Does Muslim Immigrant Health Decline from Sociopolitical Stress? Evidence from County-Level Election Results and Birth Outcomes in the Trump Era

The 2016 U.S. presidential election cycle intensified political partisanship in the presence of well institutionalized and racially coded campaign strategies and rhetoric from Donald J. Trump, much of which centered on Muslim immigrants. Muslim immigrants living in this sociopolitical climate may experience intensified and direct day-to-day racism, in addition to vicarious (second-hand) racism encountered through online news and social media, all of which has been associated with heightened stress and worsened health. Health impacts may be differentially patterned by ethnoracial categorization of Muslim immigrants, given the distinct racialized experiences of MENA, South Asian and Black Muslim immigrants. This study examines the relationship between residing in hostile local sociopolitical contexts and birth outcomes among Muslim immigrant mothers by ethnoracial categorization. I identify a unique form of sociopolitical stress – residing in a county that pivoted from voting Democratic in the 2012 elections to voting for a divisive and prejudiced Republican candidate in 2016. I examine the potential health consequences of this local climate through the prevalence of PTB and LBW before (2013-2016) and after (2017-2019) the 2016 U.S. Presidential election among Muslim immigrant mothers residing in pivot counties (2012: Democrat; 2016: Republican) compared to non-pivot counties (2012: Democrat; 2016: Republican). MENA and South Asian Muslim immigrant women living in pivot counties are at increased risk for PTB after the Trump election compared to their counterparts in reliably Democrat counties. The rate of PTB increased most severely for South Asian Muslim immigrant mothers. The findings from this study suggest that religion, specifically Muslimness, is another potentially marginalized social status and important axis of analytical consideration for population health research in the U.S. Just as intersectional work on immigrant health has elaborated how nativity and ethnoracial categorization are experienced simultaneously, we must wrestle with the complexities of how Muslimness crosscuts these social positions.