Fear as policy: the health harms of immigration enforcement

I have been trying to write this column for months. Each time I start, I’m overwhelmed by horror at the actions of Immigration and Customs Enforcement (ICE) in the United States. Words feel insufficient to capture the brutality, injustice, and moral failure of what’s happening daily in a system reportedly driven by pressure to expand detention capacity.I’m writing from the US, where the activities of ICE reach far beyond border policy. While the raids may no longer be global headlines, they’re a source of daily terror for many. ICE harms health by keeping people away from care and by failing those it detains, driving preventable illness and death.12 At its extreme, this is a system capable of lethal force without clear accountability.3Immigration enforcement is often debated in legal and political terms, but its effects are clinical, measurable, and increasingly well documented. First, fear deters people from seeking care. Patients delay…