In the weeks since the election of Donald Trump, I have started to double check whether I have my birth registration card in my wallet. This is an ID card that looks like a green credit card and is proof that I am a US citizen.
Growing up in Douglas, Arizona, just walking distance to the US-Mexico border, I have been stopped by US Border Patrol. In high school, I was stopped while in a car with my friend and her mother and we were questioned about our citizenship status. Commuting to other parts of Arizona means Border Patrol checkpoints where you are often asked random questions to see how well you speak English.
And this could happen with greater frequency under President Trump, who has said he would build a wall and beef up Border Patrol.
I also realize that I am more vulnerable to question because of the way that I look. I am a petite, brown-skinned woman with long dark hair and would not be mistaken for being white.
The election of Trump has created mental stress for many of us in border states, and not just for immigrants, but for those of us who were born here.
I work with health promoters, promotoras in Spanish, and they provide valuable health information to the community and act as a trusted source of knowledge and support to the Latino community.
The promotoras have their ear to the ground. And this is what they are hearing:
"I'm afraid to go to the informational health classes that are held at the neighborhood center because I have all noticed that Border Patrol cars always end up in the parking lot around the time the classes are about to begin or end," one woman reported.
"I don't want to go the free back to school round up activities because even though my child is a citizen, it stresses both of us to be in a place where I could be detained. My daughter stresses out every time we have to get in the car to go anywhere," another said.
We can expect to see higher rates of chronic stress-related illnesses among Latino immigrants and US citizens.
This is an issue that first arose when Arizona Senate Bill 1070 passed in 2010. This law had four main provisions and has been greatly disputed. Three of the four provisions were struck down by the US Supreme Court. The one provision that was upheld by the Supreme Court requires police to determine the immigration status of someone arrested or detained when there is "reasonable suspicion" they are not in the US legally.
The Arizona Health Survey in 2010 found Latino residents appeared to experience slightly higher levels of psychological distress.
There is a connection to prolonged stress experienced by those who do not have adequate resources to meet their needs and poor health and mental health outcomes, the survey found.
Research from Harvard Medical School suggests that chronic stress contributes to heart conditions and can cause brain changes that may contribute to anxiety, depression and addiction, along with a plethora of additional physiological and psychological problems.
Latino communities need safe spaces where individuals can seek out mental health services without the fear of surveillance. We need to demand the integration of behavioral health care into primary care services. This will only occur if new payment models are created that reward doctors for improving health outcomes and reducing health care spending by integrating behavioral health and primary care services.
Evidence from our conversations with Latinas indicate that seeking out mental health services is still seen as taboo topic in the Latino community. We found that developing a rapport with women we were able to create a safe space where topics like depression could be addressed without judgment.
Opponents of providing health care services to all individuals, regardless of immigration status, would state the costs are too great.
The Medicare cost for a depression screening is $17.36 per person, or $5.6 billion dollars. But the US currently loses $84.7 billion of productivity due to people working with depression, according to the London School of Economics and Political Science. This loss does not include the cost of those individuals who take the days off due to depression.
A study published in the Journal of Clinical Psychiatry in 2015 found that the economic burden of individuals in the US suffering from major depression disorder rose 21 percent from $173.2 billion in 2005 to $210.5 billion in 2010.
We need a comprehensive approach to health, which includes equitable access to mental health services, to ensure a brighter and healthier outlook for our current and future generations.