Nothing is more vital to the safety and survival of Western nations than the enduring health of their populations. During earlier periods of population migration, countries that encountered high immigration levels, such as the United States during the 1880s and early 1900s, took stern measures to restrict the flow of immigrants, in part out of public health concerns. Poor hygiene among immigrants and inadequate screening measures by public health officials during these high-influx periods triggered legislative reforms that severely restricted immigration levels to the United States. Lately, public health officials have considered another potential risk of importing infectious diseases.
A recent panel discussion featuring speakers from the Harvard University School of Public Health warned of diseases being newly introduced into the United States. Increasing risk, they said, was linked to 25 million Americans who travel annually to third world countries. Who would have considered that American tourists could become such a risk to their local communities, contaminating hearth and home with infectious diseases from abroad!
What, then, of infections brought into the United States through immigration, by the approximately 1.2 million legal and half-million illegal aliens who enter each year? It is American travelers who are the threat, not immigrants, insisted the Harvard panelists. Their stark message was that nothing could be blamed on immigration.
The U.S. Centers for Disease Control (CDC) deal, rather more forthrightly, in facts. An impartial concern for public health drives their frequent reports on the rising incidence of tuberculosis, hepatitis (A, B, C, and E), malaria, and various contagious or infectious diseases long thought to have been defeated ― or never before seen ― in the United States.
Tuberculosis (TB) is a prime example. The bacterium that causes tuberculosis “infects one third of the world’s population.”1 Keeping pace with the increasing impact of post-1965 immigration from the third world, America’s TB rate has been growing since 1984. The prevalence of TB in the countries of origin of most immigrants to the United States is 10 to 30 times greater than in this country.2 Risk is greatest where recent immigrants concentrate. For example, a 1996 investigation of an Alexandria, Virginia, high school found that one-quarter of the students carried tuberculosis bacteria.3
In December 2000, the Journal of the American Medical Association cited the CDC’s conclusion that tuberculosis is continuously being reintroduced by new immigrants.4 The TB rate among foreign-born U.S. residents was 32.9 per 100,000 persons over a six-year observation period ending in 1999, more than five times as great as the native-born rate of 5.8 cases per 100,000. Through late 1999, immigrants accounted for 42 percent of the 18,000 identified cases of TB.5 The CDC estimates that the rate among the foreign-born will continue to escalate, as it has already in California, New York City, and Northern Virginia.6
In Canada, immigrants account for two-thirds of active TB cases. Twenty per 100,000 of foreign-born persons carry the TB bacterium, a rate fifteen times as great as among native-born Canadians (excluding Indians).7
The principal beneficiaries of immigration are the immigrants themselves and employers who benefit from cheap labor. Business profits from paying low wages while shifting certain of their labor force costs to the public at large. Employers enjoy the concentrated benefits of low-wage labor, whereas the cost of public services, including healthcare, education, and the infrastructure used by immigrants and their children, are widely distributed. Public debate on the costs and benefits of immigration, and the national interest in receiving approximately 1.2 million legal and half a million illegal newcomers annually, is long overdue.
1. “A Weak Link in TB Bacterium Is Found,” Science 289 (Aug. 18, 2000): p. 1123.
2. Virginia Abernethy, “Third World Hospital De Luxe,” Population and Environment 17, no. 3 (1996): pp. 191–193.
3. “Carrying Capacity Checkup and Connections,” Network Bulletin 1–2, no. 5 (1996). Carrying Capacity Network, Washington, D.C.
4. August Gribbin, “CDC Report Links TB, Immigration,” Washington Times, Dec. 13, 2000.
5. Samuel Francis, “Uncontrolled Immigration Creates Serious Health Threat to U.S. Citizens,” Tribune, Jan. 2, 2001: sec. A, p. 7.
6. Leef Smith, “TB Still on Rise in No. Va.,” Washington Post, March 18, 2002.
7. Andre Picard, “TB Threat,” Toronto Globe and Mail, May 18, 2002.
8. E. Geng, B. Kreiswirth, et al., “Changes in the Transmission of Tuberculosis in New York City from 1990 to 1999,” New England Journal of Medicine 346, no. 19 (May 9, 2002): pp. 1453–1458.
9. August Gribbin, “CDC Report Links TB, Immigration,” Washington Times, Dec. 13, 2000.
10. J. McConnaughey, “Immigrant Child Takes Tuberculosis to Country Town,” San Francisco Chronicle, Nov. 11, 1999: sec. A, p. 16.
11. Greg Weston, “Every Canadian’s Health Nightmare,” Toronto Sun, Jan. 28, 2001.
12. M.C. Raviglione, D. Snider, and A. Kochi, “Global Epidemiology of Tuberculosis,” Journal of the American Medical Association 273, no. 3 (1995): pp. 220–226.
13. Andre Picard, “TB Threat,” Toronto Globe and Mail, May 18, 2002.
14. Centers for Disease Control, "Hepatitis B Virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination." MMWR: 40 (RR–13) Nov. 1991; Gale Scott, “Hepatitis in Infants ‘Ticking Time Bomb,’ ” Nashville Banner, Sept. 8, 1992.
15. Oakland Tribune, April 3, 1997: sec. A, p. 9.
16. Philip Rosenthal, “Assessing the Hepatitis: A Threat to California,” Liver Lifeline (American Liver Foundation, San Francisco), Spring 2000: p. 6.
17. Charlie Frago, “N.C. Leads Nation in Rubella,” The News and Record (Piedmont Triad, N.C.), Jan. 9, 2001.
18. R.I. Glass, M. Libel, and A.D. Brandling-Bennett, “Epidemic Cholera in the Americas,” Science, June 12, 1992: p.1524; “New York’s Lethal Virus Came from Middle East, DNA Suggests,” Science, Nov. 19, 1999: p.1450;“Plague Fever,” Science, July 31, 1998; Ken Kilpatrick, “Woman from Congo in Hamilton Hospital,” Toronto Globe and Mail, Feb. 6, 2001; T.D. Mastro, S.C. Redd, R.F. Breiman, “Imported Leprosy in the United States, 1978 through 1988,”American Journal of Public Health 82, no. 8 (August 1992); E.H. Kossoff, “Neurocysticercosis,” EMedicine Journal, Dec. 13, 2001.
19.“Disease Fights Back,” The Economist, May 20, 1995: pp.15–16.
20. Eric Stokstad, “Drug-Resistant TB on the Rise,” Science, March 31, 2000: p. 2391.
21. Donald Huddle, The Net Costs of Immigration: The Facts, the Trends, and the Critics, Washington, D.C.: Carrying Capacity Network, October 22, 1996.
22.“Immigrant Welfare,” USA Today, May 7, 1993.
23. Stephen A. Camarota and James R. Edwards, Without Coverage: Immigration’s Impact on the Size and Growth of the Population Lacking Health Insurance, Washington, DC: Center for Immigration Studies.
24. R. Kennedy, “Desperately Ill Foreigners at U.S. Emergency Rooms,” New York Times, July 1, 1999: p. 1.
25. Janny Scott, “Foreign Born in U.S. at Record High,” New York Times, February 7, 2002: p. 18.
26. M.L. Berk, C.L. Schur, and L.R. Chavez, “Health Care Use among Undocumented Latino Immigrants,” Health Affairs, July–August, 2000.