To acquire wisdom, one must observe

The public health cost of political fear

In this new presidential administration, many Americans are angry. This is especially true of black Americans, undocumented Americans and members of other marginalized communities. The histories and reasons behind their fear and anger are too numerous to count, but one of the key reasons is the Trump administration’s efforts to roll back health care. Unfortunately, Trump’s various offensive policies, when combined with his anti-affordable health care stance, form a deadly catch-22 for poor and marginalized Americans. This is because the stress caused by policies that target certain marginalized groups creates awful mental and physical health issues that cannot be treated without help from programs like the Affordable Care Act.

Many people ignore the emotional aspect of oppression, but it’s important to note that emotions such as fear and anger can massively impact health. Stress causes problems in nearly every system of the body. It suppresses the immune system’s ability to fight disease, weakens the heart and contributes to long-term mental illnesses such as depression and panic disorders. This is especially true when someone experiences sustained stress over an extended period of time. Periods of political oppression and fear are a perfect example of a situation that causes sustained stress. For example, undocumented people who are concerned about deportation might incur health problems from the stress of avoiding immigration authorities. The precariousness of their undocumented status in the Trump administration also leaves them vulnerable to abuse from employers and loved ones, which is disastrous for mental health.

Additionally, much of the stress caused by the Trump administration originates not from the oppression itself, but from the knowledge that the oppression is unjust yet still tolerated in our political system. That the people proposing and executing oppressive policies were publicly elected emphasizes the idea to marginalized people that the majority of the public wants them to be oppressed. This can cause incredible amounts of stress and anger.

Often, during discussions of public health policy, the impact of extended periods of stress of marginalized populations is ignored. This leads to public health gaps within marginalized communities. During periods of political strife, one might expect a steady increase in stress-related health issues. However, the American health system would not account for political anxieties when deciding how to provide and distribute care. Even with Obamacare still intact, there is no precedent for increases in health care in underserved communities during politically stressful periods. Without the ACA, or preferably a more efficient and comprehensive replacement, health outcomes during these periods would likely be even worse.

Increases in stress-related health issues during periods of political anxiety are impossible to quantify partially because of the failings of the American health care system. Due to mental health stigma, people with mental illness often do not seek psychiatric care. This can be exacerbated by poverty or language barriers.

For example, I am from Orange County, CA, where a huge portion of the population exclusively speaks Spanish. However, there is only one psychiatrist in the whole county who speaks Spanish. This means that a Spanish-speaking OC resident, even if they do have the money to see a psychiatrist, probably would not be able to get an appointment due to the volume of Spanish speakers seeking appointments with this one doctor. The issue of people not seeking health care is not exclusive to mental health issues. If someone is uninsured, or knows that they cannot afford a medical expense, they often do not seek health care for important medical issues.

In America, we often make the tragic mistake of perceiving health problems as purely individual, rather than happening to communities, and this can lead to massive oversights. The idea that public health is truly public is uncommon to most Americans, but in this political era, the issue is particularly urgent. This is because many Americans are running low on anger endurance. The sustained stress of political oppression causes a slew of public health problems that our current system is nowhere near equipped to handle. It is likely that instances of physical and mental health issues will increase in marginalized communities, and unlikely that our current system will do anything to remedy this.

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