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Monday, September 02, 2024

Trump TV Ad Repeats False ‘Border Czar,’ Illegal Immigration Claims

Trump TV Ad Repeats False ‘Border Czar,’ Illegal Immigration Claims

“Este artículo estará disponible en español en El Tiempo Latino.

Former President Donald Trump’s campaign has launched a new general election ad that falsely labels Vice President Kamala Harris the “border czar” and falsely suggests that 10 million people illegally crossed the southern border on her watch and are still “here.”

As we’ve written before, Harris was specifically tasked with leading efforts to address the root causes of migration from three countries in Central America. She was not put in charge of U.S. border security, as the “border czar” title implies. That is the responsibility of the secretary of the Department of Homeland Security.

Also, during the Biden-Harris administration, there have been nearly 7 million apprehensions of those trying to cross the southern border illegally through June, according to the most recent figures available from U.S. Customs and Border Protection. Another 1.1 million people arrived at legal ports of entry without authorization to enter the U.S. There may have been nearly 2 million who illegally crossed and were not caught.

But data on the initial action taken at the border, available only through March, shows that in about 3 million cases, the encountered individuals were either quickly removed or denied entry.

The Trump campaign released the 30-second ad, titled “I Don’t Understand,” on July 30 and said it “will run across six battleground states.”

Not the ‘Border Czar’

The ad begins with a video of Harris dancing while a narrator says, “This is America’s border czar and she’s failed us.” But the claim that Harris is the “border czar” is false. 

Not long after taking office in 2021, President Joe Biden appointed Harris to head up the “Root Causes Strategy,” an effort to “improve security, governance, human rights, and economic conditions” in Central American countries. The strategy included a number of actions designed to “address the root causes of migration” from El Salvador, Guatemala and Honduras, specifically. The synopsis released by the White House said that the strategy would focus on tackling economic insecurity and inequality, confronting corruption, and reducing violence, among other things.

Biden did not put Harris in charge of issues at the border. (Another Trump adclaims that “Biden made Kamala Harris border czar to fix immigration.”)

Harris addressed her role in a June 2021 NBC News interview with Lester Holt in Guatemala. A clip from that interview is featured in the campaign ad embedded above.

“Well, Lester, here’s the thing,” Harris began, as she explained why she had saidthat migrants should not come to the U.S. illegally. “I’ve been working on this issue for a very long time, and the kind of violence and danger that is associated with that trek, especially when we are talking about from Guatemala through Mexico to the United States. It’s extremely dangerous, and the reason that I am in Guatemala is to address the reasons people leave home, flee. … They want to stay. They don’t want to leave, but they need opportunity, they need assistance, they need support and we have the ability to give them that.”

Later in the interview, when Holt pressed her about not having gone to the U.S.-Mexico border by that point in her vice presidency, Harris said that she believed the border and the underlying reasons for illegal immigration are both important.

“I care about what’s happening at the border,” she said. “I’m in Guatemala, because my focus is dealing with the root causes of migration. There may be some who think that that is not important, but it is my firm belief that if we care about what’s happening at the border, we’d better care about the root causes and address them. And so that’s what I’m doing.”

About two weeks after that interview, Harris and Homeland Security Secretary Alejandro Mayorkas did travel to part of the border in El Paso, Texas. In remarksmade at a press conference during the trip, Mayorkas talked about the administration’s plan to address a surge in migration and who would take on what role.

“The vice president is leading our nation’s effort to tackle the root causes of migration — why people leave their home in the first place,” Mayorkas said. “I and my colleagues in the Cabinet have been directed to execute the rest of the plan: to build safe and legal pathways for people who qualify for humanitarian relief under the laws our Congress has passed; to rebuild our country’s asylum system that was dismantled under the prior administration; in an orderly and just way, to remove those whose claims for relief do not qualify.”

He went on to say that he and DHS had the “responsibility to secure the border.”

Border Crossings

The ad also gives the false impression that, during the Biden-Harris administration, 10 million people entered the U.S. illegally and remain in the country.

A graphic on screen reads, “over 10 million illegal border crossings.” Meanwhile, the ad’s narrator says, “under Harris, over 10 million illegally here.”

But all the people who were encountered at the border are not still here; millions were removed or denied entry, almost immediately.

