Young healthy Latina pregnant woman

1
At the initial encounter Laura was very low
risk from the biological point of view
Pregnancy expected changes in Body Functions and
Structures
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
Young healthy Latina pregnant woman
2
But she had many risks coming from the environment
Environmental Factors
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
Isolation Insecurity Exclusion Illegal
status Poverty Migration
3
Which resulted in poor functionality
Environmental factors as barriers to performance!
d.175 solving complex problems d.230 carrying
out a daily routine d.240 handling
stress d.310,d.330 communicating d.470 using
transportation d.570 looking after ones
health d.590 employment systems, policy d.630
preparing meals d.760 family relationships d.770
intimate relationships d.839 education about
pregnancy d.870 economic self-sufficiency d.950
political life and citizenship
Poor functionality
Body functions and structures with full capacity
4
Adding the Activity Settings dynamic perspective

Input
The environment
Participation
Output
Process
FUNCTIONALITY?
Activities
Laura
Input
5
Non accepting community
Health System
Home in Mexico
Home in Wisconsin
Laura had multiple activity settings
6
Activity settings influence each other..
Non-accepting community
Health System
Home in Mexico
Home in Wisconsin
7
Activity setting evolve. It has some stable
qualities and some changing qualities as it
propagates through time.
new
new
new
same
same
same
Home yesterday
Home today
Home tomorrow
WHAT IS DRIVING CHANGE?
8
Home in Mexico
CAPITALISM IS THE UNDERLYING FORCE DRIVING
UNHEALTHY CHANGE IN ALL THE ACTIVITY SETTINGS
Home in Wisconsin
Non- accepting Community
Health System
9

• Without her familys approval, she and her
  boyfriend used the money saved for their wedding
  to pay the coyote to cross the border

Home in Mexico
Good for capitalism
Bad for health
10

• The babys 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
Good for capitalism
Bad for health
11

• She wanted to wait until she could send money to
  contact her family so they could see the benefit
  of her leaving, and she didnt call her mother or
  sister for advise about the baby

Home in Wisconsin
Good for capitalism
Bad for health
12
Non-accepting community

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

Good for capitalism
Bad for health
13
Non-accepting community

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

Good for capitalism
Bad for health
14
Non-accepting community

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

Good for capitalism
Bad for health
15
Health System

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

Good for capitalism
Bad for health
16
Health System

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

Good for capitalism
Bad for health
17

• 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.