Science
Migrants Are Skipping Medical Care, Fearing ICE, Doctors Say
A man lay on a New York City sidewalk with a gun shot wound, clutching his side.
Emily Borghard, a social worker who hands out supplies to the homeless through her nonprofit, found him and pulled out her phone, preparing to dial 911. But the man begged her not to make the call, she said.
“No, no, no,” he said, telling her in Spanish that he would be deported.
Ms. Borghard tried to explain that federal law required hospitals to treat him, regardless of his immigration status, but he was terrified.
“He said, ‘If I go to the emergency department, that will put me on their radar,’” she recalled in an interview recounting the incident.
Across the country, doctors, nurses and social workers are increasingly concerned that people with serious medical conditions, including injuries, chronic illnesses and high-risk pregnancies, are forgoing medical care out of fear of being apprehended by immigration officials. Since the Trump administration announced plans for mass deportations and rescinded a Biden-era policy that protected spaces like hospitals, medical clinics and churches from immigration enforcement, doctors said they have seen sharp increases in patient anxiety and appointment no-show rates.
If the trend continues, health care officials say, the list of consequences could be long: Infectious diseases circulating unnecessarily; worsening health care costs because of untreated chronic illnesses; and dangerous birth complications for women who wait too long to seek help, among others.
In a survey conducted by KFF, a health policy research organization, 31 percent of immigrants said that worries about immigration status — their own or that of a family member — was negatively affecting their health. About 20 percent of all immigrants surveyed said they were struggling with their eating and sleeping; 31 percent reported worsened stress and anxiety.
A White House spokesman did not respond to messages seeking comment. When the administration announced that it was ending protections at hospitals on Jan. 21, a statement from the Department of Homeland Security said the new policy was intended “to enforce our immigration laws and catch criminal aliens.”
Research has shown that immigration crackdowns are linked with poorer birth outcomes and mental health status, lapses in care, and fewer people accessing the types of public programs that reduce illness and poverty overall.
“We’re really creating not just very serious health risks, but economic risks in the long run for our country,” said Julie Linton, a pediatrician and member of the committee on federal government affairs for the American Academy of Pediatrics. “These policies are creating very real fear and uncertainty for people and have a tremendous impact on their ability to function on a day-to-day level.”
Chronic Conditions
Many immigrant communities suffer from high rates of chronic conditions such as high blood pressure and diabetes, which, if left untreated, can lead to heart attack, stroke and other grave complications.
That is why doctors worry about patients like Maria, a 47-year-old woman with pre-diabetes, who has been going to the same primary care clinic ever since she arrived in the United States from El Salvador 20 years ago. Even during the first Trump administration’s crackdown on immigration, she continued to seek medical care. But when the protections around hospitals and clinics were rescinded earlier this year, Maria canceled her appointment to have her blood sugar checked, a routine and crucial element of diabetes prevention in patients like her.
“We’re very scared of being in the clinic and having ICE arrive while waiting to be called,” she said in Spanish, referring to U.S. Immigration and Customs Enforcement.
Maria, who asked that her last name not be published, said that she is in a state of “constant anguish.” She said she avoids leaving the house and is working on a plan for the care of her children, who are American citizens, in case she and her husband are deported.
One of their daughters, who is 15, is being treated for fatty liver disease and the other, 11, needs therapy for a developmental condition. Their older daughter has another doctor’s appointment in June. Maria and her husband don’t want to interrupt her care, but they are worried about taking her there themselves. “It’s very complicated,” Maria said. “I can put myself at risk for my children. But if it’s for my own health, I prefer to let it go.”
The consequences of abandoning regular medical care can turn serious quickly, however. Jim Mangia, president of St. John’s Community Health Network in Los Angeles described one patient with diabetes who stopped showing up for a weekly diabetes education class. When a clinic staff member called the woman, they discovered she was afraid to even go to the grocery store, and had been subsisting for days on tortillas and coffee, he said.
“Thank God we reached her and she came in,” said Mr. Mangia, whose network serves an estimated 25,000 undocumented patients across more than 20 locations. Tests at the clinic showed that her blood sugar had become dangerously high.
