Population Health

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Collateral Damage and the Coming Immigration Raids

A report from the San Francisco Gate indicates that immigration officials may soon try to arrest up to 1,500 undocumented people in the Bay Area of California (“Feds planning massive Northern California immigration sweep to strike against sanctuary laws”). If true, it is likely to have an effect on the wider community.

A 2017 study by Nicole Novak and colleagues looked at the effects of a major government raid against migrant workers in Postville, Iowa — most of whom were Latino — who were suspected of being undocumented (Novak et al 2017). In May of 2008, nearly 400 workers were arrested at a meat-processing plant in Postville by 900 ICE agents in a surprise raid that used military tactics, including a Black Hawk helicopter. Two hundred and ninety-seven people were eventually deported after a five month prison sentence. However, even those who were not deported (or even arrested) were affected.

From fairimmigration.org.

Novak et al. looked beyond Postville for their sample, including 52,344 births across Iowa from 2007 to 2009. Infants who were born in the 37 weeks following the raid were classified as being prenatally “exposed” to the raid’s effects. The results showed that for White and Latina mothers, rates of low birth weight (LBW) were steady before the raid. However, after the events at Postville, LBW rates increased by 24%, though only among Latina mothers. This was true for both foreign-born and U.S. born Latinas and their infants, showing a widespread effect that was due to ethnicity, rather than immigration status. The effect appeared to be greatest among those mothers who were exposed to the raid in the first trimester.

From Novak et al. 2017. Rates of LBW in three groups of mothers/infants in Iowa: Whites, U.S. born Latinas, and foreign-born Latinas.

Because data were only available at the state rather than local level, Novak et al. were unable to determine if rates of LBW were even higher among Latina mothers who lived closer to Postville than those in more distant parts of the state. However, the authors reasoned that Latina mothers throughout Iowa (and possibly outside of the state as well) were likely aware of the raid, either through following the news or direct communications with friends and relatives. Given that rates increased among U.S. born and foreign-born Latinas, it is certainly possible that Latina mothers felt vulnerable or anxious about raids targeting them for their ethnicity, and that the stress from this could trickle down to their infants.

If the raids in the U.S. continue, like the one apparently planned in California, there will likely be more collateral damage in terms of the health of Latina mothers and the development of their future infants, including those who are U.S. citizens. Furthermore, there is evidence that poor early development in life can have lasting health deficits. Somewhere in the debates about undocumented immigration, that should be factored into the equation of things to weigh. 

 

Reference

Novak NL, Geronimus AT, Martinez-Cardoso AM. 2017. Change in birth outcomes among infants born to Latina mothers after a major immigration raid. International Journal of Epidemiology. 46(3): 839-49. Link

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Infant Mortality Rates, War & Laos

I finished my dissertation on how the war in Laos was correlated to the physical growth of Hmong refugees in 2004. The general idea was that early stressors, particularly prenatally and in infancy, can have long-term impacts on growth and health. The model I was working with came largely from David Barker’s (and others’) ‘fetal origins hypothesis,’ based on evidence that low birth-weight infants tended to grow up to have higher rates of things like type 2 diabates, coronary heart disease, hypertension, etc. A classmate in graduate school, Stephanie Rutledge, introduced me to Barker’s work and told me that I’d find it really enlightening. I did. Sadly, Barker passed away earlier this year, but his work helped spawn a new direction in research. 

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Inequality, Health Disparities, & Obesity

An October poll of 1,000 likely voters found that Americans are increasingly concerned about income inequality. When asked: “How Big a Problem is Income Inequality in the US?,” the majority (74%) replied that it was either a big problem or somewhat of a problem. Predictably, there were differences in opinion by political ideology, but a majority of liberals (94%), moderates (81%), and conservatives (55%) answered that inequality was at least somewhat problematic. However, as is true of many polls, it was not specified exactly what people found unsettling about it. I suppose there are many reasons that people might find increasing inequality (and climbing rates of poverty) to be troubling, but I wanted to focus here on inequality and health, particularly on obesity.

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First, what do we mean by poverty? I remember watching an interview on PBS with the economist Jeffrey Sachs years ago (transcript here – thank you, Google), where he distinguished between two types of poverty. The first was an extreme form, which he called the type of “poverty that kills.” The other type was more of a poverty of inconvenience or jealousy. I don’t want to over-interpret Sachs’ meaning. It was a passing phrase in an interview from ten years ago, and his primary focus was on alleviating the extreme poverty faced by more than a billion people in the world living on $1 per day (see Sachs 2005). Elsewhere, Sachs has lamented that the media have ignored poverty in the United States at a time when “the U.S. has the greatest income inequality, highest per capita prison population and worst health conditions of all high-income countries.” His credentials in fighting poverty are unassailable. But I cite the old interview here because I think his descriptions (‘poverty that kills’ vs. ‘poverty of jealousy’) might resonate with many people today, and not necessarily in a good way.

