Friday, February 21, 2014

Price on the Origins of the Immigration-Public Health Divide

Polly J. Price, Emory University School of Law, has posted Can U.S. Immigration Law Be Reconciled with the Protection of Public Health?  Here is the abstract:    
Current immigration law actively undermines public health in the United States in a number of ways. Historically, federal authority to exclude immigrants on health grounds alleviated costs otherwise borne by state and local governments. Today, however, immigrant health exclusions are only minimally effective to prevent the spread of communicable disease originating outside U.S. borders. The federal and state governments confront a stark division of authority with respect to non-citizens: The federal government decides which non-citizens to admit into the country and the terms under which they may stay, while states are charged with the cost of care for foreign nationals who present a public health threat. Because the U.S. Public Health Service today has no authority or funding to accept responsibility for the health of immigrants, the cost of public health control measures falls on state and local governments, with uneven effectiveness and greatly disproportionate impact in some communities. For historical reasons, we are prone to view immigration and public health as separate interests, but they are in fact convergent. All levels of government should rethink immigration law in light of public health realities, without further delay. This article concludes with a discussion of a specific public health threat – drug-resistant tuberculosis – to provide a compelling context for the problems I identify.