From February 2021 to June 2024, there were nearly 7 million apprehensions of people crossing the border illegally, according to CBP data. There were another 1.1 million instances of individuals who showed up at a legal port of entry but were “inadmissible,” meaning they did not have legal permission to enter the country. Also, based on an average annual apprehension rate of 78%, according to DHS, there were an estimated nearly 2 million “gotaways” who illegally entered the country and avoided being detected by authorities.

Adding those all together gets to 10 million border crossings, although each one does not necessarily represent a different person because some people may have been encountered more than once due to repeated attempts to gain entry into the country.

However, for the people encountered at the border, many of them did not get to stay. 

We have comprehensive data on what happened after initial border evaluations only through March. For the nearly three-year period of February 2021 through March 2024, there were about 3 million removals or repatriations by CBP, according to monthly figures from the Office of Homeland Security Statistics.

Another 3.3 million were released into the country with notices to appear in immigration court or report to Immigration and Customs Enforcement in the future, or other classifications, such as parole. There were also 414,900 transfers to the Department of Health and Human Services, which is responsible for unaccompanied children who cross the border without adult family members or legal guardians, and about 910,000 transfers to ICE. The transfers to ICE include those who are then booked into ICE custody, enrolled in “alternatives to detention” (which include technological monitoring) or released by ICE. So, we don’t know how many of those were released into the country with a court notice and how many are still in ICE custody.

Also, these figures are for the initial dispositions of migrants encountered at the border, as we’ve explained before. Some of the people released into the country still may be removed later, if they do not qualify for asylum or another form of protection from removal. That would further subtract from the “10 million” the ad falsely suggests have stayed in the country.

Fentanyl and ISIS

The ad also says that there have been 250,000 deaths from fentanyl “on Harris’s watch,” suggesting that those deaths are connected to illegal immigration. Then the ad goes on to say, “ISIS now here,” citing a news story about men who entered the U.S. through the southern border and were later arrested because they may be connected to the Islamic State terrorist group.

First, there is not an exact count of deaths from fentanyl, a synthetic opioid that is lethal in small doses, a spokesperson for the National Center for Health Statistics told us in an email.

The NCHS does report overdose deaths from synthetic opioids other than methadone, a category that includes deaths due to fentanyl or fentanyl analogs. In 2021 and 2022, there were a combined 144,439 overdose deaths from synthetic opioids other than methadone, according to finalized NCHS data based on death certificates for U.S. residents. There were an additional 74,702 estimated deaths from the use of those drugs in 2023, according to NCHS provisional data released in May.

Although not official, that’s a total of 219,141 overdose deaths, which could exceed 250,000 once the final figures for 2023 and 2024 are known.

Overdose deaths from non-methadone synthetic opioids have been rising for several years, including during the Trump administration. The estimated deaths for 2021-2023 are about 44% higher than the 152,676 deaths over Trump’s four years as president, and the total under Trump had increased about 306% from the 37,642 deaths during Barack Obama’s last four years as president.

Furthermore, as we’ve written, the vast majority of fentanyl is smuggled into the U.S. by American citizens coming through legal ports of entry — not people illegally crossing the border between those ports.

As for ISIS being “here,” according to the ad, that’s based on a June 14 CNN article about eight Tajikistan nationals who entered the U.S. through the southern border seeking asylum. They were screened by border officials and allowed into the country, but they were later arrested for potentially having ties with the terrorist group.

CNN reported: “Though there is no hard evidence indicating they were sent to the US as part of a terror plot, at least some of the Tajik nationals had expressed extremist rhetoric in their communications, either on social media or in direct private communications that US intelligence was able to monitor, three officials said.”

The arrests “heightened concerns among national security officials that a dangerous affiliate of the now-splintered terror group could potentially carry out an attack on US soil,” CNN said.

But the story noted that the men would be held in federal custody on immigration charges until they are deported after a counterterrorism investigation is completed.

It’s not clear if all eight men entered the country illegally, as at least one of them reportedly used the CBP One app, which launched in January 2023 to accept appointments for migrants who are in Mexico and want to request asylum or parole in the U.S.


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Sunday, September 01, 2024

LIVE: Top Psych Gives URGENT UPDATE on Trump MENTAL SPIRAL | The Weekend...

Harris doesn't get convention bounce, but widens gap with women: POLL

Harris doesn't get convention bounce, but widens gap with women: POLL

“Kamala Harris has maintained her advantages over Donald Trump on personal attributes and broadly is seen as running the better presidential campaign in a new ABC News/Ipsos poll, with comparative doubts about Trump's campaign in his base and the political center alike.

