Legal and illegal immigrants to the United States are more likely to have worse oral health, and poorer health overall, when compared to natives and naturalized citizens. According to new research published in the Journal of the American Dental Association, researchers at the University of Nebraska, University of Wisconsin, City University of New York and University of Alabama looked at national survey data on oral health. Analyzing data collected on 4,520 adults who received a dental exam, the researchers focused on associations between citizenship status and whether patients received recommendations to visit a dental professional, had cavities or periodontal disease.
Among the issues they found were that more than half of noncitizens had periodontal disease and nearly 40 percent had cavities. However, only 34 percent of native citizens had periodontal disease and 27 percent had cavities. Also, the noncitizen group was seven years younger than the natives studied. After adjusting for factors that including smoking and the number of permanent teeth, noncitizens still had higher instances of periodontal disease and were more likely to be prescribed dental care. Naturalized citizens were not significantly more likely to have periodontal disease or cavities than natives.
In the contentious debate over illegal immigration, one of the factors that has received little media attention is the incidence of communicable diseases among illegal immigrants. In the case of legal immigration, U.S. immigration authorities have demanded that persons applying for immigration must provide a medical history and undergo a physical examination performed by a physician, which includes blood analysis and a chest x-ray. According to the Centers for Disease Control and Prevention (CDC, the reason for a mandated “medical examination is to detect inadmissible conditions, including communicable diseases of public health significance, mental disorders associated with harmful behavior, and substance use or substance-induced disorders.”
Among the most dangerous diseases that continues to be of concern to health authorities is tuberculosis (TB), which the CDC says is “one of the world’s deadliest diseases.” All applicants for immigration to the U.S. must be screened for TB, and present a physical examination with a chest X-ray, and provide a medical history. If there is evidence of TB, the applicants are subjected to further and aggressive screening for the TB bacteria. If the disease is identified, the CDC and Immigration and Customs Enforcement agency require proof of appropriate TB treatment before the applicant is allowed admission to the United States.
According to the World Health Organization, tuberculosis is “one of the top 10 causes of death worldwide.” TB is highly contagious: the coughs and sneezes of infected persons spread contagion in bacteria-laden droplets into the air inhaled by nearby uninfected individuals. While TB is life-threatening for persons with cancer, HIV, and compromised immune systems, it has become more dangerous to even healthy persons because of the new strains of the deadly disease that are resistant to common antibiotics.
Because illegal immigrants are not checked for diseases such as tuberculosis, they may pose a significant risk to Americans and resident aliens. According to the Pew organization, there are approximately 11 million illegal immigrants residing in the United States. While the majority had long been identified as Mexican nationals, as of 2016 they constitute about half of the illegal immigrant population. Many illegal immigrants come from Asia and Central America. The top ten countries of origin for illegal immigrants in 2012 data, in descending order, are: Mexico, El Salvador, Guatemala, Honduras, Philippines, India, Korea, China, Ecuador, and Viet Nam.
In 2017, Pew noted that six states account for 59 percent of all illegal immigrants: California, Texas, Florida, New York, New Jersey and Illinois. Some states have seen a downward trend: from 2009 to 2014, the illegal immigrant population decreased in Alabama, California, Georgia, Illinois, Kansas, Nevada, and South Carolina, due to the outflow of Mexican nationals.
In 2015, CDC ranked the following states according to the number of tuberculosis cases per 100,000 population: Nevada at #10, California #3, Texas #4, New Jersey #6, and Arizona #13. According to 2015 WHO data, the number of people infected with TB per 100,000 (link is external) in the general population for the top ten illegal immigrant origin countries is:
Mexico – 21
El Salvador – 43
Guatemala – 25
Honduras – 43
Philippines – 322
India – 217
Korea – 80
China – 67
Ecuador – 52
Viet Nam - 137
In 2015, when 52 percent of 11 million illegal immigrants of Mexican nationality were living in the U.S., an estimated 2,300+ infected Mexican illegal immigrants were currently living in the country. While about 720,000 Mexicans attempt to illegally cross into the U.S. every year, statistically there are approximately 151 illegal immigrants infected with TB who cross into the U.S. every year. While half may be arrested by immigration authorities and deported, many soon return.
Even though illegal immigrants from China, the Indian subcontinent, and the Philippines are fewer in number, they are many times more likely to be infected with tuberculosis when they enter our country undetected and unvetted. These illegal immigrants may also carry other diseases, such as HIV, syphilis, smallpox, chikungunya, and hepatitis, thus exposing citizens and resident aliens to health risks.
According to analysis released by the CDC in March, "Among non–U.S.-born persons, the highest TB rate among all racial/ethnic groups occurred among Asians (27.0 per 100,000 persons), followed by blacks." It went on to say, "As in previous years, in 2017, the top five countries of birth of non–U.S.-born persons with TB were Mexico (1,204; 19.0% of all non–U.S.-born persons with TB), Philippines (783; 12.3%), India (595; 9.4%), Vietnam (526; 8.3%), and China (400; 6.3%). Persons who received a diagnosis of TB ≥10 years after arriving in the United States accounted for 2,854 (45.0%) of all TB cases among non–U.S.-born persons."