“That’s what we’re going to see more and more of,” Mr. Mangia said. “It kind of breaks my heart to talk about it.”
Acute Care
For doctors working in urgent care settings, a drop-off in immigrants has become apparent through some unusual metrics. For example, Dr. Amy Zeidan, an emergency room physician in Atlanta, said that requests for Spanish-language interpretation in her hospital’s emergency department had fallen more than 60 percent from January to February.
Theresa Cheng, an emergency room physician at Zuckerberg San Francisco General Hospital and Trauma Center, said one of her residents had seen an immigrant patient who had suffered multiple facial fractures from an assault, but had not sought care for more than two weeks. “There is tremendous fear,” Dr. Cheng said.
In late January, Dr. Cheng said, she saw a patient who arrived with severely untreated diabetes. The patient, an undocumented woman, said she had waited to receive help because she was scared. She died that day.
Dr. Carolina Miranda, a family physician in the Bronx, spoke of a patient who had been granted asylum but, fearful of ICE, had failed to show up for a doctor’s appointment about a possible brain tumor.
Similar delays or cancellations are arising among pregnant women and new mothers, according to obstetrician-gynecologists around the country. Dr. Caitlin Bernard, an obstetrician in Indiana, said a patient had skipped her postpartum visit, explaining that she would no longer be leaving her house. On an obstetrics floor in a San Diego hospital, multiple staff members said they had seen an overnight drop-off following the inauguration in the number of immigrant women coming in with acute issues during their pregnancies.
“Obviously those women still exist,” said one doctor, who asked not to be identified because her employer forbade her from speaking publicly on the matter. “I fear it’s going to increase maternal mortality over time. ”
Children’s Health
Many of the children of immigrant parents who have skipped appointments or left medications unfilled are American citizens. But in mixed-status families, parents who are at risk of deportation are often unwilling to take the risk of going to the clinic or pharmacy.
A pediatrician at a health center that cares for underserved populations on the central coast of California reported a 30 percent increase in no-shows for pediatric appointments. Many of those who do bring their children, and are referred elsewhere for specialty care, such as speech therapy, or an autism evaluation, refuse, saying they are too frightened, said the pediatrician, who asked to be unidentified because he wasn’t authorized to speak publicly.
Dr. Tania Caballero, a pediatrician at Johns Hopkins who sees patients at a health center for underserved groups called Baltimore Medical System, said she had encountered parents who had not wanted to go with their babies to the emergency room out of fear, and parents of children with chronic conditions like cerebral palsy, asthma, and Type 1 diabetes who had told her they have stopped getting vital care.
“I tell patients, ‘I can’t control what happens outside of my space, and I can’t control if somebody comes into my space, But you know me. I have the tools, and I want to help you navigate this journey and do it together,’” she said.
Some parents of children in other dire situations — such as those receiving cancer treatment — are hoping that their child’s condition might actually protect them. Some have asked pediatricians for letters explaining their child’s medical requirements, in hopes that immigration officials who detain them might be convinced that the child needs to stay in the United States to survive.
Dr. Lisa Gwynn, a pediatrician in South Florida who serves families from across the Caribbean and South America, said that her plummeting patient attendance rate is particularly worrisome because patients are missing out on childhood vaccines necessary for preventing diseases like measles, pneumonia and whooping cough.
Dr. Gwynn also worries that without coming to see her, children who have experienced severe trauma before coming to the United States aren’t being connected to social workers or psychologists who can help.
“Imagine your children living in a home where everyone’s scared, and they’ve come to this country to not feel scared anymore,” she said. “We know that stress does not fare well for health. Period. Kids don’t perform as well in school, they have mental health issues, depression, anxiety. ”
A Dilemma for Hospitals
Some medical facilities have said they will comply with immigration officials. NYU Langone, in New York City, sent a memo to employees warning them not to try to protect illegal migrants. But many other health centers and organizations are finding ways to take a stand, telling staff to display “Know Your Rights” information on the walls and to never record their immigration status in a patient’s medical records. ”
Last week, the New England Journal of Medicine published an article by two doctors and a lawyer detailing how physicians can continue to provide health care and lawfully push back in the face of some ICE requests.
