Officials with U.S. Immigration and Customs Enforcement arrest a man on the street in San Antonio, Texas, on Feb. 5.
Photo courtesy ICE
Rapid and frequent deportations of immigrants by the Trump administration — sometimes without legal cause — are driving fear among immigrants and their families across the U.S., putting their health and that of their communities at risk.
Many immigrants, including those with legal status, are avoiding health care visits, sidestepping services they qualify for and shunning law enforcement even when they are victims of a crime because of concerns they will be swept away from their homes by U.S. Immigration and Customs Enforcement agents.
“Recent raids have disregarded the protections normally provided for immigrants without a criminal record who simply want to work and take care of their families,” Frankie Miranda, president and CEO of the Hispanic Federation, said following mass deportations in January. “The raids are fostering fear in our communities, limiting people’s ability to work and go to school, and generally pushing people to live in the shadows.”
On President Donald Trump’s first day in office, he issued an executive order that set the stage for what he called the “largest domestic deportation operation in American history.” He directed the U.S. Department of Homeland Security to lift long-standing restrictions that had prevented federal immigration agencies from arresting immigrants in certain “sensitive” areas, such as schools, religious spaces and facilities where people seek health care.
The action could have devastating consequences for immigrants and their children, as the threat of deportation can deter people from receiving vaccines, prenatal care, screenings and even emergency care.
“When health care facilities become sites of fear instead of care, everyone loses,” said Y. Tony Yang, DSc, MPH, professor of health policy at the George Washington University School of Nursing and Milken Institute School of Public Health. “Clinicians have a moral and legal duty to protect patient trust, because no one should have to choose between getting care and getting deported.”
Protesters show their support in April for international students who have had their visas revoked by the Trump administration.
Photo by Michael Nigro, courtesy Pacific Press/LightRocket/Getty Images
As of mid-March, ICE had made nearly 33,000 arrests in 2025 — more than made by the agency in all of 2024. In April, the agency released an ominous new ad campaign telling people who are in the U.S. without legal permission “You are next,” and encouraging them to leave the country.
Organizations around the nation that provide health care for all have experienced declines in the number of patients accessing care. Chicago-based Community Health, which is one of the largest volunteer-based health centers in the nation, has been tracking the decrease.
“In the short term, this creates a crisis for those with chronic conditions like diabetes and hypertension,” Stephanie D. Willding, MPA, the organization’s CEO, told The Nation’s Health. “Even missing one appointment can impact the management of a chronic condition, worsening a patient’s disease. And if patients avoid important screenings like mammograms and colonoscopies, we may see later-stage cancer diagnoses.”
In many health centers around the country, Trump’s orders have been met with confusion, said Willding, noting that her organization saw a significant decline in patient visits, including no-shows and cancellations, following the start of Trump’s new presidential term. Community Health provides primary and specialty care, medications, lab testing, mental health services and health education at no charge to low-income, uninsured and underinsured adults in Chicago.
“Overall, we saw 30% of patients not attend their appointments, and a 40% reduction in medication pick-up at our pharmacy,” Willding said.
Frequent and mass deportations can also cause anxiety and other mental health stress for immigrants. Children are particularly vulnerable, according to Physicians for Human Rights medical expert Altaf Saadi, MD, MSc, a neurologist at Massachusetts General Hospital and assistant professor of neurology at Harvard Medical School.
“These people are part of families and communities who feel the ripple effect of having a loved one, often a breadwinner, taken away,” Saadi told The Nation’s Health. “There are disruptions to children’s ability to eat, sleep and learn in school. They lose emotional and material support.”
In some families, older children take on jobs or increased roles to care for siblings, Saadi said, noting that the consequences are devastating. Health harms of losing a family member to deportation can extend into adulthood and even be transmitted across generations.
Amid the fear, chaos and confusion, immigrant rights advocates are firing back with legal advice and written guidance to help staff know what to do if immigration enforcement agents show up at their health care facilities.
CommunityHealth, for example, is partnering with key organizations, such as the Illinois Coalition for Immigrant and Refugee Rights, to ensure staff are following model policies that preserve patients’ privacy rights. In response to growing anxiety and fear, the coalition created the Illinois Alliance for Welcoming Healthcare, which aims to create an inviting, safe environment for everyone in every health care institution in Illinois.
“Staff have all received training on the process to follow when engaging with immigration enforcement officials,” Willding said.
CommunityHealth has also established‘ micro-clinics” throughout the city to help patients access health care closer to home, where they might feel safer, she said.
The National Immigration Law Center recently partnered with Physicians for Human Rights to create “Health Care and U.S. Immigration Enforcement: What Providers Need to Know.” The handbook provides guidance to clinicians and hospital administrators on how to defend the rights of patients and providers if U.S. immigration enforcement comes to their health facilities.
“Our obligation is to protect all of our patients, regardless of their immigration status,” said Saadi, who joined with the law center on behalf of Physicians for Human Rights to co-author the guide, which instructs providers to clearly communicate that immigration status does not affect a patient’s right to receive medical care.
The guide also advises providers to avoid asking for or documenting patients’ immigration status, as well as to ensure that enforcement agents do not enter private spaces without verification from a designated staff member and a judicial warrant.
“Health care providers want more support from their hospital leadership on education around what to do when or if immigration enforcement interferes with their providing health care,” Saadi said. “They want education, training and explicit institutional policies.”
As the Trump administration’s anti-immigrant actions increase, telehealth might prove to be a safe way forward, Willding said. The Chicago organization has been proactively texting patients to give them the option to schedule health visits online and has seen an increase in telehealth use, she said.
Meanwhile, deportation crackdowns and the confusion and fear surrounding health care for immigrants continues to be a toxic combination, Yang said, especially in public health.
“Public health depends on trust,” Yang said. “My message is simple: We must separate politics from care. Fear should never be a barrier to prevention. The health of one community affects us all.”
For more information, visit www.nilc.org.
- Copyright The Nation’s Health, American Public Health Association
