Re:Topic 2 DQ 1   Reeves et al. (2013), focus their study on a Hispanic immigrant community in Albuquerque, New Mexico to establish whether there was a correlation between fear and health as they claimed.  Diabetes is reported to be more prevalent in  Albuquerque being the sixth cause of mortality(New Mexico Health Policy Commission 2009).The authors identified three core elements that determined the connection between health and fear(cost, language, discrimination and immigration status, and cultural differences).   The cost of health care being too high causes a level of stress that leads to fear as identified by the participants. Reeves et al. (2013) further explain that this fear is perpetuated not by diabetes but by the structural economic obstacles faced the low-income immigrant community. Most immigrants face language barriers and claim to be discriminated against when they go to health care institutions. They feel that they cannot clearly communicate their health needs. Even though some institutions have translators others report that they are not effective. Immigrants feel that being in a foreign country makes their immigration status conspicuous thus creating fear of being deported.   Reeves et al. (2013) report that according to Walton(2009),cultural disconnection arises from the perceptions health care providers have about alternative medicines which patients use to treat their health issues even diabetes. Patients are reluctant to tell their doctors that they use alternative medicine for fear of being criticized. This limits open communication between them thus degrading the quality of healthcare services given to the patients.   Structural violence does accelerate health disparities because it is embedded in social structures that expose individual to dangers. Individuals feel the lack of support from economic and political constructs in the social arrangements and this limits their access to health care services. Farmer et al. (2006), report that medical and public health programs will fail if healthcare providers do not understand the social factors of disease regarding structural violence. Montesdeoca (2013) further supports this argument that health disparities are related to past and present inequalities in social, economic, political and environmental resources elements of structural violence. References Farmer, P.E., Nizeye, B., Stulac, S. & Keshavjee, S. (2006).Structural Violence and Clinical Medicine. PLoS Medicine, 3(10), 449. doi:10.1371/journal.pmed.0030449 Montesdeoca, C. (2013).Inadequate Access to Healthy Opportunities and Structural Violence: A Case Study of Health Disparities among Hispanics in McLean County. Senior Theses-Antropology. Paper 5 Page-Reeves,J.,Niforatos,J.,Mishra,S.,Regino,L.,Gingrich,A., & Bulten,R.(2013).Health Disparity and Structural Violence: How Fear Undermines Health Among Immigrants at Risk for Diabetes. Journal of Health Disparities Research and Practice, 6(2), 30-47  Deactivated 5 p ...

1. Re:Topic 2 DQ 1
Reeves et al. (2013), focus their study on a Hispanic
immigrant community in Albuquerque, New Mexico to establish
whether there was a correlation between fear and health as they
claimed. Diabetes is reported to be more prevalent in
Albuquerque being the sixth cause of mortality(New Mexico
Health Policy Commission 2009).The authors identified three
core elements that determined the connection between health
and fear(cost, language, discrimination and immigration status,
and cultural differences).
The cost of health care being too high causes a level of stress
that leads to fear as identified by the participants. Reeves et al.
(2013) further explain that this fear is perpetuated not by
diabetes but by the structural economic obstacles faced the low-
income immigrant community. Most immigrants face language
barriers and claim to be discriminated against when they go to
health care institutions. They feel that they cannot clearly
communicate their health needs. Even though some institutions
have translators others report that they are not effective.
Immigrants feel that being in a foreign country makes their
immigration status conspicuous thus creating fear of being
deported.
Reeves et al. (2013) report that according to
Walton(2009),cultural disconnection arises from the perceptions
health care providers have about alternative medicines which
patients use to treat their health issues even diabetes. Patients
are reluctant to tell their doctors that they use alternative
medicine for fear of being criticized. This limits open
communication between them thus degrading the quality of
healthcare services given to the patients.
Structural violence does accelerate health disparities because
it is embedded in social structures that expose individual to
dangers. Individuals feel the lack of support from economic and