The St. John’s clinic network in Los Angeles recently launched an ambitious home visitation program in which a doctor, nurse and medical assistant visit patients’ where they live to perform exams and deliver medications. They aim to inform all 25,000 of their undocumented patients of this option.
In the New York area, a hospital association suggested designating a “hospital liaison” who can be paged to quickly usher an agent into a private office, and then ask to see a signed warrant, which would then be reviewed by in-house counsel.
At the emergency room of University Hospital, a safety net facility in Newark, staff members hand out cards, in Spanish and other languages, reminding patients of their rights. “You have the right to refuse consent for immigration or the police to search yourself, your car or your home,” the cards state.
But even there, the fear is palpable. Annalee M. Baker, an emergency physician, said she had seen a young woman who said her partner had beaten her until she was unconscious. Covered in welts and bruises, she had waited hours to come in. The reason given: she was terrified that her partner would be deported.
Dr. Baker also treated a minor who had been stabbed; she had needed his parents’ consent to treat him, but the boy had been skittish about providing any details about them, out of fear they might be caught in the immigration dragnet.
Still, it is the people who never come in at all that haunt Dr. Baker the most.
“The tragic message to these people is: Be a shadow and hope that you do not die.”
Sarah Kliffcontributed reporting.
Science
Here’s why the Lincoln Memorial Reflecting Pool went green so fast
Just days after the Trump administration completed millions of dollars in renovations on the Lincoln Memorial Reflecting Pool to make it American flag-blue, residents and online users noted it had turned a phosphorescent green.
Here’s why:
The calm, still waters of the Reflecting Pool make it an ideal nursery for algae growth. Algae need nitrogen and phosphorus to grow, and the Reflecting Pool is primarily fed by the Potomac River, which gets heavy doses of those nutrients from nearby urban and agricultural lands.
The Potomac also absorbed one of the largest sewage spills in U.S. history earlier this year when a pipe burst five miles upstream of Washington, although that event probably happened too long ago to contribute to the algal bloom today.
Untreated sewage is high in nitrogen and phosphorus. When nutrient levels are high, feasting algae can quickly reproduce.
The Department of the Interior said when the algae first appeared that it was “residual,” from the supply lines to the pool.
Experts also speculate that the darker blue color may be helping the Reflecting Pool absorb more heat. The higher temperatures promote algae growth by allowing their metabolisms to shift into overdrive.
Summer temperatures in D.C. aren’t helping. This week, temperatures are as high as 95 degrees in the city, prompting a heat alert.
The combination probably explains the excessive growth, turning the water surface an opaque green and preventing onlookers from seeing the new blue hue of the concrete basin.
Algae are important and beneficial organisms when the ecosystem is in balance. They’re the base of the aquatic food chain, fed on by herbivores of all shapes and sizes, including shrimp and juvenile fish, which in turn feed organisms higher up the food chain. The single-celled organisms use the power of the sun to produce energy through photosynthesis, similar to houseplants on your balcony.
In an effort combat the algae in the Reflecting Pool, employees of the National Park Service were seen pouring in gallons of hydrogen peroxide, a chemical commonly used in pool maintenance.
The Department of the Interior also is employing a “high-tech nanobubble ozone technology” to destroy the cells of the algae.
Ozone — yes, the same irritant that is in smog — is a gas composed of three oxygen molecules, and the small size of the bubbles allow the most gas transfer into the water, where it can damage algal cells, similar to how it irritates our lungs.
This only treats the symptoms, however. Generally, ozone nanobubbling is effective as a temporary solution for algae blooms. Longer-term fixes would have to address what makes the Reflecting Pool so ideal for algae, such as its depth, darker color and inflow of nitrogen and phosphorus.
In California, ozone nanobubbles also have been used in a project to improve water quality in the Tijuana River. The 120-mile river that runs near the border in northern Mexico and Southern California was the site of a pilot study in 2025. The U.S. section of the International Boundary and Water Commission reported that the nanobubbling reduced “odors and bacteria,” but the project concluded prematurely after a flood swept some of the instrumentation into the river.
