Winter Blankets

I live and operate within cultural circles unseen. The boundaries are padded with comfort, enveloping me in an invisible blanket of beliefs, perspectives, and ideas that determine everything from my clothes to my choice of soda or pop (It’s February in Michigan. My life is in terms of blankets). Weeks of training and education have presented me with new ways of thinking about communities, people, and how we serve as students of public health. But as my Texas field deployment nears, one theme continues to resonate each day. Culture matters.

Studying epidemiology, culture is rarely stated but always present. Covariates like diet, smoking practices, and the environment are all defined by the groups and identities we adopt, but in my circle they too easily become parameters of a causal equation stripped of their context and relationship.

Older adults in the Rio Grande Valley are not taking advantage of the preventive programs available to them through Medicare, this we know. The epidemiologist in me immediately wants to ascribe this decision to measurable parameters like distance to a care center, frequency of advertisement, or availability of transportation and make grand conclusions about the factors that increase the likelihood of program utilization.

However, people are not bound by the rules of a regression model. Predictions fall short when outcomes are shaped by intangibles and the answer to problems like preventive program utilization is not what, but why.

I want to help create an environment where healthy choices become the norm. These decisions determine not just our quality of life but factor into our future burden of disease and health outcomes. Preventive care programs in south Texas are an opportunity for older adults to minimize that risk and set a healthy precedent for the future generations to follow.

The Rio Grande Valley operates by its own rules and within its own unseen cultural circles. If I want to make an effective change here I have to observe and understand the underlying beliefs, perspectives, and ideas that influence their decision to take part in the practices we aim to promote. Instead of prescribing a solution it’s time to connect with the people themselves and approach the problem from a context of culture and identity. As I continue to prepare for that challenge, I can’t help but ask myself, what will their blanket look like?


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