IMMIGRATION REFORMS ARE HUGE FOR REGION

Without a doubt, the Biden-Harris administration has taken on immigration reforms that give hope and excitement to many immigrants, including refugees, asylum seekers and undocumented migrants. This has particular significance to all of us here in San Diego. These unprecedented steps not only include using more inclusive language, such as replacing the term “alien” with “noncitizen,” but also thinking through a much-needed shift in how we view and humanize forced migration. More importantly, this also offers tangible solutions that directly impact people’s lives and the future of this country.

Last month, President Joe Biden outlined steps to address the root causes of “irregular” migration by confronting instability and violence in countries producing many refugees. He proposes a more collaborative and diplomacy-driven approach to working with regional partners. These include foreign governments and nonprofit organizations that provide protection and aid to asylum seekers and refugees. The administration has substantially increased refugee admissions and funding to agencies working with refugees. It has also reversed the refugee ban on Muslim-majority countries — the ban initially applied to the seven countries of Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen, then adjusted to 11 countries in total — and started reviewing and reversing the Migrant Protection Protocols program, which the previous administration introduced to transfer asylum seekers who enter the U.S. through Mexico back to Mexico.

These policies will impact the diverse San Diego community in many ways. It is important to remind ourselves of two geopolitical aspects that make San Diego unique: 1) It is home to one of the busiest land border-crossing areas in the world, and 2) it is a major refugeeresettlement hub. Refugees and noncitizens have contributed to the prosperity, diversity and economic growth of San Diego in many ways. A recent report by colleagues at UC San Diego found that the fastestgrowing foreign-born populations in San Diego come from five Middle Eastern and African nations: Syria, with an increase of 866 percent; Kenya, 304 percent; Sudan, 303 percent; Iraq, 279 percent; and Nigeria, 224 percent. Many in these communities were directly impacted by the refugee ban and now have hope to be able to reunite with their families, who can resume applying for asylum in the U.S.

As an epidemiologist working with families resettled from these nations, I believe that this administration’s policies offer signs of healing despite the disproportionate and often overlooked burden of COVID-19 infections in these communities. Our experience working with refugee research participants resettled from Somalia, Syria and Iraq — some are new migrants and some had been resettled as children — speaks to this as they described the refugee ban during interviews as inhumane, targeting certain nations that were already shattered by war, making people live in continuous stress and taking a toll on mental health.

Our research focuses on chronic disease management and interactions with the health care system. We have learned that some of the most significant factors influencing these communities’ health care related to immigration policies. Perceived discrimination, job and life loss due to COVID-19, cuts in funding to refugee-serving organizations, and inability to reunite family members all directly impact health behaviors and trust in public health systems. These limitations have hindered vaccine uptake (the proportion of the eligible population who received a vaccine) and health care engagement. Research institutions that have traditionally offered insight into these communities’ needs to inform health care policy have struggled to offer muchneeded data on the pandemic’s rapidly evolving impact among refugees.

Although our borders are partially shut now due to COVID-19, the numbers of refugees are swelling worldwide due to raising inequalities, conflict and climate change that the pandemic is, in fact, accelerating. As we celebrate Biden’s immigration reforms, we must not lose sight of how we as local organizations and citizens must complement this move by the administration as we prepare to deal with more forced migration in the near future.

One example of this is a recent multi-institutional collaboration between faculty at UC San Diego’s newly founded School of Public Health, the Family Health Centers of San Diego (a Federally Qualified Health Center and the main health care provider for refugees in the county), and the Majdal Center (a refugee-serving ethnic-based organization in El Cajon). These three entities have come together, catalyzed by a small grant from the National Institutes of Health and a group of health equity champions and volunteers, to build momentum in producing high-quality public health research that can tell the stories of these communities and how trust can be built to ensure a successful public health system that serves all San Diegans.