The race between them remains close, with no overall bounce in support for Harris out of her nominating convention, albeit with a wider gender gap. Trump, too, was bounce-free after his convention in July, indicating the locked-in nature of their highly polarized contest as it enters its final two months.

Democratic presidential nominee and U.S. Vice President Kamala Harris takes the stage on Day 4...

Kevin Lamarque/Reuters

Results show Harris' competitiveness as a walk-on candidate. Fifty-six percent of Americans in the national survey say she has done an excellent or good job running her campaign, compared with 41% who say the same for Trump. Most, instead, rate Trump's campaign negatively.

Notably, 93% of Democrats and 56% of independents rate Harris' campaign positively, as do 24% of Republicans in this poll, produced for ABC by Langer Research Associates with fieldwork by Ipsos. Fewer across groups see Trump's campaign positively -- 79% of Republicans, 38% of independents and 13% of Democrats.

See PDF for full results.

Campaign Ratings

ABC News/Ipsos poll

Harris' supporters are 14 percentage points more apt than Trump's to be satisfied with the matchup, similar to pre-convention results. And the public by a 6-point margin, 43%-37%, picks Harris to win the ABC News presidential debateon Sept. 10.

Here, too, Harris shows more strength in her base -- 86% of Democrats expect her to win the debate, while 79% of Republicans expect Trump to win it. In the political center, independents pick Harris by 7 points.

Harris also leads in the level of angst among her supporters. Seventy-five percent of them say it would be "a crisis" if Trump were elected, a sentiment that could motivate turnout. Fewer Trump supporters, but still 67%, see a Harris win as a crisis.

As to running mates, Minnesota Gov. Tim Walz continues to win a warmer welcome than Ohio Sen. JD Vance. Americans divide essentially evenly, 49%-50%, in confidence that Walz would be qualified to take over as president, while 57% aren't confident that Vance is qualified. And Walz is seen favorably by 42%-31%, while Vance is underwater in favorability, 32%-44%. About a quarter are unready to express an opinion of either.

At the same time, Trump continues to lead on the top concerns in the race, trust to handle the economy in general and inflation in particular, both by 8 points, and by 9 points on the immigration situation at the U.S.-Mexico border, albeit a lower-rated issue in importance in previous data. Trump also benefits from the fact that 46% call Harris too liberal -- though, on the other hand, 43% call him too conservative.

The race

All in all, the horse race is essentially the same now as it was before the Democratic convention -- 50%-46%, Harris-Trump, among all adults and registered voters alike, and 52%-46% among likely voters. That's a slight Harris lead in the first case and a full lead among likely voters. (Results exclude those who say they wouldn't vote.)

2024 Vote Preference

ABC News/Ipsos poll

While the overall numbers are essentially unchanged from before the convention, the gender gap has widened. Harris leads by 13 points among women, 54%-41%, while it's Trump +5 points among men, 51%-46%, for an 18-point gap. (The Trump-Harris difference among men is not statistically significant.) Pre-convention, Harris had been a slight +6 points among women and a non-significant +3 among men, a 3-point gap. The gender gap now is more in line with recent elections -- an average of 19 points in exit polls since 1996.

Much of the moves among women and men have occurred among white people. White women have gone from +13 points for Trump pre-convention to a virtual dead heat (Trump +2) now; white men, from +13 points for Trump before the convention to +21 points now.

Vote Preference by Gender

ABC News/Ipsos and ABC News/Washington Post/Ipsos polls

With Robert F. Kennedy Jr. suspending his campaign and backing Trump, the poll finds similar results when the remaining independent and minor-party candidates are included: overall, another slight +4 points for Harris among all adults (49%-45%) and +5 points among both registered voters (50%-45%) and likely voters (51%-46%).

Any help for Trump from Kennedy is scant. Seventy-nine percent overall say Kennedy's support makes no difference in their choice. Twelve percent say it makes them more likely to support Trump -- but nearly all who say so are Republicans and GOP-leaning independents, so apt to be Trump supporters in the first place. Nine percent overall -- nearly all Democrats and Democratic leaners -- say Kennedy's endorsement leaves them less likely to support Trump.

In terms of intensity, 64% of Harris' supporters back her strongly; one of the few measures to shift, this is up slightly from 60% before the convention. Sixty percent of Trump's support is strong, unchanged. For comparison, President Joe Biden, in July, had just 34% strong support.

