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Since the enactment of the 1965 Immigration and Nationality Act, the United States (U.S.) has granted asylum to vulnerable people fleeing persecution.1 An asylum seeker is defined by the United Nations High Commissioner for Refugees (UNHCR) as a person seeking international protection on the grounds of persecution in their home country relating to their race, religion, nationality, political belief, or membership in a particular social group. This population is distinct from refugees or other migrants, as their requests for protection by the home country are not yet finalized, and asylum seekers have the right to wait within the host country until their claims are processed. Nearly all asylum seekers who successfully receive asylum have experienced physical or psychological violence or face an imminent risk to their lives if they return to their home country.2
In 2019, 46,508 people, approximately 15% of applicants, were granted asylum to the U.S.3 Though increasing numbers of Latin Americans have sought asylum, recent policies made doing so more difficult. The Migrant Protection Protocols (MPP), implemented July 2019, allowed border authorities to deport or deny U.S. entry to asylum seekers for the duration of their immigration proceedings, a process that can last years.4 Enacted mainly at ports of entry along the Southern Border, MPP specifically affected Spanish-speaking asylum seekers fleeing violence from Mexico, Central America, and South America.5 These changes to longstanding U.S. asylum policies created a public health catastrophe at the U.S.-Mexico border, resulting in preventable morbidity for asylum seekers.6
Due to MPP, asylum seekers established tent encampments along the U.S.-Mexico border while waiting for their asylum claims to be adjudicated; in the encampments they became susceptible to gang violence, kidnapping, and disease.7 In one encampment in Matamoros, Mexico, approximately 2,500 residents, including 500 children, lived in precarious conditions from August 2019 to March 2021, with minimal access to health care and relying on nongovernmental organizations (NGOs) to provide basic services.8 The medical NGO working in Matamoros reported significant malnutrition, respiratory illnesses, and gastrointestinal diseases among this population.9 The relationship between inhumane conditions and health is clear, particularly among migrant populations.10 Research has demonstrated how material and experiential disparities can increase morbidity and mortality, and that experiencing repeated stressors...