Ryleigh Rawson

Dr. Montgomery

PUBH 498 001

February 26, 2021

Reflection Assignment #2 Question 1

1 One of the other courses that I have taken at UofSC that added to my knowledge and

appreciation of public health was SPAN 304, Cultural Readings and Advanced Conversation. I

am a Spanish minor, as I think that my knowledge of the language and culture in Spanish-

speaking countries adds to my ability to help a large population of the US as well as the people

in the vast amount of Spanish-speaking countries. The Cultural Readings and Advanced

Conversation course focused on five different major themes: Spanish history in the US, identity,

women, immigration, and drugs / violence. Each of these themes in and of themselves are

inherently related to public health. We often learn in public health courses about how the

Hispanic population of the US is an often underrepresented and marginalized group, with

disparities ranking in a higher percentage in this population than others. Additionally, these

Hispanic countries face more corruption, violence, and poverty than we even realize. SPAN 304

helped bring these concepts to light and have provided me with a better understanding of the

origin of these differences and how they contribute to public health disparities.

One important topic that we covered was of how neocolonialism in their countries led to

steamrolling over their cultural and socioeconomic differences for our own gain. Instead of

developing ways to work alongside these communities that we were invading, so that both

countries could profit, we went in there and imposed our businesses, lifestyles, cultures, and

ideals on them, leaving many of these populations high and dry, without a sense of self. Growing
up we learn about how glorious our country’s rise to power is and glorify the explorers that have

contributed to our economic development – we are never framed to be the bad guys to these

communities, and it was important to me to relearn this information. I believe it translates into

how we treat the Hispanic population now. When we discuss the disparities among these

populations in public health courses, they seem to stem from a lack of empathy of their cultures

and backgrounds. Specifically, in PUBH 302, or Introduction to Public Health, I remember

talking about how they have to deal with less access to care, language barriers, higher rates of

poverty, and less-educated lifestyle choices in the US. This causes them to have higher rates of

health conditions like cardiovascular diseases, cancers, sexually transmitted infections, diabetes,

strokes, liver disease, maternal and infant mortality, and homicides, to name a few. We also

talked a lot about how the health care system profits off of chronic diseases and how providers

spend less time with patients because they gain better profit from seeing more patients for a short

time than they do spending ample time with less patients. As a result, the Hispanic population is

not given the amount of education or care needed to attain a higher quality of life. There is

minimal equity in their care – we seldom choose to recognize that they come from backgrounds

of misogyny, racism, violence, poverty, and less education, and instead treat them as inhuman

profits. Their cultural differences and language barriers are not addressed in clinical settings and

therefore the patients lack the confidence to ask questions to clarify their understanding of

certain health problems and lifestyle choices. They struggle to feel safe in these settings due to a

lack of trust in the providers. Conversely, but also contributing to these problems, is the concept

discussed in PUBH 302 of the wide gap in knowledge between providers and patients; there is so

much education behind medical professionals and so little in the general population that doctors

can order things that may not be necessary but will contribute to their own profit, and a patient
won’t know any better. The fee for service model of health care thrives off of this lack of general

knowledge, as the providers can order test after test to incur more costs against these uneducated

people and perpetuate the cycle of chronic disease. The Hispanic people of the US who do seek

care are more likely to become subject to this problem, as culturally they are still taught to

respect people in this position of power, and will do so even if they lack trust in them. In

addition, pertaining to a more community setting based off of some discussion in the course

Community Health Problems, there aren’t enough programs or interventions that are effective

enough to change their understanding on a more population scale. The ones that are focused on

this are not quite as developed or haven’t been in place that long, and are often confronted with

battles in funding and support from the major stakeholders within communities. There is no

profit in emphasizing education and prevention, specifically among this population. However,

the Hispanic population accounts for about 20% of the total US population as of 2020 and is only

expected to increase. This is a significant amount of people to continue to marginalize, and part

of that also stems from the fact that many are immigrants, representing more than one-half of the

Hispanic population.

SPAN 304 focused heavily on immigration. We learned firsthand accounts of how

dangerous immigration to the US is, with people dying on the way due to starvation,

dehydration, injuries, lack of care, and pure exhaustion. The stories people told were

heartbreaking, with the sheer majority of people also struggling mentally because of the

separation from their family members who may be in the US already or had to be left behind.

