The Impact of the “Muslim Ban” Executive Order on Healthcare Utilization in Minneapolis-St. Paul, Minnesota

Objective Determine whether the 2017 “Muslim Ban” Executive Order impacted healthcare utilization by people born in Order-targeted nations living in the United States. Methods We conducted a retrospective cohort study of people living in Minneapolis-St. Paul, MN in 2016-2017 who were: 1) born in Order-targeted nations, 2) born in Muslim-majority nations not listed in the Order, and 3) born in the United States and non-Latinx. Primary outcomes were: 1) primary care visits, 2) missed primary care appointments, 3) primary care diagnoses for stress-responsive conditions, 4) emergency department visits, and 5) emergency department visits for stress-responsive diagnoses. We evaluated visit trends before and after Order issuance using linear regression and differences between study groups using a difference-in-difference analyses. Results In early 2016, primary care visits and stress-responsive diagnoses increased among individuals from Muslim majority nations. Following the Order, there was an immediate increase in emergency department visits among individuals from Order-targeted nations. Conclusions Increases in healthcare utilization among people born in Muslim majority countries before and after the “Muslim Ban” likely reflect elevated cumulative stress including the impact of the Order.