Stakeholder advocacy in action!

In this part of the course, we are learning how deep and strong the connections between socioeconomic status and population health really are. A number of factors (culture, institutional and public policy, individual beliefs and behaviors) have led to stratification of our local community in Madison; stratification that has produced and deepened disparities in health. Poverty is a concept that can be defined at multiple levels and has effects at multiple levels: individuals and communities can both suffer from poverty.

A PHS 795 student found an example of local stakeholders stepping up and calling for action to reduce poverty in the Latino community of Madison. They write:

Dane County Latino leaders issue call to action

This article relates to the lecture last week about socio-economic status, poverty, and health. It’s about how Latino community leaders in Madison are advocating for a “holistic, multi-generation strategy” to reduce poverty. The article explains how the Latino community is the largest non-white demographic in Madison, but they earn less than 46 percent of what white households earn. The Latino community has a 30 percent high school graduation rate and an increasing poverty rate. This local issue fits the Grossman model as discussed in lecture due to the incorporation of income, education, and racial groups. The community has goals to eliminate disparities in Madison such as increasing youth education services and providing more preventive health education programming.

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4 thoughts on “Stakeholder advocacy in action!

  1. I think this is a great example of a community recognizing an issue and acting to change it. As mentioned, we have discussed the devastating effects that poverty and low socioeconomic status can have throughout the life course. Recognizing that this needs to change is the first step in making a difference. It’s fortunate that there are strong leaders getting involved. They have strong goals fro the program, especially the point about having “culturally and linguistically competent health care providers” and increased bilingual training programs. In addition, maybe with the increased college preparatory initiatives, this will help more Latino students go into these fields. The necessity to adapt to changing population demographics has been an important topic in healthcare for many years, and I think that their objectives may help with this. I think it’s also important that they are making policymakers and other stakeholders aware of Latino perspectives and struggles through education of the issues. Hopefully, this will help spur them into action, including changes in immigration policies. Overall, this was a great article about the disparities among different groups and how they affect health outcomes through education, income, and poverty. It also shows clearly (through their emphasis on childhood education) that the leaders involved understand the importance of reaching children before they an accumulation of life course events that could impact them negatively later on in life.

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  2. This a great that we are having this conversation!

    In my own research, I have found that there is link between Latina/os’ perceptions of where they live (if they believe it is anti immigrant) and the health status of their children. In this research, I find that mixed-status families (when a parent is undoc and child is US born) are less likely to report optimal health relative to their co-ethnic counterparts. Moreover, for respondents who perceive their community has anti immigrant it exacerbates this disparity.
    http://edwardvargas.com/wp-content/uploads/2015/09/VargasnYbarra_JOIH_2016.pdf

    As part of this conversation is use of social services and living in the shadows…in this other paper, I lay out a typology of mixed status families……http://edwardvargas.com/wp-content/uploads/2015/09/SSQ_WIC_Vargas.pdf
    where mixed-status families are less likely to use WIC and Medicaid (another published paper) due to risk of being deported…I also find this in the child support policy arena.

    My most recent project examines the association between personally knowing a deportee on the physical and mental health of Latinos. Thus far, I have found that knowing a deportee increases the odds of adults having to seek help for mental health problems. Regarding children’s outcomes, I find that knowing a deportee increases the probability of a child being referred or diagnosed for a developmental disorder.

    Anyway….if you want to read about race and its implications for health…read bellow….but thanks for sharing this article!

    In addition to immigration policy, is the role of racialization that is negatively impacting Latino communities. In my research, I use ascribed race or socially assigned race….the idea that it might matter more how others see your race…then how you seen your own race…..
    http://www.ncbi.nlm.nih.gov/pubmed/25410381

    I find that there is a white advantage of health among Latinos….so Latinos who think that others see them as white have better health than Latinos who aren’t seen as White (they are seen as Latino, Mexican, etc.).

