Donald Trump has vowed to deport millions of immigrants if he is elected to a second term, claiming that, among other things, foreign-born workers take jobs from others. His running mate JD Vance has echoed those anti-immigrant views.

Researchers, however, generally agree that massive deportations would hurt the U.S. economy, perhaps even triggering a recession.

Social scientists and analysts tend to concur that immigration — both documented and undocumented — spurs economic growth. But it is almost impossible to calculate directly how much immigrants contribute to the economy. That’s because we don’t know the earnings of every immigrant worker in the United States.

We do, however, have a good idea of how much they send back to their home countries – more than US$81 billion in 2022, according to the World Bank. And we can use this figure to indirectly calculate the total economic value of immigrant labor in the U.S.

Economic contributions are likely underestimated

I conducted a study with researchers at the Center for Latin American and Latino Studies and the Immigration Lab at American University to quantify how much immigrants contribute to the U.S. economy based on their remittances, or money sent back home.

Several studies indicate that remittances constitute 17.5% of immigrants’ income.

Given that, we estimate that the immigrants who remitted in 2022 had take-home wages of over $466 billion. Assuming their take-home wages are around 21% of the economic value of what they produce for the businesses they work for – like workers in similar entry-level jobs in restaurants and construction – then immigrants added a total of $2.2 trillion to the U.S. economy yearly.

That is about 8% of the gross domestic product of the United States and close to the entire GDP of Canada in 2022 – the world’s ninth-largest economy.

Immigration strengthens the US

Beyond its sheer value, this figure tells us something important about immigrant labor: The main beneficiaries of immigrant labor are the U.S. economy and society.

The $81 billion that immigrants sent home in 2022 is a tiny fraction of their total economic value of $2.2 trillion. The vast majority of immigrant wages and productivity – 96% – stayed in the United States.

Remittances from the U.S. represent a substantial income source for the people who receive them. But they do not represent a siphoning of U.S. dollars, as Trump has implied when he called remittances “welfare” for people in other countries and suggested taxing them to pay for the construction of a border wall.

The economic contributions of U.S. immigrants are likely to be even more substantial than what we calculate.

For one thing, the World Bank’s estimate of immigrant remittances is probably an undercount, since many immigrants send money abroad with people traveling to their home countries.

In prior research, my colleagues and I have also found that some groups of immigrants are less likely to remit than others.

One is white-collar professionals – immigrants with careers in banking, science, technology and education, for example. Unlike many undocumented immigrants, white-collar professionals typically have visas that allow them to bring their families with them, so they do not need to send money abroad to cover their household expenses back home.

Immigrants who have been working in the country for decades and have more family in the country also tend to send remittances less often.

Both of these groups have higher earnings, and their specialized contributions are not included in our $2.2 trillion estimate.

Additionally, our estimates do not account for the economic growth stimulated by immigrants when they spend money in the U.S., creating demand, generating jobs and starting businesses that hire immigrants and locals.

For example, we calculate the contributions of Salvadoran immigrants and their children alone added roughly $223 billion to the U.S. economy in 2023. That’s about 1% of the country’s entire GDP.

Considering that the U.S. economy grew by about 2% in 2022 and 2023, that’s a substantial sum.

These figures are a reminder that the financial success of the U.S. relies on immigrants and their labor.

Ernesto Castañeda, Professor, American University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A simple difference in the genetic code – two X chromosomes versus one X chromosome and one Y chromosome – can lead to major differences in heart disease. It turns out that these genetic differences influence more than just sex organs and sex assigned at birth – they fundamentally alter the way cardiovascular disease develops and presents.

While sex influences the mechanisms behind how cardiovascular disease develops, gender plays a role in how health care providers recognize and manage it. Sex refers to biological characteristics such as genetics, hormones, anatomy and physiology, while gender refers to social, psychological and cultural constructs. Women are more likely to die after a first heart attack or stroke than men. Women are also more likely to have additional or different heart attack symptoms that go beyond chest pain, such as nausea, jaw pain, dizziness and fatigue. It is often difficult to fully disentangle the influences of sex on cardiovascular disease outcomes versus the influences of gender.

While women who haven’t entered menopause have a lower risk of cardiovascular disease than men, their cardiovascular risk accelerates dramatically after menopause. In addition, if a woman has Type 2 diabetes, her risk of heart attack accelerates to be equivalent to that of men, even if the woman with diabetes has not yet gone through menopause. Further data is needed to better understand differences in cardiovascular disease risk among nonbinary and transgender patients.

Despite these differences, one key thing is the same: Heart attack, stroke and other forms of cardiovascular disease are the leading cause of death for all people, regardless of sex or gender.