Most vote preferences look locked in. Among Americans who don't currently support Harris, 86% rule out doing so, and among people who don't currently support Trump, 89% wouldn't consider him. Among likely voters, these rise to 96% and 97%, respectively. As such, getting out the vote likely will be more fruitful than trying to change people's minds.

Attributes

Compared to pre-convention results, Harris has retained her lead on personal attributes. These include favorability -- 46% see Harris favorably as a person versus 33% for Trump -- and (more closely) being seen as qualified for the office, 53% for Harris, 47% for Trump.

Favorability and Qualifications

ABC News/Ipsos poll

In a list of other attributes, Harris leads Trump by a broad 32 points on having the physical health for the job (57%-25%), 18 points on honesty and trustworthiness (43%-25%), 10 points on mental acuity (47%-37%), 8 points on understanding the problems of people like you (41%-33%) and 7 points on representing your personal values (41%-34%). All these closely reflect pre-convention results.

On some of these, again, partisan results are striking. While 91% of Democrats see Harris favorably as a person, 72% of Republicans say the same about Trump. Among independents, 44% see Harris favorably versus 28% who see Trump favorably.

In another example of a partisan differential, 88% of Democrats say that being honest and trustworthy applies more to Harris than to Trump. Many fewer Republicans, 61%, say it applies more to Trump than to Harris. (Instead, 30% of Republicans say it applies to neither.) Indeed, in each head-to-head test of personal attributes in this survey, Harris both leads among independents and does better among Democrats than Trump does among Republicans.

Top issues

Partisanship works the other way on the two top issues. Ninety percent of Republicans trust Trump more on the economy, while fewer Democrats, 82%, trust Harris more, and independents pick Trump by 14 points. On inflation, similarly, 88% of Republicans pick Trump, while fewer Democrats prefer Harris, 79%, and independents again side with Trump by 14 points.

On immigration, as well, 90% of Republicans prefer Trump, while fewer Democrats, 79%, trust Harris. Independents prefer Trump by 16 points. Then again, Harris does better in her base and with independents on a variety of other issues, most widely on handling abortion and race relations.

Trust more to handle...

ABC News/Ipsos poll

Among all adults, out of 11 issues tested in this survey, there are four on which Trump has the lead -- in addition to the economy and inflation, these are immigration and handling the Israel/Hamas war -- and six on which Harris leads. They're tied in trust to handle one other, crime and safety, an issue on which Trump had led Biden by 7 points in July.

That said, not all issues are created equal; to the extent the focus is on the economy, Trump benefits -- not a surprise given the 40-year high in inflation that occurred on Biden's watch.

Dissatisfaction with both candidates

Views on the choice of candidates are better than in July, but far from ideal. The public by 53%-45% is more apt to be dissatisfied than satisfied with a Harris-Trump contest. But that compares with 71%-28% in July, with Biden in the race. The difference reflects more Democrats and Democratic-leaning independents on board with Harris than with Biden.

Dissatisfaction shows up in preferences on issues and attributes as well. Anywhere from 15% to 26% don't trust either candidate to handle the issues tested in this survey (peaking on the Israel/Hamas war). And 15% to 30% say each item on the attributes list doesn't apply to either candidate; that peaks in the number who see neither as honest and trustworthy.

Applies to neither candidate...

ABC News/Ipsos poll

That said, some of that dissatisfaction reflects the views of people who are less likely to vote.

Registered voters on average are 5 points less apt than all adults to pick neither candidate on issues and attributes alike, and likely voters on average are 10 points less likely to do so.

Methodology

This ABC News/Ipsos poll was conducted online via the probability-based Ipsos KnowledgePanel® Aug. 23-27, 2024, in English and Spanish, among a random national sample of 2,496 adults. Partisan divisions are 29%-29%-30%, Democrats-Republicans-independents. Results have a margin of sampling errorof 2 percentage points, including the design effect, for the full sample. Sampling error is not the only source of differences in polls.

The survey was produced for ABC News by Langer Research Associates, with sampling and data collection by Ipsos. See details on ABC News' survey methodology here.“

Kamala Harris Is Breaking Barriers. She Just Isn’t Talking About It.

Kamala Harris Is Breaking Barriers. She Just Isn’t Talking About It.