Science
This plant extract can make a lethal drug cocktail. Can it also treat opioid addiction?
A plant extract that’s gaining popularity as a pain cure-all and has been associated with multiple California deaths in its concentrated, synthetic form has been approved for research as a treatment for opioid addiction by the federal government.
Kratom is derived from the leaves of Mitragyna speciosa, a tree native to Southeast Asia, and is commonly made into a powder or pill.
Researchers say people in the U.S. are using kratom to alleviate anxiety, treat chronic pain or as a remedy for the symptoms associated with quitting opioids, due to its ability to bind with opioid receptors in the body. But recently, public health officials have raised alarms about a component of the leaf called 7-hydroxymitragynine, also known as 7-OH, an alkaloid that has the potential for abuse and addiction in high doses.
Last year, the Los Angeles County Public Health Department linked the deaths of six county residents to the use of 7-OH mixed with other substances. The toxicology screens for some of the deceased revealed both kratom and 7-OH, leading to a countywide crackdown of products with either compound because they’re unregulated.
Although there is no scientific consensus on whether kratom has therapeutic value, the Food and Drug Administration has recommended that its potent 7-OH form be classified as a controlled substance. Consumers who use 7-OH as a pain reliever expecting an experience similar to consuming kratom are at risk, said Dr. Mason Turner, president-elect of the California Society of Addiction Medicine.
“I have a couple of patients that I work with who use 7-OH for chronic pain management, not realizing the potential of the medication, and then developed an opioid use disorder,” Turner said. “I think in that case it was very clear they were seeking it for the chronic pain, not to get high, not to have some kind of experience, but really to reduce their pain.”
About two decades ago, Turner said, the healthcare industry started acknowledging the limits and risks of prescribing opioids for chronic pain. Some doctors pulled back on prescriptions, recognizing the potential for abuse.
That led some patients to find alternative solutions, he said.
“Maybe they don’t get a good benefit, or maybe the benefit from some of the other treatments is not as robust as what they got from opioids,” Turner said. “So they seek out some of these illicit products … or they look for kratom or 7-OH to be able to mitigate the pain.”
Turner said he supports further research into kratom and regulation because “it could be worth exploring as a treatment for chronic pain.”
On June 1, the National Institutes of Health announced that researchers from the University of Florida would begin the first phase of clinical trials on kratom to evaluate it as a potential treatment for opioid addiction. The research would be done with the FDA’s approval, according to officials.
“This … is a major step toward expanding treatment options for the millions of Americans struggling with opioid use disorder, which has contributed to historically high overdose mortality rates,” said Dr. Nora Volkow, director of NIH’s National Institute on Drug Abuse, in a statement.
Interest in kratom surged in the last couple of years as users have reported consuming the compound in the form of a pill, powder or tea to treat various ailments. A John Hopkins survey conducted in 2020 reported that 91% of respondents used kratom to treat chronic pain, 67% to treat anxiety, 64% for depression and 41% to treat opioid dependence.
A more recent study by the University of Michigan and Texas State University found that more than 5 million people in the U.S., including more than 100,000 children ages 12 to 17, have used kratom, the compound experts say is growing in popularity with young adults.
In the study, which analyzed data from the National Survey on Drug Use and Health collected between 2021 and 2024, researchers say that despite numerous state-level bans on kratom across the nation, its use is at an all-time high and is increasing.
People between the ages of 21 and 34 said they used kratom at least once and 1% said they used it in the last year. The share of children ages 12 and older who said they had used kratom increased from 1.6% in 2021 to 1.9% in 2024.
The FDA has stated that neither kratom nor 7-OH are approved as drug products, dietary supplements or food additives, but that hasn’t stopped storefronts and companies from selling them as such.
Up until November you could find kratom and 7-OH products in smoke shops and specialty stores in California, but that has stopped.
“Until kratom and its pharmacologically active key ingredients mitragynine and 7-OH are approved for use, they will remain classified as adulterants in drugs, dietary supplements and foods,” the California Department of Public Health told The Times via email.
