Young healthy Latina pregnant woman

b.134 sleep functions

b.152 emotional functions

b.156 perception functions

b.420 blood pressure functions

b.515 digestive functions (tolerance)

b. 535 digestive sensations (nausea)

b.545 water balance functions (retention)

b.620 urination functions (frequency)

b.660 procreation functions

b.670 reproductive sensations

s. 620 structures of pelvic floor

Pregnancy expected changes in Body Functions and Structures

At the initial encounter:

Laura was very low risk from the biological point of view

But she had many risks coming from the environment

e.130 prod/tech for education

e.225 climate

e.315 support from immediate family

e.430 individual attitudes of people in position of authority

e.450, 455 individual attitudes of health professionals, other professionals (dis.)

e.465 social norms, practices and ideologies (cultural barriers)

e.550 legal services, systems, policies

e.580 health services, systems, policies

e.590 labor/employment services, systems, policies

e. 595 political services, systems and policies

Environmental Factors

Isolation

Insecurity

Exclusion

Illegal status

Poverty

Migration

d.175 solving complex problemsd.230 carrying out a daily routined.240 handling stressd.310,d.330 communicatingd.470 using transportationd.570 looking after one’s healthd.590 employment systems, policyd.630 preparing mealsd.760 family relationshipsd.770 intimate relationshipsd.839 education about pregnancy d.870 economic self-sufficiencyd.950 political life and citizenship

Environmental factors as barriers to performance!

Body functions and structures with full capacity

Poor functionality

Which resulted in poor functionality

Adding the Activity Setting’s dynamic perspective

FUNCTIONALITY?

Activities

Participation

Laura

The environment

Input

Input

OutputProcess

Home in Mexico

Non accepting community

Home in Wisconsin

Laura had multiple activity settings

Health System

Home in Mexico

Non-accepting community

Home in Wisconsin

Activity settings influence each other…..

Health System

Activity setting evolve. It has some stable qualities and some changing qualities as it propagates through time.

same same same

new

new new

Home yesterda

y

Home today

Home tomorrow

WHAT IS DRIVING CHANGE?

Home in Mexico

Non- accepting Community

Home in Wisconsin

Health System

CAPITALISM IS THE UNDERLYING FORCE DRIVING UNHEALTHY CHANGE IN ALL THE ACTIVITY SETTINGS

Good for capitalism

•Without her family’s approval, she and her boyfriend used the money saved for their wedding to pay the “coyote” to cross the border

Home in Mexico

Bad for health

Good for capitalism

•The baby’s dad depended on a friend to get to work so he was saving to buy a car, the baby was an unexpected expense, she waited to tell him about the pregnancy

Home in Wisconsin

Bad for health

Good for capitalism

Home in Wisconsin

Bad for health

• She wanted to wait until she could send money to contact her family so they could see the benefit of her leaving, and she didn’t call her mother or sister for advise about the baby

Good for capitalism

•They considered it too risky to ask the employer for a poof of (low) income, a requirement to receive the coverage

Non-accepting community

Bad for health

Good for capitalism

•She knew she had no rights to services and was afraid that any institution would deport her if she ask for help

Non-accepting community

Bad for health

Good for capitalism

•She knew LHO, as many other non-profits, is struggling for resources and that only gave health education, not health care so she didn’t call us

Non-accepting community

Bad for health

Good for capitalism

•Someone told her that the clinic was sending collection agents to people that did not pay for care

Health System

Bad for health

Good for capitalism

•Coverage rationale was not the women but that prenatal care was cost-effective ($1 saves $3 of post-natal care)

Health System

Bad for health

QUESTIONS:

• Is capitalism a trickle-down of well-being or a “sucking up” of the health of populations? Have we become the means of its ends?

• Can a small advocacy organization have an impact against such a tremendous force?

• What should the Latino Health Organization do? Please suggest….