2. political constructs in the social arrangements and this limits
their access to health care services. Farmer et al. (2006), report
that medical and public health programs will fail if healthcare
providers do not understand the social factors of disease
regarding structural violence. Montesdeoca (2013) further
supports this argument that health disparities are related to past
and present inequalities in social, economic, political and
environmental resources elements of structural violence.
References
Farmer, P.E., Nizeye, B., Stulac, S. & Keshavjee, S.
(2006).Structural Violence and Clinical Medicine. PLoS
Medicine, 3(10), 449. doi:10.1371/journal.pmed.0030449
Montesdeoca, C. (2013).Inadequate Access to Healthy
Opportunities and Structural Violence: A Case Study of Health
Disparities among Hispanics in McLean County. Senior Theses-
Antropology. Paper 5
Page-Reeves,J.,Niforatos,J.,Mishra,S.,Regino,L.,Gingrich,A., &
Bulten,R.(2013).Health Disparity and Structural Violence: How
Fear Undermines Health Among Immigrants at Risk for
Diabetes. Journal of Health Disparities Research and Practice,
6(2), 30-47
Deactivated
5 posts
Re:Topic 2 DQ 1
The article, “Health Disparity and Structural Violence: How
Fear Undermines Health Among Immigrants at Risk for
Diabetes,” explains the fear that certain cultures, as well as
immigrants have related to health and diabetic health outcomes
(Page-Reeves, Niforatos, Mishra, Regino, Gingrich & Bulten,
2013). Diabetes affects many people and race, ethnicity and
minorities are factors related to the increased risk for this
disease. This as well as many other factors, such as
discrimination, clinical uncertainty, and stereotyping, affect the

3. maintenance of the disease and disparity (Page-Reeves,
Niforatos, Mishra, Regino, Gingrich & Bulten, 2013).
There are three dimensions of fear in the article related to
health and diabetes. These three fears include cost, language,
discrimination, and immigration status, and cultural disconnect.
Health issues are tied to certain socioeconomic aspects and low
economic status correlates with high uninsured rates, thus
making people not go to the doctor. The fear of financial burden
associated with an illness such as diabetes makes it hard to get
help because they fear the cost of getting help (Page-Reeves,
Niforatos, Mishra, Regino, Gingrich & Bulten, 2013). They also
stated in the study that they will put their children first and
neglect their own health concerns because they would like to
pay for food, clothing, bills, and many other things. It was also
said that they felt that people with a Spanish accent or someone
who lacked English are discriminated against in clinics and
hospitals. The fear of these areas makes it so they do not get
help with their health, eventually making it worse for them.
Structural violence is a systemic way where social structures
harm and disadvantage people (Structural Violence, n.d.). This
is said to be violent because it can cause injury. A structural
violence framework would take into consideration the extent of
how people’s lives are affected by institutionalized inequality,
influencing and often governing individual experience (Page-
Reeves, Niforatos, Mishra, Regino, Gingrich & Bulten, 2013).
The article shows a race that finds many obstacles in getting
health care. Structural violence most definitely perpetuates
health disparity. However, applying this type of framework to
better understand diabetes health disparities in this type of
community would help provide insight into the process that
produces and encourages disparity (Page-Reeves, Niforatos,
Mishra, Regino, Gingrich & Bulten, 2013).
References

4. Page-Reeves, J., Niforatos, J., Mishra, S., Regino, L.,
Gingrich, A., & Bulten, J. (2013). Health Disparity and
Structural Violence: How Fear Undermines Health Among
Immigrants at Risk for Diabetes. Retrieved from
eds.b.ebscohost.com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewe
r?sid=40982cc1-206c-49d7-bdc3-
77194c11b3eb%40sessionmgr101&vid=1&hid=108
Structural Violence. (n.d.). Structural Violence. Retrieved from
http://www.structuralviolence.org/structural-violence/