By Hina Tai and Winn Periyasamy
30 November 2016
A university student takes part in a walkout in protest of Republican president-elect Donald Trump in New Jersey. Photograph: A Jones/PacifiC/Barcroft Images
Sarah Zaffar was stopped at a red light near Huntington Beach, California – a predominantly pro-Trump town – when a truck pulled up beside her.
“Hey, hey!” bellowed a white man in a wife-beater and a buzz-cut, trying to get her attention.
“Call it women’s intuition,” Zaffar said, but she refused to acknowledge the aggressive male voice.
“Hey! You’re kind of cute. Why don’t you give me your number so I can send you the fuck out of this country,” he said. Zaffar continued to ignore him.
It was Thursday afternoon, barely two days after the election. Ironically, the 29-year-old psychology graduate student was on her way home from a class on multiculturalism, where they often discussed ways of effectively integrating minorities into the education system. That day Zaffar was wearing a tank top with her hair down – nothing about her indicated that she was a Pakistani Muslim American except the brownness of her skin.
“Hey, look what I have!” the man said. Zaffar finally glanced over and in his hand was some kind of weapon. Silver and shiny. She assumed it was a gun and quickly rolled up her window. As soon as the traffic light turned green, Zaffar sped away. Terrified, she kept checking to make sure she was not being followed until she reached her apartment.
The next day, Zaffar went to the police station to report the incident.
“I have never experienced something like this before,” Zaffar said. “I’m still a little shaken up about it. It plants a seed of fear in you.”
Throughout his campaign, Donald Trump utilized rhetoric laced with xenophobia to attack minorities while feeding on white America’s growing economic distress. Following the election, Trump reaffirmed his support of policies that unequivocally target Muslims – such as denying entry to refugees escaping humanitarian crises from “terror-prone regions”. The Council on American-Islamic Relations has recorded more than 100 incidents against Muslims since Election Day. In New York, Governor Andrew Cuomo was forced to create a special police unit to address the spike in hate crimes state-wide.
As fear grows in response to the escalating hate crimes and discrimination, Trump’s presidency signals an impending public health crisis for Muslims, said Bob Fullilove, professor and associate dean for community and minority affairs at Columbia University.
Decades of research on minority communities has documented how stress associated with stigma, intimidation and discrimination is detrimental to physical and mental health. These health effects are especially concerning for Muslims given Trump won the elections on a platform of Islamophobia.
According to research, Islamophobia is associated with poor psychological outcomes among Muslims. A study assessing discrimination among Arab Americans in Detroit post-9/11 found discrimination increased psychological distress, reduced levels of happiness and worsened overall health for Muslims.
Islamophobia can also adversely affect physical health. Research on Iraqi refugees living in the US after 9/11 found that race-related stressors were correlated with neurological, respiratory, digestive and blood disorders.
Health is expected to further deteriorate if Trump follows through on his proposed Muslim registry. Prejudicial surveillance of Muslim Americans has been found to increase negative mental health outcomes, particularly subclinical paranoia and anxiety.
Constant stress, such as from religiously biased surveillance, can cause health to deteriorate prematurely, a phenomenon known as the weathering effect, said Merlin Chowkwanyun, assistant professor of sociomedical sciences at Columbia University Mailman School of Public Health.
“To be constantly worried that you might have to register, put your name in a database or that some sort of connotation is going to be ascribed to you based on name and look is going to cause some wear and tear [on your body],” Chowkwanyun said.
Further studies found that both Muslim patients and providers face religious discrimination within the healthcare system. As the Trump administration continues to target and stigmatize Muslims, it will undoubtedly negatively affect how these communities interact with the healthcare system and providers.
“People are afraid to go to a clinic, a doctor’s appointment, an emergency room because somehow their identity will be questioned, their immigration status will be held up for some sort of interrogation,” Fullilove said. “All things that will keep people away from accessing the services we know to be enjoyable to health.”
In addition, stigma surrounding mental health continues to be a significant barrier to accessing services among many Muslim and immigrant communities. And many clinicians may not be adequately equipped to treat mental illness arising from Islamophobia.
“Most psychologists and psychiatrists are trained in a very kind of narrow clinical way to think about a diagnostic category and what’s necessary to alleviate them, but much less about social context and how it can impact mental health,” said Chowkwanyun.
If Trump follows through on his promises to repeal or reform the Affordable Care Act (ACA), these health effects will be further compounded. The ACA was a revolutionary public health act that allowed millions of people who never had health insurance before to access preventive care. Removing public health-friendly provisions will make it difficult for medical professionals to implement the necessary interventions, programs and policies to improve population health.
“This is part of what I see as the crisis,” Fullilove said. “This is the moment when we should be sending out messages that we understand the nature of the crisis we are all in. That we are committed to maintaining the principles of a democratic society, that we stand with people in their fight for dignity and human rights. Those are the kinds of conditions that promote public health at its best.”