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Extreme poverty: scavenging at a garbage dump in Phnom Penh (abcnews)

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Demography and the Possible

Living in New England, we have older cemeteries than most other areas of the country (though Eastern hemisphere readers might scoff at what Americans consider ‘old’). I frequently walk with my sons and nephew through a cemetery near my home, as it is a tranquil place away from traffic, where we can go through the woods and throw rocks in the pond. We do this so often that the headstones sometimes become little more than a forgotten backdrop.

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However, I do make an effort to remind myself that these headstones are markers of actual human lives. One recently caught my attention, the story of Henry and Susan Battey. I have no knowledge who these individuals were — what they looked like, where they lived — other than their names, vital statistics, and the names of their children. It is their children on the backside of the headstone that struck me. The Batteys had three children, losing all of them as infants. That occurs to me as nature (or poverty, or whatever the cause) at its most cruel and indifferent.

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One Planet. One Species. Homo sapiens.

“One planet, one experiment.”
………………..— Edward O. Wilson. 1992. The Diversity of Life.

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Hadzabe men (wikimedia commons)

The BBC has compiled what looks to be an absolutely visually stunning television series, titled ‘Human Planet.’  The footage is said to contain video from 80 different locations, highlighting the relationship of humans to various ecological conditions.1 The description from the website:

Uniquely in the animal kingdom, humans have managed to adapt and thrive in every environment on Earth. Each episode takes you to the extremes of our planet: the arctic, mountains, oceans, jungles, grasslands, deserts, rivers and even the urban jungle. Here you will meet people who survive by building complex, exciting and often mutually beneficial relationships with their animal neighbours and the hostile elements of the natural world.”

Have a look for yourself at the preview:

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Killer Ghosts & Broken Hearts: The Mystery of Sudden Unexplained Death in Sleep in Asian Men

One of the strengths of a biocultural perspective in anthropology is its broad approach to understanding human biology and health (Wiley and Allen 2008). Such a framework seems particularly appropriate when looking at the fascinating phenomenon of SUDS (Sudden Unexplained Death During Sleep). Though SUDS first appeared in the medical literature 1917 in the Philippines, where it is referred to as ‘bangungut’ (Guazon 1917), it was largely forgotten until the late 1970s when it regained notoriety as an important cause of mortality among Southeast Asian refugees in the United States, particularly among young men (Baron et al 1983).

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A Human Biology of War: The Proximate and the Ultimate

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On the surface, it may not be so clear where war, health, and evolution intersect. From the perspective of biological anthropology, many have called for a holistic, transdisciplinary approach to human biology and health which considers the environment as the totality of its evolutionary, ecological, and social components, including social inequality (Little and Haas 1989; Thomas et al. 1989; Wiley 2004).

Girl in Darfur refugee camp (source: Colin Finlay)

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More than a decade ago, Leatherman and Goodman (1998) suggested that biological anthropologists put more effort toward better understanding what they termed the ‘biology of poverty.’ In this sense, poverty is an ‘environment’ that may induce consistent, but obviously varying, biological responses depending upon local circumstances. Similarly, war can be conceived as a biological environment. At least in the short term from an evolutionary point of view, wartime conditions may be as biologically challenging as some of the classic ecologically extreme environments faced by humans (circumpolar, tropical, high-altitude, desert, etc.) (Clarkin 2010).

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Refugees and Health

A recent book, “War and the Health of Nations“,  by Zaryab Iqbal (Political Science, Penn State) takes a look at the associations between national health statistics and the presence and duration of war.

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Chapter 8 explores the topic of forced migration and population health, though with a novel approach. Instead of exploring the ways that forced displacement by war is associated with health in refugees themselves, Iqbal looked at whether an influx of refugees affected overall health statistics in the host country. Utilizing aggregate health data from the World Bank and the number of refugees entering a state in a given year, she tested for associations between the two while accounting for multiple covariates (presence and duration of conflict, GDP, population size, openness to trade, and how democratic/autocratic a country is).

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Shrinking babies

Harvard researchers are reporting in the journal Obstetrics & Gynecology that the average birth weight in the U.S. has actually dropped over the past 15 years. The study looked at more than 36 million full-term births between 1990 and 2005. After controlling for confounding variables, it was found that birth weight had decreased by 52 grams. This trend ran counter to that found previously, which was that birth weights had been steadily increasing over the last century. A secondary analysis suggested that the drop was not due to a change in maternal demographics, as the trend was also found in a subset of white, well-educated non-smoking women as well.

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