Toward an Abolitionist Epidemiology of Displacement: Lessons from U.S. Immigration Detention

Roberto SirventBilal Irfan^*

• Harvard Medical School, Boston, United States

citizenship" without interrogating the racial-capitalist soil into which that status is planted may inadvertently reproduce harm.Externalized borders amplify those harms overseas. The Black Alliance for Peace documents how the United States Africa Command (AFRICOM) has expanded to fifty-three African states, coupling counter-migration surveillance with live-fire exercises that contaminate water tables and displace pastoralist communities [7]. Environmental epidemiology must therefore link transnational military emissions to cardiopulmonary disease patterns in host populations and to the forced migration they catalyze. Any serious account of migrant health that ends at the boundary fence undercounts the upstream toxicants of colonialism and imperialism.Beyond detention, migrant health is shaped by the exploitative labor arrangements awaiting those who survive the border. Immigrant workers disproportionately occupy precarious jobs marked by low wages, hazardous exposures, and minimal protections, realities that can sometimes treat as background variables rather than central determinants of health. Housekeepers, construction laborers, and care workers, many of whom are Black, Brown, undocumented, or women, experience high rates of musculoskeletal injury, chemical exposure, and psychological distress [8]. In one Florida-based survey, nearly 60% of immigrant hotel housekeepers reported moderate to severe back and neck pain, sprains, and burns, with many suffering fingerprint loss from prolonged chemical contact despite glove use [8]. These injuries were strongly associated with poor-quality equipment and excessive workloads, yet the institutional indifference to these conditions reflects broader patterns of racial capitalism [8]. Similarly, the COVID-19 pandemic illuminated how low-wage immigrant workers, meatpackers, agricultural laborers, and janitorial staff bore disproportionate infection risk not due to biological vulnerability but because structural arrangements concentrated hazard in racialized, underprotected workplaces [9]. Epidemiologic studies show how race-based adjustments in occupational health metrics, such as pulmonary function thresholds, serve to systematically understate workplace harms and reduce industry accountability [9].What, then, does an abolitionist epidemiology require? First, the method. Surveillance systems must disaggregate detention-related diagnoses, time-to-care intervals, and mortality by race, sex, and legal classification, moving beyond the generic "non-citizen" denominator. Second, praxis. Clinicians stationed at border encampments have begun to translate solidarity into refusal, for instance, by withholding medical clearance for deportations deemed clinically unsafe and by publicly documenting abuses in peer-reviewed forums [10]. Such acts illuminate the professional duty to disrupt structures that manufacture disease rather than merely palliate symptoms. Third, policy. Epidemiologists should lend quantitative backing to abolitionist campaigns that call for the closure, not reform, of detention facilities engaged in human rights violations, and the redirection of federal carceral budgets toward community-governed housing, food, and primary care infrastructures proven to shorten hospital stays and avert overdose deaths.Public health as a discipline has challenged its scholars and contributors to grapple with displacement as both health exposure and analytic blind spot. Meeting that challenge demands a paradigm that refuses to exceptionalize the border while normalizing the violence behind it. Centering those most criminalized clarifies how abolition is not a metaphor but a measurable health intervention. In displacing detention from the clinical periphery to the epidemiological core, we may finally align public health with the emancipatory ambitions of those it purports to serve.