We are researchers who study women’s health and the way cardiovascular disease develops and presents differently in women and men. Our work has identified a crucial need to update medical guidelines with more sex-specific approaches to diagnosis and treatment in order to improve health outcomes for all.

Gender differences in heart disease

The reasons behind sex and gender differences in cardiovascular disease are not completely known. Nor are the distinct biological effects of sex, such as hormonal and genetic factors, versus gender, such as social, cultural and psychological factors, clearly differentiated.

What researchers do know is that the accumulated evidence of what good heart care should look like for women compared with men has as many holes in it as Swiss cheese. Medical evidence for treating cardiovascular disease often comes from trials that excluded women, since women for the most part weren’t included in scientific research until the NIH Revitalization Act of 1993. For example, current guidelines to treat cardiovascular risk factors such as high blood pressure are based primarily on data from men. This is despite evidence that differences in the way that cardiovascular disease develops leads women to experience cardiovascular disease differently.

In addition to sex differences, implicit gender biases among providers and gendered social norms among patients lead clinicians to underestimate the risk of cardiac events in women compared with men. These biases play a role in why women are more likely than men to die from cardiac events. For example, for patients with symptoms that are borderline for cardiovascular disease, clinicians tend to be more aggressive in ordering artery imaging for men than for women. One study linked this tendency to order less aggressive tests for women partly to a gender bias that men are more open than women to taking risks.

In a study of about 3,000 patients with a recent heart attack, women were less likely than men to think that their heart attack symptoms were due to a heart condition. Additionally, most women do not know that cardiovascular disease is the No. 1 cause of death among women. Overall, women’s misperceptions of their own risk may hold them back from getting a doctor to check out possible symptoms of a heart attack or stroke.

These issues are further exacerbated for women of color. Lack of access to health care and additional challenges drive health disparities among underrepresented racial and ethnic minority populations.

Sex difference in heart disease

Cardiovascular disease physically looks different for women and men, specifically in the plaque buildup on artery walls that contributes to illness.

Women have fewer cholesterol crystals and fewer calcium deposits in their artery plaque than men do. Physiological differences in the smallest blood vessels feeding the heart also play a role in cardiovascular outcomes.

Women are more likely than men to have cardiovascular disease that presents as multiple narrowed arteries that are not fully “clogged,” resulting in chest pain because blood flow can’t ratchet up enough to meet higher oxygen demands with exercise, much like a low-flow showerhead. When chest pain presents in this way, doctors call this condition ischemia and no obstructive coronary arteries. In comparison, men are more likely to have a “clogged” artery in a concentrated area that can be opened up with a stent or with cardiac bypass surgery. Options for multiple narrowed arteries have lagged behind treatment options for typical “clogged” arteries, which puts women at a disadvantage.

In addition, in the early stages of a heart attack, the levels of blood markers that indicate damage to the heart are lower in women than in men. This can lead to more missed diagnoses of coronary artery disease in women compared with men.

The reasons for these differences are not fully clear. Some potential factors include differences in artery plaque composition that make men’s plaque more likely to rupture or burst and women’s plaque more likely to erode. Women also have lower heart mass and smaller arteries than men even after taking body size into consideration.

Reducing sex disparities

Too often, women with symptoms of cardiovascular disease are sent away from doctor’s offices because of gender biases that “women don’t get heart disease.”

Considering how symptoms of cardiovascular disease vary by sex and gender could help doctors better care for all patients.

One way that the rubber is meeting the road is with regard to better approaches to diagnosing heart attacks for women and men. Specifically, when diagnosing heart attacks, using sex-specific cutoffs for blood tests that measure heart damage – called high-sensitivity troponin tests – can improve their accuracy, decreasing missed diagnoses, or false negatives, in women while also decreasing overdiagnoses, or false positives, in men.

Our research laboratory’s leaders, collaborators and other internationally recognized research colleagues – some of whom partner with our Ludeman Family Center for Women’s Health Research on the University of Colorado Anschutz Medical Campus – will continue this important work to close this gap between the sexes in health care. Research in this field is critical to shine a light on ways clinicians can better address sex-specific symptoms and to bring forward more tailored treatments.

The Biden administration’s recent executive order to advance women’s health research is paving the way for research to go beyond just understanding what causes sex differences in cardiovascular disease. Developing and testing right-sized approaches to care for each patient can help achieve better health for all.

Amy Huebschmann, Professor of Medicine, University of Colorado Anschutz Medical Campus and Judith Regensteiner, Professor of Medicine, University of Colorado Anschutz Medical Campus

This article is republished from The Conversation under a Creative Commons license. Read the original article.