I was not thinking of public health when the presidential election of 2012—the first in which I was eligible to vote—was around the corner. I also was not yet connecting the dots around me when it came to public health, and it would be a few years before I was to come across the concept of “health in all policies” in an academic textbook.
At the time I was in the West Bank of Palestine, starting my second year of undergraduate studies at Birzeit University. I remember listening to one of my classmates’ excitement as she went through the motions of casting her first absentee ballot. The rest of us American citizens were not too thrilled with the election season or outcome possibilities. All of us, including the classmate, experienced firsthand, the constant disappointment that came along with the Obama administration not being different in its stance on Palestine and the Palestinians. That is what mattered to us, living in the West Bank surrounded by ever-expanding settlements and barriers.
Late last year, I found myself reflecting on the sentiment of that period of time whilst in conversation with an acquaintance about the upcoming elections. She was curious about the take of Arab and Muslim communities on voting, since those demographics were not as familiar to her as were others. I couldn’t give her exact numbers, and I find that I still can’t, but I shared with her a common sentiment about voting that the communities I am a part of hold. With the United States’ constant meddling in Arab and Muslim countries, voting becomes a complicated right for Arab and Muslim Americans. One the one hand, there are local, regional and national issues to consider; on the other hand, there are foreign policies and relations to consider. Heading to the polls to vote this year is no different, but I still have a plan to exercise the right to vote this year.
“But [this time], we’re voting for public health,” she remarked.
Indeed, this year put the ‘public’ back in public health. Susan Jaffe’s report in The Lancet on public health and the U.S. elections outlines where each presidential candidate stands on the contemporary public health issues: Covid-19, women’s health, gun violence, and the opioid epidemic. From the pandemic to police violence and racism, the impact of these issues on the health of the public, specifically minorities, cannot be ignored. Data around the health of Arab and Muslim communities in America is limited for a number of reasons, such as not being counted in the census as their own categories and the conflation of Arab and Muslim identities, so these communities are rarely mentioned in the mainstream health conversations of the country. Despite these limitations, there are a number of studies that speak to the health of Arab Americans . Though the prevalence of the health issues that Arab Americans face is different than other ethnic groups across the U.S., the health issues themselves are not and include chronic diseases, such as diabetes and cardiovascular disease, as well as mental illness. Policies targeting Arab and Muslim communities in the U.S., as outlined by Dr. James Zogbi, have health consequences even if the policies are not brought to light with a public health lens.
As an Arab Muslim American public health professional, I have yet to see a presidential candidate that is working towards health in all policies, including education and housing and an agenda for global health that acknowledges the impact of wars and conflict, which are directly or indirectly funded by the U.S. Certainly, Arab and Muslim voters took note when the Trump administration pulled funding in last May from the World Health Organization (WHO) and withdrew all Palestinian aid in 2019, harming Palestinians in the West Bank and Gaza, further impacting global health.
I have been thinking about my acquaintance’s sentiment on voting for public health. Public health is not impacted by a single issue, and it does not impact everyone in the same way. I think that as a country, we have a long way to go before we get to the point where health is dutifully considered in all policies, despite the reckoning with the country’s history of racism and the calls for social justice seen this year.
We must demand to get to a point where health is not a matter of debate, where universal health care is the default and not a “radical idea”. Making universal healthcare the default means that as a nation, we have agreed that public health extends beyond the field and that we have understood that the nation would be a step closer to eliminating health disparities; that no matter what our background is, Arab, Muslim or anything in between, we are global citizens, and the impact of the policies we advocate and vote for reaches beyond our doorsteps into American neighborhoods.
Hasheemah Afaneh is a writer and public health professional based in New Orleans. She has written for the Fair Observer, HuffPost, This Week in Palestine and others, with work forthcoming in Rusted Radishes and International Poetry Review.