The Importance of Understanding Privilege and Community in Public Health.
Community.
During the spring semester of my junior year at USC, I took HPEB-553: Community Health Problems. Taught by Dr. Edena Guimaraes, HPEB-553 focuses on community health problems and heavily emphasizes the importance of personal involvement and responsibility for community health. Dr. Guimaraes defined community as “a group of people who have common characteristics” such as “location, race, ethnicity, age, occupation...or common bonds.” We are all part of a community whether we acknowledge it or not – as a student I am part of the gamecock community, as a research assistant I am part of my work community, and as the president of Gamecock Club Swimming I am part of the club swim community at USC. These are just a few of the communities that I am proud to be a part of and that affect my day-to-day life. During my time here at USC, I have found a wide range of communities full of people who have similar values, norms, and commitments. Community can also be used as a way of describing the health and health problems of certain populations.
During HPEB-553, we learned that there is archeological evidence of community health dating back to 2000 B.C. Although community health in the past looked different than it does today – think taboos and rituals compared to vaccinations and hygiene – it has always been an important part of our lives. A substantial part of the field of public health is understanding the social determinants of health. According to the World Health Organization (WHO), “the social determinants of health are the conditions in which people are born, grow, live, work, and age, including the health system. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between.” These social determinants and the shared experiences that they create are part of the common characteristics that create communities.
During HPEB-553, we learned that there is archeological evidence of community health dating back to 2000 B.C. Although community health in the past looked different than it does today – think taboos and rituals compared to vaccinations and hygiene – it has always been an important part of our lives. A substantial part of the field of public health is understanding the social determinants of health. According to the World Health Organization (WHO), “the social determinants of health are the conditions in which people are born, grow, live, work, and age, including the health system. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between.” These social determinants and the shared experiences that they create are part of the common characteristics that create communities.
Many of us are unaware of the social determinants that affect our own lives. One way of better understanding the world around us and the world that others experience is to understand our privilege. During one of our first HPEB-553 classes, we participated in a privilege exercise, the Privilege Walk. It was uncomfortable and made us think about things we would often rather avoid. However, exercises like the one we completed in class are vital in becoming a leader and valuable member of society. According to the Privilege Walk, the purpose of the exercise is to “highlight the fact that everyone has some privilege, even as some people have more privilege than others. By illuminating our various privileges as individuals, we can recognize ways that we can use our privileges as individuals and collectively to work for social justice.” The exercise started with all of us forming a straight line across the classroom. Dr. Guimaraes then read off statements instructing us to take one step forward or one step backward based on our experiences. Some of the statements are “If English is your first language take one step forward,” “If your family had health insurance take one step forward,” “if you were ever stopped or questioned by the police because they felt you were suspicious, take one step backward,” “if your ancestors were forced to come to the United States not by choice take one step backward,” and “if you have ever felt unsafe walking alone at night take one step backward.” After the exercise was completed, we were asked about how we were feeling and how we felt about our privilege. It is a challenging exercise but I have learned how important it is that we challenge ourselves to recognize the effects of privilege. I have also learned that oftentimes it is the responsibility of a leader to help others see their privilege and what they can do with it. This is a difficult task but one I believe is necessary for us to improve and move forward - and one that is necessary when addressing the public health problems that are present in our world.
Artifact One: The Privilege Walk Activity (University of Houston)
Artifact Two: The logo of the Good Samaritan Clinic where I volunteer - Click the photo to see the GSC website.
One community that I am passionate about is the Spanish-speaking population. In public health and other fields, this group is often referred to as Hispanic or Latino, however, these terms which were created by the U.S. government fail to acknowledge the vast differences between the many rich cultures that the terms attempt to group together. For example, the culture of Mexico is extremely different from that of El Salvador or Puerto Rico and the experiences of individuals who are from these countries are extremely different. I started working in depth with the Spanish-speaking population in South Carolina when I began volunteering at the Good Samaritan Clinic, a free medical clinic in Columbia for Spanish-speaking patients. This clinic is an extremely important part of my experiences - however, due to HIPPA I am unable to share many of the things I worked on during my time there. As Artifact Two, I have included the Good Samaritan Clinic logo and linked to the clinic's website. Please visit their website to learn more about the programs offered there. At the clinic, we work with patients from all Spanish-speaking countries including Mexico, El Salvador, Argentina, and many more. I had learned about many of these cultures in my Spanish classes throughout high school and college but to experience it first hand was completely different. In the United States, immigrants from these diverse countries form their own community here in this country based on their shared experiences and language. This community was what Dr. Guimaraes had been talking about in all of our classes and was a real world example of what I had been learning about.