They live in a lower quality of life because of the stress and anxiety placed on them from the

danger of the process. Specifically, we discussed the migrant caravan from Honduras, which is a

country is so wracked with gang violence, drug trafficking, governmental corruption, and
poverty that so many people have no paths to success or a decent quality of life, which continues

to perpetuate these vicious cycles. People find themselves involved in gangs and drug trafficking

because it is their only option to survive. We don’t provide enough foreign aid to countries like

Honduras, nor do other countries, which makes it harder for them to reach their own

development. They then have to rely on nonprofit or NGO work to assist on a smaller scale,

which I also learned about from my time with Students Helping Honduras, an organization that

aims to supply more education and jobs through building schools and training the citizens to

become things like teachers and construction workers. It is evident that the immigration process

in and of itself is a public health crisis due to the amount of death and disability it causes;

however, it doesn’t stop when people make it into the US. Xenophobia runs rampant in this

country, which can cause an alienation of these people and adds to their distrust in the healthcare

system, which is something else that was discussed in Introduction to Public Health as well as

Global Health. Additionally, immigration naturally lends itself to a lack of access to healthcare.

Many Hispanic people in the US don’t have health insurance and therefore cannot comfortably

seek treatment for chronic or acute conditions without fear of the cost or deportation. They also

struggle to find secure and safe jobs as well as the training for skills necessary for these secure

jobs, continuing the cycle of poverty and adding to a lack of decent quality of life. They are then

forced into poor housing, poor nutrition, and poor lifestyle choices. They don’t have the same

amount of security or knowledge of how to eat well or exercise, nor do they have the

understanding of how to break bad habits of things like unprotected sex or smoking. All of these

things become determinants of the health disparities we see.

There are also the problems of the cultural aspects of misogyny, drugs, and violence. In

SPAN 304, we talked about violence against women and the general violence surrounding drug
trafficking and gangs. Women in these cultures are accustomed to the traditional roles of being

the woman of the house, raising children, and taking care of their husbands. As a result, they

struggle to stand up for themselves against machismo, which is the term for aggressive

masculine pride. There is a hesitance to seek help in unhealthy relationships, but there is also the

threat of financial or physical insecurity if they were to leave their relationships. These problems

carry into the disparities specific to the female Hispanic population. In PUBH 302, I remember

discussing that they have higher rates in cardiovascular diseases, obesity, diabetes, sexually

transmitted infections, maternal mortality, and domestic violence, as well as cancers of the

cervix, stomach, and liver, when compared to white women. They have less freedom to seek

access to healthcare and less practical knowledge in taking care of themselves. As far as drugs

and gangs go, many within this population don’t know any better than this lifestyle and become

involved in the dangers of these processes. We watched movies and personal accounts of the

gang lifestyle in SPAN 304 that showed that these people were not inherently bad or violent

people, but felt that this type of lifestyle was the best thing to protect their families and develop

an income. It carries into the culture of violence within these countries as well as here, as there

are still gangs and drug trafficking that exist to this day. This puts them in physical danger by the

law or by the organizations they work for should they choose to not listen to directions, while

also putting their families at risk.

In general, I think that this course gave me a comprehensive background to the cultural

aspects that contribute to the public health crises that this population faces. It made me realize

that public health disparities are inherently cultural as well as systemic, and that breaking the

cycle of them is challenging. I think that realizing that helps me recognize that important changes

take time and patience, and we won’t see results right away, so I know that I’ll be able to remain
optimistic and patient in the changes we as public health professionals will institute. It also

provided me with more empathy than I had prior to taking the course; I had always believed that

health and safety are human rights regardless of background, but this provided me with a more

comprehensive knowledge of why things are this way and fueled the passion I have for this field

of work. The stronger sense of empathy will help me to prepare for ways to explain the

importance and scope of public health disparities to others. The knowledge will give me a

stronger background in the face of any adversity or misinformation when trying to accomplish

tasks in the field, or when someone tries to argue that they know better when they don’t. I feel

more confident in my ability to present this information that I have learned to others in the field

as well as in my general life, as I think the concept of advocacy and education is important. I

want other people to be able to understand where these problems come from and I know now

that I have the background and passion to do so. I recognize better where we as a country and a

global power are going wrong, and know now to approach these problems with patience and

understanding. I love being able to explain the connections I’ve made between this course and

the courses I’ve taken as a public health major, and I’m so grateful to have been provided with

the opportunity to further my understanding of the language and culture of such an at risk group

in this country, and hopefully to be able to spread that awareness and make changes going

forward.