Written by: Laura Ramirez
One of the major driving forces that led me to pursue a career in public health was my own personal experiences navigating the health care delivery system in the United States. Though my family moved to Delray Beach, Florida, just 30 minutes away from Miami, we still struggled with limited accessibility as a result of language barriers. Believe it or not, even in South Florida, we find shortages of medical personnel who speak Spanish or Creole in an area where a significant proportion of the population only speak those languages. I remember watching my parents struggle in the pediatrics waiting room, flipping through endless pages of paperwork in a foreign language that might as well have been written in some Martian language, with no translation services or Spanish versions to be found.
Rest assured, I poured my heart out on this topic in all my graduate school personal statements (the admissions boards can attest to this), because I knew what I wanted to focus on as a future public health professional: reduce the health disparities that exist in the Latinx communities in the United States, barriers to access such as language and cultural barriers, and link this community to health care services that are culturally relevant and competent through navigation efforts. I knew these were all important public health issues, but it wasn’t until I went through some of my course material in my Adolescent Health class that I became aware of another problem: mental health in Latina adolescents. My heart sank as I went through the statistics of the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System on suicide attempt and suicidal thoughts. As of 2015, 46.7% of Hispanic females (the CDC’s terminology) in the U.S. reported feeling sad or hopeless every day for 2 or more consecutive weeks. Among females, Hispanic females were at greater risk for seriously considering attempting suicide. During our class discussion, one of my colleagues voiced the same thoughts I had in my mind, “This doesn’t make any sense. From what I know about this community, they are so unified and lively. Why do the stats show they are lonely and isolated?”
It was at that moment that it clicked in my mind. I knew this was a problem all along, but I couldn’t quite put my finger on how to explain it until now: social and cultural isolation. If you’ve ever watched the movie My Big Fat Greek Wedding, you’ve caught a glimpse of what many immigrants go through when they move to the U.S. and leave their homes. Every time I watch that movie, what I most identify with is the scene in the lunchroom, where Tula gets bullied by some of her peers over her “weird” Greek food. This kind of thing happens in real life! First day of elementary school, I open my lunch box and the kids next to me laughed at my food, and if that wasn’t awful enough, threw it on the floor. That marked the beginning of my social isolation from my peers. I wouldn’t necessarily call it a traumatic experience, but it did create a precedent for my difficulty in forming relationships with my peers, learning how to communicate, and making meaningful connections.
And the worst part? This doesn’t just happen to me. I met a Peruvian family with two little girls a few months ago when they moved into my apartment complex. The little girls, about the same age I was when I first moved to the states, were so energetic and enthusiastic. I recall her mom told me she enrolled the eldest, Lucia, in the Baby Gator program in our village and was about to start soon. One day, as I was walking back from classes, I saw all the kids running around in the playground and in one of the secluded corners, I spotted little Lucia by herself, looking down at the floor, no longer radiating that energy from before. I couldn’t help but see my own experiences intertwined with hers and wonder. Is this the start of her isolation?
As children of immigrant parents, we are taught not to complain, not to speak out, because we should be grateful. We have such a great life, full of opportunities in the states. What could we possibly be unhappy about? If anything, hardships makes us stronger, and we should get over it. It is this type of thinking in our cultures that stigmatizes and silences us from talking about our mental health. This is why we don’t say anything. This is why we don’t seek help. This is why we pretend nothing is wrong, until it is too late.
So what can we do as public health professionals on a population level? According to a recent study that looked into risk factors for mental health disorders in the Latinx community, the loss of social support systems from someone’s home country can significantly put them at risk for suicidality and depression. Another study had similar findings, where they found that Latinx immigrants who lived in the U.S. longer than 20 years were at greater risk for suicidality than those who lived in the U.S. for 5 years or less due to less exposure to isolation and less time away from friends and family. This is the power of connections. So if we want to create an intervention, one of the focuses should be to build resiliency through establishing connections and meaningful relationships that will serve as a protective factor for depression and suicidality.
What can we do at an individual level? We’ve learned the stigma that exists in this culture, so what are some signs we can look for? Do you notice a classmate who may be isolating themselves frequently? Do they seem constantly distracted? Reach out. Invite them over. Take them out for food. This is absolutely crucial to helping them create a new support system here in the U.S. and create a protective factor against poor mental health and suicidality. We know that social connections are powerful and can significantly mediate the negative impacts of isolation and loneliness on an individual. Even if they deny your invitations multiple times, don’t give up. Keep insisting. Don’t leave them alone.
You might just save a life.
Edited by Casey Parker
Laura Ramirez is currently a second-year Master of Public Health Candidate at the University of Florida College of Public Health and Health Professions concentrating in Social and Behavioral Sciences.