Counting Demographics: Patient Trust in the Era of Deportation

With the entry of U.S. immigration enforcement into health facilities and health records since January 2025, timely questions have arisen over data justice and patient trust in health care. Although guidelines for the collection and analysis of demographic data promote statistical nuance and data disaggregation, not all patients will want to provide details about their personal information and may interpret these questions as especially intrusive or risky in the current sociopolitical context. Reckoning with the motives that cause patients to mask potentially sensitive information is a necessary path forward for health systems and an actionable way for health care spaces to become as welcoming and inclusive of immigrants as possible. Health care leaders and the systems they represent can proactively approach patient nondisclosure with care by providing abundantly transparent communication over the use of personal information, avoiding documentation of certain questions-like immigration status-altogether, and affirming nonresponse as a valid and welcome response.