Ali Abdullah
Kansas City, Missouri, United States

Bigotry affects the health of nations. This is exemplified in Germany, where in the early 1900s roughly 50% of Berlin’s¹ physicians were Jewish, as were 70% of doctors in Vienna¹ and 16% in Prussia.² After the ascent of the National Socialist German Workers’ Party and the passage of the Enabling Act, Adolf Hitler was given sweeping executive powers and Jewish doctors were forced out of the workplace²; many fled the country.² Eventually Germany would end up paying the price: with much of its medical talent gone, public health and medical care declined. Between 1933 and 1937, diphtheria deaths nearly doubled, while scarlet fever and meningitis became more prevalent.²

In other countries, Jewish physicians were also not safe from antisemitism. In 1934, when Dr. Samuel Rabinovitch was appointed chief intern at Notre Dame Hospital in Montreal, Canada, the hospital staff went on what became known as the “Days of Shame.”³ He would eventually resign and leave Canada for the United States,³ like many Jewish graduates from Quebec.

In the aftermath of WWII, Britain lay in ruin and entire cities had been leveled during the Blitz. In an attempt to rebuild⁴ and heal their war-weary population, the British established the National Health Service (NHS). To bolster their medical ranks, they called for subjects from their colonies.⁴ Nurses came from the Caribbean⁵ and doctors from India and Pakistan.⁵ Many worked in underserved areas, with some making up over 70% of all medical staff in those areas.⁶ The health minister who had made this call was Enoch Powell.⁶ But as immigration increased, tensions began to mount. Years later in 1968, Powell delivered his “Rivers of Blood” speech,⁴ in which he argued the UK was committing suicide by allowing so many non-Britons into the country. Following the speech, racists were emboldened and attacks on non-white people and communities became more common.⁴

Anti-immigrant sentiment would not end with Powell. In 2016, the UK voted to leave the European Union. Survey data indicates that one driving reason was anti-immigration sentiment.⁷ This rhetoric has now become so prevalent that many foreign-born doctors have expressed a desire to leave the country.⁸ Some in the UK went as far as to call for “remigration,” the removal of people based on national origin. Among those who strongly favored large-scale deportation of immigrants, nearly 20% said they wanted the immigrant doctors and nurses gone too.⁹ This was particularly short-sighted, as the UK depends more on foreign doctors than other wealthy nations.¹⁰

This is not just a racial problem either. In the US, anti-LGBT legislation contributed to the departure of one of only three pediatric heart surgeons in Louisiana.¹¹

Driving away doctors is just one way bigotry can negatively affect the health of a nation. It can also harm patients directly. For instance, throughout the 1980s, tens of thousands of LGBTQ people lost their lives to HIV/AIDS. The first known case of HIV in the United States was detected in 1981, but President Reagan did not even mention the word “AIDS” until 1987, after 20,000 Americans had already died.¹²

The majority of those who died were gay men.¹³ The perception that HIV/AIDS was a “gay plague”¹⁴ was reflected in the early name given to the disease, “GRID,” or “Gay-Related Immune Deficiency Syndrome.”¹² This was exacerbated by the gutting of social services and scientific research.¹²

The result was a one-two punch impeding care. First, the stigma against gay people led to indifference towards the epidemic, or in some cases, celebration as “God’s wrath.”¹⁴ Second, the novelty of the virus and the lack of research into it led to a poor understanding of its transmission, which helped create a climate of fear. The result was some healthcare providers refusing to provide care.¹²

Sub-Saharan Africans were also adversely affected by the prejudice surrounding HIV/AIDS. For instance, the apartheid government of South Africa dismissed AIDS and tried to depict it as a “black disease.”¹⁵ The prevalence of HIV in pregnant women increased from 0.8% in 1990 to 7.6% in 1994.¹⁵

The plan to send HIV treatment to South Africa was met with opposition from both pharmaceutical companies¹⁶ and USAID itself.¹⁷ In 2001, the head of USAID, Andrew Natsios, argued against sending anti-retroviral therapy (ART) to Africa, claiming that “many people in Africa have never seen a clock or a watch in their entire lives”¹⁷ and that they “use the sun”¹⁷ to tell time. Despite his claims, sub-Saharan Africans had an adherence rate of 82%,¹⁷ whereas the adherence rates in Canada and the US were 55%.¹⁷

If illness does not discriminate, then medicine cannot afford to do so either. While greater medical knowledge helps in understanding and combating disease, delivering it to those who need it is another matter entirely. Bigotry can set up arbitrary designations of who is allowed to provide treatment and who can receive it. Public health requires solidarity because protecting the health of one group cannot be separated from protecting everyone else’s.