Illustration by The New York Times; source photo by Damon Winter/The New York Times

By Jessica Bennett

“Ms. Bennett is a contributing editor in Opinion, where she writes about gender, politics and personalities. She reported from the Democratic National Convention.

When Kamala Harris took the stage in Chicago last week, she spoke of her “trailblazer” mother and her encouraging father — “Don’t let anything stop you.” She told of how the sexual abuse of her best friend led her to become a prosecutor. She encouraged people to imagine abortion rights being restored in a Harris presidency. What she did not do, as she described her “unlikely journey,” was state the obvious — and that silence spoke volumes.

As the first Black woman and first South Asian to receive a major party nomination, she was all but expected to talk about her candidacy as a historic first. She could have easily tipped her hat to the galvanizing power of “representation” or referred to the “highest, hardest glass ceiling” that Hillary Clinton had tried so hard to shatter. Some enthusiastic delegates had dressed in suffragist white, but she was not among them. She wore a dark navy suit. That color, too, spoke volumes.

We’re only beginning to grapple with the audacity of what Kamala Harris is doing: She’s trying to take identity politics out of presidential politics. Don’t get me wrong, Ms. Harris is savvy enough to know how important identity is in America today. But if identity is in, gender and racial politics are out. As she put it on CNN on Thursday night, when asked during her first interview as the Democratic nominee to respond to Donald Trump’s attacks on her identity: “Same old tired playbook — next question.”

She aspires to be the first post-gender POTUS. So many American voters loathe being asked to assess their candidates through the lens of gender and race, and they cringe at the performative nature of identity politics — including, yes, Mrs. Clinton and that ever-present glass ceiling, as well as the argument that her supporters were “voting with their vaginas” if they dared to feel inspired by it.

The metaphor may have yielded feel-good empowerment for a while — and lots of clever merch — but we all know the outcome. And how many times can you declare “The future is female,” tattered sign in hand, before it starts to get awkward?

Ms. Harris is a woman, and a Black woman, and a woman of Jamaican and South Asian descent, and the first woman to be vice president. But we know all that. Other people can talk about history; she’ll be too busy making it.

Gender and race are plenty present in this election, of course — and not just in the form of Mr. Trump’s fixation with it. Pollsters predict this will, in fact, be the most gendered election in American history, with young women and men increasingly polarized.

But that doesn’t mean Ms. Harris is about to let herself be sucked into all of that, and she’s wise not to. As Nancy Pelosi put it recently, speaking at an event with former Obama adviser David Axelrod at the University of Chicago: Ms. Harris becoming the first female president “brings tears to my eyes, but not votes to the ballot box.”

“It’s icing on the cake. It ain’t the cake,” she added.

There was a funny moment that crystallized things for me on the first night of the convention: As Mrs. Clinton wrapped up her speech and left the stage, a familiar chorus began to play over the loudspeakers: Rachel Platten’s “Fight Song.”

This was the ubiquitous anthem of Mrs. Clinton’s 2016 campaign — a cringingly earnest, one-hit-wonder that seemed to embody an over-the-top “you go, girl” sentiment of the moment, almost to the point of parody. “Nooooo,” my seatmate groaned, as the dashed hope of Mrs. Clinton washed over us again. It was like instant PTSD.

The truth is, there is a hangover of sorts for those of us who lived through the hope, and then the letdown, of the last eight years.

I, like many women, was energized by Mrs. Clinton in 2016, writing about the message she would send to little girls, donning my “Pussy Grabs Back” T-shirt, delighting in the unabashed solidarity of groups like Pantsuit Nation.

By 2020, there were six women running for the Democratic nomination, and the language of gender solidarity had grown more muted — and, perhaps, more nuanced — but it was still there: in the Democrats calling attention to double standards, talking about “intersectionality” or working to normalize seeing a woman onstage. (Elizabeth Warren often noted how, when she encountered girls on the campaign trail, she would say: “Hi, my name is Elizabeth, and I’m running for president because that’s what girls do.”)

It’s as if Mrs. Clinton, and the women who came after, boxed themselves into identity politics, in effect if not intent. Even those who didn’t play up their womanhood didn’t quite know how to get out of the box.

We know by now, thanks to social science and polling, that women are just as likely to win elections, even as their “electability” seems to be an ever-present question. And yet there is a very real worry that the more attention is paid to a candidate’s gender — whether by the candidate herself, or the public asking questions like, “Is America ready for a woman?” or “Can a Black woman win?” — the more it sows doubt about her ability to win. “It has the potential to be a self-fulfilling prophesy,” the sociologist Marianne Cooper told me.

