Why the difference?

Before our departure for South Texas, I was watching Food Inc. with a friend of mine and just as a group of overweight Californians flashed across the screen, my friend interjected with, “Well, it’s obvious why there are so many overweight people there, so many of them are Hispanic—it’s genetic.” As you can imagine, my jaw about hit the floor when I heard this comment. I actually wasn’t sure if I heard him right, so I questioned him. However, his response confirmed what I originally heard.

Although I was extremely heated, as I explained more about the factors contributing to differences in the distribution of obesity among Americans, I realized he had never learned about the social determinants of health.

We decided to stop the movie and have a discussion about the multitude of factors that explain differences in health status: physical environment, social environment, income and social status, education, culture, employment, and many other factors. I also made sure to clearly outline how racial and ethnic discrimination play a huge role shaping our health. By the end of our conversation, we both walked away with a deeper understanding of the upstream problems affecting health status.

In my first couple days of working in Brownsville, many of the things I discussed with my friend have also been put into perspective for me. Today, along with my University of Michigan colleagues and our University of Texas Brownsville partners, I spent the day completing a community health assessment centered on neighborhood design, safety, and food access. As we worked towards completing the walkability survey and the community health assessment, we took note of the many factors contributing to the 80% prevalence of obesity in these neighborhoods, which were just over 90% Hispanic. We examined sidewalk conditions, bike lanes, parks, open spaces, traffic calming measures, and local food options.

Each of these items demonstrate why it’s important to consider the upstream factors contributing to health disparities in our society. As public health professionals, we not only need to educate ourselves on this topic, but we also need to develop innovate ways to make our communities more aware of these issues—we hold the responsibility of dispelling myths around health disparities. Taking this step will ultimately help gain community support and the political leverage to alter the structural and institutional inequalities that lead to differences in health status.


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