According to the assigned article, “Health Disparity and Structural Violence: How Fear Undermines Health Among Immigrants at Risk for Diabetes,” narratives tell the story of the interconnectedness between fear and health. Thematically, the issue of fearis a dominant feature that affects how an individual approaches day-to-day living and health. Explain the relationship between fear and health identified by the researchers in the article. Do you agree that structural violence perpetuates health disparity?
The fear around illegality expressed by participants is partially an abstract concern with the discriminatory treatment involved, but for individuals who lack documents or have family members without documentation, the fear is more concretely about being discovered. Deportation is an ever-present reality for people living in the shadows because they lack legal immigration status. This threat, especially when combined with the other dimensions of fear, becomes virtually paralyzing for many people in terms of seeking assistance with health problems. Many of those who lack documents do not feel comfortable or safe going to a clinic or to the emergency room. Discussing the fear associated with lacking documents and demonstrating the cross-cutting nature of fear, one participant who works for an agency that serves immigrants said, “Our clientele run on fear because of their documentation status…if a bill collector is bugging them, then they fear INS [Immigration and Naturalization Service]
may be looking over the bill collector’s … shoulder… people are really fearful.” Participants described a local medical provider’s aggressive questioning of patients (or, in this case, it was referred to as “interrogation”). It was reported that this physician routinely asks patients about their legal status. If the patient is an illegal resident, the physician asks to know how the patient entered the country (e.g., via a “coyote”), how much it cost the patient and who they paid. This line of questioning is viewed by participants as intrusive and inappropriate in a medical environment. Knowledge of encounters like this, especially with physicians who are proverbial “gatekeepers” in the system, spreads like wildfire throughout the community.
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