Ms. Harris’s ability to avoid all that may be as much about her own political instincts as it is about any cultural shift; after all, she has always been a first, in virtually every job she’s held — did she really need to keep talking about it?

“I am who I am. I’m good with it,” she told The Washington Post in 2019. “You might need to figure it out, but I’m fine with it.”

To Vogue, later that year, she explained how, “If someone says, ‘Talk to us about women’s issues,’ I look at them and smile and say, ‘I am so glad you want to talk about the economy’” — a stinging emphasis on “so.”

And this week, when asked about the symbolism of her candidacy — and a viral photo of her great-niece staring up at her as she accepted the nomination — she deftly steered again: “Listen, I am running because I believe that I am the best person to do this job at this moment for all Americans, regardless of race and gender,” she said.

Still, she has found subtle ways to signal who she is. She has used her mother, a “5-foot-tall brown woman with an accent,” to nod to her heritage. She has relied on political surrogates — Michelle Obama, Mrs. Clinton, Oprah — to hammer home the more identity-driven aspects of her biography, like attending a historically Black university. Her supporters can self-segregate in any way they want, and have — “White Dudes for Harris,” “Cat Ladies for Kamala,” “Moms for Momala” — but she is not the person leading these efforts.

And, anyway, it’s not exactly a secret who she is: From her style of speechto her family, to the fact that she chose a Beyoncé song as her official campaign anthem (just not the one about girls running the world), she is showing us.

“Quite frankly, I think she’s doing something very clever,” said Carol Moseley Braun, who ran in the 2004 Democratic presidential primary and was the first Black woman to serve in the Senate. “Nobody wants to hear ‘I’m the first, I’m the first, I’m the first.’ What they want to hear is what you’re going to do for them.”

A recent polling experiment seems to suggest that her approach is working.

In a survey of 800 registered voters, Dan Cassino, a political scientist at Fairleigh Dickinson University, found that when voters were prompted to think about gender and race — specifically, they were asked whether these things were important to them in a generic candidate — their support for Ms. Harris grew substantially.

And yet the opposite was true during the 2008 primaries, when he conducted a similar study looking at Mrs. Clinton. That signifies some progress — and is perhaps a testament to Mrs. Clinton’s perseverance. But it also implies that Ms. Harris has skillfully cracked the code.

“I would argue that telling people to vote for a candidate on the basis of identity is too explicit,” Mr. Cassino said. “Voters want to think they’re voting for a candidate on the issues, and making identity appeals explicit is going to work against that, and potentially trigger a backlash.”

With that in mind, Mr. Cassino told me, other people drawing attention to Ms. Harris’s identity, as they have been, may in fact be the most effective way of replicating those survey results in real life. But even better, he added, would be to have the opposing candidate do it — because it makes it salient, without overdoing it.

In which case, Ms. Harris has one very strong (albeit reluctant) man working for her. His name is Donald Trump.

Jessica Bennett is a contributing editor in the Opinion section of The Times. She teaches journalism at New York University and is the author of “Feminist Fight Club” and “This Is 18.” @jessicabennett  Facebook

We Know Mental Health Affects Physical Health. Why Don’t We Act Like It?

We Know Mental Health Affects Physical Health. Why Don’t We Act Like It?

An illustration of a person’s head in which the brain is depicted as a person under mental stress.
Mia Oberländer

By Helen Ouyang

“Dr. Ouyang is an emergency physician and an associate professor at Columbia University.

“Do you think my symptoms could be from stress?” This is a question more and more of my patients have been asking me when seeking care for problems such as a stubborn cold or an aching back.

For other patients who don’t first raise the idea, when I propose that their mental health could be worsening their physical symptoms, they no longer bristle at that suggestion. An idea that was once dismissed as New Age fluff is now being embraced.

Our health care system, however, has yet to catch up to this connection. While it promotes preventive care, the emphasis has largely been on physical health, overlooking the significant influence of mental well-being on our overall health and vulnerability to illness. For people to truly be healthy, modern medicine must prioritize the prevention of mental ailments alongside physical ones.