References

1. Roni Caryn Rabin, “Exhibition Traces the Emergence of Jews as Medical Innovators,” New York Times, May 14, 2012, https://www.nytimes.com/2012/05/15/health/exhibition-traces-the-emergence-of-jews-as-medical-innovators.html.
2. Alexa R. Shipman, “The German Experiment: Health Care without Female or Jewish Doctors,” International Journal of Women’s Dermatology 1, no. 2 (2015): 108–10, https://doi.org/10.1016/j.ijwd.2015.02.003.
3. Lilly Groszman and George Weisz, “A History of the Antisemitic 1934 Montreal Hospital Strike,” Canadian Medical Education Journal 16, no. 1 (2025): 115–18, https://doi.org/10.36834/cmej.79539.
4. Lauren Frayer, “An Anti-Immigration Speech Divided Britain 50 Years Ago. It Still Echoes Today,” NPR, April 20, 2018, https://www.npr.org/sections/parallels/2018/04/20/603884872/an-anti-immigration-speech-divided-britain-50-years-ago-it-still-echoes-today.
5. Julian M. Simpson, Aneez Esmail, Virinder S. Kalra, and Stephanie J. Snow, “Writing Migrants Back into NHS History: Addressing a ‘Collective Amnesia’ and Its Policy Implications,” Journal of the Royal Society of Medicine 103, no. 10 (2010): 392–96, https://doi.org/10.1258/jrsm.2010.100222.
6. Patrick Butler, “How Migrants Helped Make the NHS,” The Guardian, June 18, 2008, https://www.theguardian.com/society/2008/jun/18/nhs60.nhs2.
7. Felix Danbold, Jesús Serrano-Careaga, and Yuen J. Huo, “Prototypicality Threat Drives Support for Nativist Politics in U.S. and U.K. Elections,” Current Research in Ecological and Social Psychology 4 (2023): 100080, https://doi.org/10.1016/j.cresp.2022.100080.
8. Denis Campbell, “Foreign Medics Shunning NHS Because of Anti-Migrant Rhetoric, Says Top Doctor,” The Guardian, December 26, 2025, https://www.theguardian.com/society/2025/dec/26/foreign-medics-shunning-nhs-anti-migrant-rhetoric.
9. YouGov, “Is There Public Support for Large-Scale Removals of Migrants?,” 2025, https://yougov.com/en-gb/articles/52704-is-there-public-support-for-large-scale-removals-of-migrants.
10. “UK Has Twice as Many Foreign Doctors and Nurses as OECD Average,” The Telegraph, December 26, 2025, https://www.telegraph.co.uk/news/2025/12/26/uk-twice-as-many-foreign-doctors-and-nurses-oecd-average/.
11. Drew Hawkins, “LGBTQ Doctors Are Leaving the Gulf South Due to Discrimination: ‘We Weren’t Welcome Anymore,’” WWNO, November 16, 2023, https://www.wwno.org/public-health/2023-11-16/lgbtq-doctors-are-leaving-the-gulf-south-due-to-discrimination-we-werent-welcome-anymore.
12. Thomas J. Coates, “The Fight Against HIV Is a Fight for Human Rights: A Personal Reflection,” Journal of Acquired Immune Deficiency Syndromes 82, suppl. 2 (2019): S91–S93, https://doi.org/10.1097/QAI.0000000000002165.
13. Liz Hamel, Jamie Firth, Tina Hoff, Jennifer Kates, Sarah Levine, and Lindsey Dawson, “HIV/AIDS in the Lives of Gay and Bisexual Men in the United States,” KFF, September 25, 2014, https://www.kff.org/hiv-aids/hivaids-in-the-lives-of-gay-and-bisexual-men-in-the-united-states/.
14. Jordan King, “The Drama That Raged against Reagan’s America,” BBC Culture, October 20, 2020, https://www.bbc.com/culture/article/20201019-the-drama-that-raged-against-reagans-america.
15. Salim S. Abdool Karim, Gavin J. Churchyard, Quarraisha Abdool Karim, and Stephen D. Lawn, “HIV Infection and Tuberculosis in South Africa: An Urgent Need to Escalate the Public Health Response,” The Lancet 374, no. 9693 (2009): 921–33, https://doi.org/10.1016/S0140-6736(09)60916-8.
16. Pat Sidley, “Drug Companies Withdraw Law Suit against South Africa,” BMJ 322, no. 7293 (2001): 1011, https://pmc.ncbi.nlm.nih.gov/articles/PMC1120171/.
17. Amir Attaran, “Adherence to HAART: Africans Take Medicines More Faithfully than North Americans,” PLoS Medicine 4, no. 2 (2007): e83, https://doi.org/10.1371/journal.pmed.0040083.