—The transformation of US immigration policy could have a harmful effect on the general public, patients and the health care system, say two public health law experts.

Writing in the JAMA Viewpoint, “President Trump’s Immigration Policies: Endangering Health & Wellbeing?” published online March 23, Lawrence O. Gostin and Katharina Eva O Cathaoir, from the O’Neill Institute for National and Global Health Law, say that while the full impact of the executive orders related to immigrants, undocumented residents, and refugees is unknown, their impact can be predicted.

Gostin and O Cathaoir say undocumented persons will be afraid to access health care and benefits for themselves and their children.

“From food assistance programs designed to help poor children, to maternal and child wellness appointments, those who are undocumented will avoid appointments for services out of fear of deportation,” explains Gostin, Faculty Director of the O’Neill Institute.

As Gostin and O Cathaoir write, deterring patients from obtaining health services could be detrimental to the public’s health.

“Parents may fail to vaccinate their children, jeopardizing herd immunity and causing outbreaks. Communicable and sexually transmitted diseases may not be diagnosed or treated, leading to spread of disease and drug resistant infections.”

In addition, the current climate of fear could affect the undocumented immigrants as well as those who are here lawfully. The authors write, “The American Academy of Pediatrics concluded that children suffer irreversible mental health effects caused by fear and family separation.”

The recent travel ban also impacts those who live in rural areas, by potentially reducing the number of health care providers available to them.

“Due to critical health worker shortages, special visas are offered to foreign physicians who practice for 3 years in rural, underserviced communities. More than 13,000 physicians from the 6 Muslim-majority countries with suspended entry practice in the US, including 9,000 from Iran and 3,500 from Syria.”

The authors calculate, “If this group of physicians was not replaced, given the size of the average primary care patient panel (2,500 patients), the ban could affect more than 1 million patients nationally.”

Gostin and O Cathaoir conclude, “The healthcare system, in particular, is a place of healing and inclusion, where the fates of immigrants and lawful residents are intertwined. By characterizing immigrants as outsiders, the president’s policies undermine American values and could potentially harm patients.”

To interview Gostin, please contact him at

The O’Neill Institute for National and Global Health Law at Georgetown University is the premier center for health law, scholarship, and policy. Its mission is to contribute to a more powerful and deeper understanding of the multiple ways in which law can be used to improve the public’s health, using objective evidence as a measure. The O’Neill Institute seeks to advance scholarship, science, research, and teaching that will encourage key decision-makers in the public, private, and civil society to employ the law as a positive tool for enabling more people in the United States and throughout the world to lead healthier lives.