It wasn’t long ago that even hinting at the notion that a relationship exists between our mental and our physical health would inevitably seem to frustrate, even infuriate, patients, as though their suffering wasn’t real. And for good reason. Women have endured the dismissal of their symptoms for centuries, resulting in missed and delayed diagnoses, even death. Pain in Black patients is often undertreated. Doctors in the past would offhandedly call certain symptoms “supratentorial” — meaning “it’s in their head.”

But our understanding is evolving, as a growing stream of research challenges old assumptions. Psychological disorders such as stress, depression and loneliness are now known to be associated with impaired immune defenses, leading to increased infections and weakened responses to vaccines. Chronic stress can disrupt our gut function, slow our wound healing and age our cells.

Our minds’ potential to unravel our bodies goes even further: People with symptoms of depression have a greater risk of developing coronary artery disease. Among patients who already have heart failure, those struggling with loneliness are around four times as likely to die. Job stress has been linked to strokes.

Fortunately, while poor mental health can worsen our physical states, the inverse seems true as well. Research suggests that interventions that boost mental health can enhance immune function, reduce inflammation and improve blood pressure and cholesterol. Stress management may shorten the duration of respiratory illnesses and lead to better glucose control in people with diabetes. In fact, overall psychological resilience has been found to be protective against cardiometabolic diseases such as heart problems, stroke and diabetes, as well as death from any illness — even after adjusting for differences in demographics.

Mental resilience could enhance our psychological well-being, which could in turn improve some of our physical ailments. Even having more optimism could help ward off disease — not just by improving our biology, but also by encouraging us to have healthier habits.

Can one simply build resilience? Experts now believe so — that resilience is a skill set that people may be able to learn over time. This is much easier said than done, but research shows it’s possible: Massachusetts General Hospital’s Resilience and Prevention Program delivered workshop-based resilience training to young adults at risk for mental illness, and it decreased their psychiatric symptoms, even reducing loneliness.

Yet much of our health care system remains obstinately siloed, with mental health relegated to the sidelines of preventive medicine.

Preventive medicine has given Americans vaccinations, colonoscopies and mammograms, and screened us for hypertension, high cholesterol and diabetes. The Affordable Care Act made “prevention is better than cure” a tenet of our health care system, mandating that insurers fully cover these services. Prevention in psychiatry has not kept up.

Many people don’t bring up their mental health at their checkups. And many doctors don’t ask. Patients who do discuss their psychological state during their insurance-covered preventive exams may be served with an unexpected bill. That these visits are often called an “annual physical” — emphasizing physical over mental ailments — is itself revealing.

Even when primary care providers screen for early signs of depression and anxiety, they often lack the training, resources and time to address what they might uncover. I feel the same in the E.R., where, again and again, I am at a loss about where to send people for mental health care. Who is accepting new patients — without requiring them to pay substantial money out of pocket?

Reimbursements around mental health are particularly low and come with significant administrative burdens, which discourages providers from taking insurance. This leaves patients with few options for their behavioral health care. While the federal mental health parity law prohibits insurers from charging higher co-pays for behavioral health visits than they do for other conditions, insurers can put up other barriers such as excluding certain diagnoses or managing the number of therapy sessions. The result is a system that too often fails to handle brewing mental health problems until they’ve already taken a physical toll.

What’s promising is that there are already some innovative approaches to build on. A collaborative care model that includes mental health care managers results in better outcomes for depression, anxiety and substance use. A new Medicaid rule change allows reimbursement for professional consultations, which could help primary care doctors meet their patients’ needs by seeking the advice of their psychiatry colleagues. Mental health services are also being integrated intosome school-based health centers. We need more such efforts that aim to dissolve the barriers between physical and mental health.

Routinely providing preventive mental health care could also reap significant economic benefits. Patients with concurrent mental illness generate some of the highest total medical costs in the United States, most of which is not spent on behavioral health. But mental well-being has been shown to reduce overall health care usage and costs, as well as improve education and employment. For adults who already have a chronic medical condition, receiving mental health services was found in one analysis to reduce their overall health care expenditure by nearly 22 percent. An ounce of psychological prevention may well be worth a pound of medical cure.

We need a care system and a medical culture that support the health of the whole person. My patients seem to already grasp this truth. Many of them are eager for integrated care that prevents both mental and physical illness. Now the health care system needs to catch up to their wisdom so that we can actually help them do so.

Helen Ouyang (@drhelenouyang) is a physician, an associate professor at Columbia University and a contributing writer for The New York Times Magazine. She is also a fellow at the Type Media Center.

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