When politicians link immigrants to disease, the science just doesn’t add up

PixabayThe following is an excerpt from Not a Scientist: How Politicians Mistake, Misrepresent, and Utterly Mangle Science by Dave Levitan.The demonizer is perhaps the most persistent misuse of science that politicians have engaged in across U.S. history....

When politicians link immigrants to disease, the science just doesn’t add up

PixabayThe following is an excerpt from Not a Scientist: How Politicians Mistake, Misrepresent, and Utterly Mangle Science by Dave Levitan.The demonizer is perhaps the most persistent misuse of science that politicians have engaged in across U.S. history....

22 April 2017 Saturday 11:43
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When politicians link immigrants to disease, the science just doesn’t add up

Pixabay

The following is an excerpt from Not a Scientist: How Politicians Mistake, Misrepresent, and Utterly Mangle Science by Dave Levitan.

The demonizer is perhaps the most persistent misuse of science that politicians have engaged in across U.S. history. The fear of immigrants has been a common theme since the early days of Ellis Island—and even before—and there are examples of misstatements about disease and immigration from various points since.

Moving backward through history, we can see that politicians have repeated, time and again, the idea that immigrants are bringing over every disease that happens to be in the news. Here’s former presidential adviser, 1992 and 1996 presidential candidate, and noted racist Pat Buchanan going for the demonizer grab bag:

High among these is the appearance among us of diseases that never before afflicted us and the sudden reappearance of contagious diseases that researchers and doctors eradicated long ago. Malaria, polio, hepatitis, tuberculosis, and such rarities of the Third World as dengue fever, Chagas disease, and leprosy are surfacing here.

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Not a Scientist: How Politicians Mistake, Misrepresent, and Utterly Mangle Science by Dave Levitan

Leprosy! This is an incredible list of misinformation, so let’s debunk it disease by disease. First of all, malaria: between one and two thousand cases of malaria are reported in the United States every year, almost all in residents who have traveled abroad to endemic areas. It is very unlikely to then pass from person to person; a mosquito in the United States would have to bite the infected person and then bite other people, transmitting the parasite that causes malaria. Such outbreaks do occur—it happened sixty-three times between 1957 and 2014, according to the CDC—but this has nothing to do with immigration, but rather with travelers failing to take basic precautions.

Next up, polio. No cases of polio have originated inside the United States since 1979, and the last time a traveler brought it in was 1993. That’ll do.

It almost isn’t worth addressing “hepatitis,” as that refers to five different diseases with differing modes of transmission. Some evidence does suggest that prevalence of hepatitis B, which is transmitted via bodily fluids, is higher among foreign-born individuals living in the United States,19 so we’ll let him have that one. Tuberculosis also may be brought across borders by those arriving both legally and illegally, though this isn’t considered a large concern.

Next, what about those “rarities of the Third World”? Most dengue fever cases are acquired outside the United States by travelers, though interestingly, experts are concerned that climate change could allow dengue’s spread northward by creating more habitat where the mosquitoes that transmit it can live. Fewer than forty cases of Chagas’ disease—caused by a parasite that is transmitted by the so-called kissing bug—have been reported in the United States since 1955.

And finally, leprosy. Yes, this disease still exists. Also called Hansen’s disease, leprosy affected 2,323 people in the United States between 1994 and 2011, and Buchanan would be right if he noted it is more common among foreign-born individuals. But the idea that there is some explosion of this disease thanks to immigration is laughable; the rate of new diagnoses in that time period actually fell by 17 percent. And here’s another fun fact: some of the cases of leprosy in recent years have been transmitted not by people, but by armadillos.

Perhaps it isn’t surprising that Pat Buchanan’s rhetoric on health and immigration isn’t exactly scientifically sound. Going back a bit further, here’s former Oklahoma senator Don Nickles during a 1993 Senate debate over trying to prevent HIV- positive foreigners from immigrating:

There are 700,000 immigrants that come into the United States every year. If we change this policy, it will almost be like an invitation for many people who carry this dreadful, deadly disease to come into the country because we do have quality health care in this country, better health care in the United States than any other country in [the world]. . . . I mention this amendment is not born out of hate. This amendment is not born out of fear. This amendment is not born out of homophobia. This amendment is raised to try and stop President Clinton’s administration from making a very serious mistake that will jeopardize the lives of countless Americans and will cost U.S. taxpayers millions of dollars.

The policy in question—preventing immigration of HIV- positive individuals—had been in place since 1987 (created by Senator Jesse Helms). The “countless” Americans, though, were a figment of Nickles’s imagination; it was estimated that in 1989, for example, fewer than a thousand HIV-positive immigrants would even seek entry into the United States. Given HIV’s limited modes of transmission, this was far from a public health crisis. Importantly, though, the demonizer really works: the policy Nickles spoke about remained in place all the way until 2009, when President Obama finally lifted the ban.

We can continue to go back in time. In 1915, for example, a typhoid fever epidemic began in Mexico, spreading fear that it would penetrate the United States as well. Along with a growing nativist sentiment and concerns about immigrants from elsewhere in the world, this epidemic led to passage of the Immigration Act of 1917. That ignominious bit of legislation lumped in the presumably diseased “other” with a whole host of supposed undesirables rivaling the Blazing Saddles army of “mugs, pugs, thugs,” and so on:

The following classes of aliens shall be excluded from admission into the United States: All idiots, imbeciles, feeble-minded persons, epileptics, insane persons; persons who have had one or more attacks of insanity at any time previously; persons of constitutional psychopathic inferiority; persons with chronic alcoholism; paupers; professional beggars; vagrants; persons afflicted with tuberculosis in any form or with a loathsome or dangerous contagious disease.

Of course, the fears that some politicians took advantage of at various points did at least have some basis in truth: there were occasional disease outbreaks in other countries less advanced than the United States, if one goes back far enough. But the language of the demonizer persisted long after many parts of the world had begun to change. In a 2002 paper on the “persistent association” of foreignness and disease in the United States, University of Michigan researchers Howard Markel and Alexandra Minna Stern wrote about how much of the developing world modernized and left the American rhetoric behind:

After World War II, many countries built hospitals and rural clinics and spearheaded campaigns to combat endemic diseases, and many parts of the world benefited from reductions in childhood mortality and various infectious diseases as well as improved standards of nutrition as a result of hygiene and maternity programs. In addition, organizations like the United States Peace Corps and the United Nations World Health Organization brought modern sanitary techniques, public health administration, vaccines, and medical treatments to areas that had neither the financial or human resources to afford them.

And yet, half a century and more later, politicians continue to connect foreigners with disease, even when those foreigners may have grown up with better health care than the politician did.

Again, the demonizer is an easy tactic for politicians to use, since the diseases in question can be scary and most people won’t know that they are exceptionally rare in immigrants, or that vaccination rates are actually better in other parts of the world. Spotting this tactic is relatively easy, since it is generally limited to this particular scientific field: if a politician warns that allowing foreigners in will spread a certain disease, doubt the claim. Check the actual modes of transmission of the disease, or the actual prevalence of that disease. The devil isn’t the immigrant; it’s in the details.

Excerpt from Not a Scientist: Not a Scientist: How Politicians Mistake, Misrepresent, and Utterly Mangle Science by Dave Levitan. Copyright © 2017 by Dave Levitan. Reprinted with permission of W.W. Norton & Company, Inc. All rights reserved.

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