Kratom “Feel Free Classic” liquid products are displayed at a smoke shop in Los Angeles in 2024 before they were banned.
(Michael Blackshire / Los Angeles Times)
In May, the California Department of Public Health and Atty. Gen. Rob Bonta filed a complaint against Ashlynn Marketing Group Inc., accusing the company of repeatedly flouting the state’s regulations on kratom products.
The filing, submitted in the San Diego County Superior Court, seeks a judge’s order to condemn and destroy the embargoed kratom products, halt ongoing unlawful manufacturing and impose civil penalties.
The California Department of Public Health “is pursuing legal action because Ashlynn’s continued manufacture and sale of these products pose a clear and preventable public‑health risk and violates state and federal law,” said Dr. Erica Pan, the department’s director and state public health officer. “7-OH and kratom-derived products have been associated with addiction, serious health harms, overdose and death.”
The state is alleging its inspectors visited Ashlynn Marketing Group’s facility in Santee in May 2025 and found kratom powders, capsules, liquids and chewable tablets being manufactured and held for sale.
During the visit, inspectors issued an embargo to prohibit the sale and distribution of all kratom-related materials on-site, according to the complaint.
Public health inspectors conducted follow-up visits at the facility in October and April, “collecting evidence at both inspections that indicated embargoed kratom products had been moved, tampered with and repackaged,” according to public health officials.
“In addition, investigators observed evidence of continued manufacturing and distribution of kratom materials,” officials said. “The firm’s owner continues to manufacture kratom products and ships orders weekly.”
To date, the California Department of Public Health has seized more than $5 million worth of kratom and 7-OH products, a spokesperson for the department told The Times.
California and Los Angeles County are considering whether to tighten regulations or ban the compounds altogether.
Science
Scientists find a whale graveyard in the Indian Ocean that’s millions of years old
NEW YORK — Scientists have unearthed communities of marine life — including jellyfish, tubeworms and brittle stars — thriving on a whale graveyard that is millions of years old.
These graveyards form when whale carcasses fall to the sea floor, becoming a sustaining snack for nearby critters. This one, located up to 23,000 feet below the surface of the southeastern Indian Ocean, spans the largest area and is so far the deepest and oldest found.
A whale’s sheer size and the unique chemistry of its bones are the keys to forming these unique underwater neighborhoods, said Xikun Song, a biologist with the Chinese Academy of Sciences’ Institute of Deep-sea Science and Engineering.
“At the same time, the very nature of the deep ocean makes these sites exceptionally difficult for scientists to locate,” Song, who was involved with the latest find, wrote in an email.
Researchers explored the remains during multiple deep-sea submersible trips in 2023, collecting samples and mapping the extent of the necropolis. They found five carcass sites and fossils, including skulls belonging to beaked and baleen whales. The oldest bones date back 5.3 million years.
Feeding and living on the carcasses were myriad creatures, large and small, including sea cucumbers, squat lobsters and saltwater clams. Many of them are likely species that have never been documented, according to findings published Wednesday in the journal Nature.
“The potential number of specimens is just astounding,” said paleontologist Stephen Godfrey with the Calvert Marine Museum in Maryland, who wasn’t involved in the research.
Many factors likely conspired to preserve the bones for millions of years, according to the study authors. They’re dense enough to outlast attacks from bone-eating worms, and located deep enough in the ocean to avoid getting buried by dust and loose particles. The bones also were coated with a light layer of minerals from the surrounding seawater, which may have prevented them from degrading.
Why did so many whales die here? Maybe they were already living in the area and died of natural causes. A few could have perished from exhaustion or illness caused by deep-sea diving. The area’s shape, akin to the letter V, could also have funneled the remains to their resting spot, the authors wrote.
Such discoveries are important because they clue scientists into the vibrant communities that find a way to live even in remote, hard-to-reach environments.
Studying the whale graveyards “is important for understanding how life can adapt to such extreme conditions, not only due to the lack of light and oxygen but also to the incredibly high pressure,” said study co-author and paleontologist Giovanni Bianucci with the University of Pisa in Italy in an email.
Ramakrishnan writes for The Associated Press.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation.
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