    In this following paper…I delve deeper in what it means to be seen as Mexican and what happens if your actually not of Mexican origin (your boricua, catrocho, or chapin) and your experiences with discrimination…turns out if you think others see your race as Mexican you are more likely to have experienced discrimination relative to being seen as White…but if your seen as Mexican but not of Mexican origin you have the highest likelihood of experiencing discrimination. Might not be that surprising given the legacy of genocide and trauma against Mexican and mestizo origin peoples in the US. Long story short…..discrimination leads to stress ultimately hurting Latina/o communities.
    http://edwardvargas.com/wp-content/uploads/2016/02/SRE-2016-Vargas.pdf

    I see race as a lived experience (and created a scale) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678876/

    where if you think others see you as white, you have never experienced discrimination, and you have light skin…you have better health than if you are dark skin, experienced discrimination, and seen as non white. I have new stuff and created a new measure called….”street-race”….but that’s for another day.

    Anyway…let me know if you have any questions about this..

    Edward D. Vargas

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  3. This article is rightfully demanding a reevaluation of the health outcomes for Dane County’s Latino population. As stated in lecture, poor health outcomes are comprised from poverty, low SES, environment, and stressors and all of these swirl together to create a repeating cycle. To stop the cycle you have to take a piece out and slowly dismantle what is causing the cycle to spin. I am not quite sure about my analogy, but where I wanted to go with was that I think Dane County needs what Milwaukee has in the Sixteenth Street Community Health Centers (SSCHC). As a future physician, I see myself contributing to improve health outcomes with the line, “hiring and retaining culturally and linguistically competent health care providers.” This is how I see myself changing health outcomes.

    Starting as a single site health center almost 30 years ago SSCHC has grown into a health care sanctuary serving the predominantly Latino Milwaukee near Southside. Here bilingual providers conduct primary health care and behavioral health. During the past 30 years SSCHC has developed a high level of trust within the Latino community and has made great strides in improving health outcomes. One of the greatest assets of SSCHC are the peripheral services that they provide. The biggest one being the social services department. Here bilingual and culturally competent social workers help patients navigate the application processes of BadgerCare applications, citizenship, and any other social or legal issue. There are a handful of other programs, such as WIC, parenting resources, and many more. Additionally, SSCHC hires a majority of it’s staff from within the community.

    I am not sure if Dane County has a Community Health Center dedicated to the Latino community like SSCHC, but we could definitely benefit from one! A community health center focusing on the Latino population will help to improve health outcomes at baseline and also provide job opportunities. This will not address all of the challenges stated in the article, I do believe it could be an excellent starting point.

    http://www.sschc.org

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  4. One might find this post to be a little bit tangential, but I think it’s entirely relevant to a few points made in the article and so therefore I find it supplemental. Anyhow, a perpetually heated debate in our country over the past few decades has centered around the topic of affirmative action in school admissions and employment. Whether a school should accept a ‘less prepared’ applicant or a business should hire a ‘less qualified’ employee to expand the racial, gender, or cultural representation of its class or workforce is fraught with controversy, but is not the right way to frame the conversation. The question should not be, ‘How can assemble the best possible class or workforce based on the applicants’ qualifications on paper?’ but rather, ‘How can we assure that we are getting an optimal representation and perspective of the community when we bring together a cohort of students or colleagues?’

    To apply this to the article at hand, it is important that schools accept students with a diverse background and that healthcare systems hire providers with a similarly diverse background. It is not hard to imagine that a larger selection of Latino/a healthcare providers will result in better care for the Latino/a community. This is not to suggest that non-minority providers cannot provide great care to a minority community, because they have and they do! It behooves us to remember, instead, that healthcare is about the patients needing to be cared for, and removing as many barriers to providing that care as possible is crucial. Therefore, if a Latino/a individual is most comfortable seeing a Latino/a provider for any host of reasons, then they have a much greater likelihood of seeking that care and experiencing better health outcomes. Thus, a healthier Latino community means a healthier collective community. And a healthier collective community benefits everyone.

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