My time at the clinic has helped to hone my skills as a leader. Over the last two years, I have taken on more responsibility and have led projects on my own including creating an updated Community Resources List (Artifact Three - Link Below) for patients and providers at the clinic. I spent over a month contacting other clinics and programs around the state and collecting information about the resources they have to offer the clinic's patients such as interpreters and sliding scale programs for lower income families. I have also begun to train other volunteers in how to triage, scribe, and complete administrative work like calling for lab results applying for health programs. Below I have included a 'How to Triage' document (Artifact Four - See Below) which I collaborated on with another senior volunteer for new volunteers to use as a guide. All of my volunteer experiences - at the Good Samaritan Clinic and other places - have taught me who I am as a leader. The environments are different but the skills needed to lead are often the same. Volunteering has given me the opportunity to grow these skills and apply them in the real world. It has also shown me the importance of understanding the roles that privilege and community play in healthcare. Medical providers must understand the differences between themselves and their patients in order to better treat them. For example, a doctor may be able to go to the gym every night if they develop prediabetes, however, a lower income patient may not be able to afford a gym membership or have the time to go to the gym. Advice more suited to them may be to walk to the bus stop or work if possible or to spend time walking around their neighbourhood at night if it is safe for them to do so. If a provider does not understand these differences, they may not be able to help an individual work on their health and lifestyle choices.
My time at the clinic has helped to hone my skills as a leader. Over the last two years, I have taken on more responsibility and have led projects on my own including creating an updated Community Resources List (Artifact Three - Link Below) for patients and providers at the clinic. I spent over a month contacting other clinics and programs around the state and collecting information about the resources they have to offer the clinic's patients such as interpreters and sliding scale programs for lower income families. I have also begun to train other volunteers in how to triage, scribe, and complete administrative work like calling for lab results applying for health programs. Below I have included a 'How to Triage' document (Artifact Four - See Below) which I collaborated on with another senior volunteer for new volunteers to use as a guide. All of my volunteer experiences - at the Good Samaritan Clinic and other places - have taught me who I am as a leader. The environments are different but the skills needed to lead are often the same. Volunteering has given me the opportunity to grow these skills and apply them in the real world. It has also shown me the importance of understanding the roles that privilege and community play in healthcare. Medical providers must understand the differences between themselves and their patients in order to better treat them. For example, a doctor may be able to go to the gym every night if they develop prediabetes, however, a lower income patient may not be able to afford a gym membership or have the time to go to the gym. Advice more suited to them may be to walk to the bus stop or work if possible or to spend time walking around their neighbourhood at night if it is safe for them to do so. If a provider does not understand these differences, they may not be able to help an individual work on their health and lifestyle choices.
Artifact Four: How to Triage at GSC
In my HPEB-553 class, I learned about the discrimination and health inequity faced by the Hispanic population in South Carolina. For example, this population has a higher rate of diabetes, hypertension, infant mortality, and other health problems. Dr. Guimaraes encouraged us to become personally involved in community health issues in order to better understand the public health problems that communities face. Volunteering at the Good Samaritan Clinic gave me that opportunity while allowing me to learn about all the unique and rich Spanish-speaking cultures and gain experience in a medical setting. It also forced me to recognize my privilege and learn how to use it to help others while in a leadership role. We need leaders to encourage others to expand their viewpoint by volunteering in communities different from their own in order to learn more about the world and what they can do to improve it. Part of understanding privilege is understanding the importance of a community. For some individuals, community is a life source while for others it is not a necessity but an added benefit to daily life. You cannot understand community without first looking at privilege, and you cannot understand privilege without looking at the role of community. If you have the privilege to volunteer while helping and learning from a community, it is your responsibility to do so.
Artifacts
| privilegewalk.pdf |
| gsc_community_resources.pdf |
| how_to_triage_at_gsc.docx |
