Commentary Sexual Health

Latinas and Cervical Cancer: The Fight for Greater Health Care Access

Natalie Camastra

No woman should be diagnosed, let alone die, of cervical cancer. For the first time, we have a comprehensive set of tools to prevent and fight the disease.

This article is cross-posted from and in partnership with the National Latina Institute for Reproductive Healthand is published as part of a series on cervical cancer.

See all our coverage of Cervical Cancer Awareness Month 2012 here.

This week you have been reading many perspectives on “what will it take to end cervical cancer?” as part of NLIRH’s blog carnival, ¡Acábalo Ya! Working Together to End Cervical Cancer.

All of us here at the National Latina Institute for Reproductive Health (NLIRH) emphasize the importance of monitoring cervical cancer incidence rates because they serve as indicators of a community’s access to preventive health care services.

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Why is this? Because no woman should be diagnosed, let alone die, of cervical cancer. For the first time, we have a comprehensive set of tools to prevent and fight the disease. Cervical cancer is highly preventable with regular Pap tests, the HPV test, and a provider’s monitoring and treatment of precancerous changes to the cells of a cervix. The HPV vaccines (both Gardasil® and Cervarix®) are also effective tools in the prevention of cervical cancer. Furthermore, the disease is also highly treatable when detected early.

Yet Latinas continue to have the highest incidence of cervical cancer among women of all ethnic/racial groups and the second highest mortality rate after African American women. In certain states, particularly along the southern border, Latinas have the highest incidence and mortality rates.

NLIRH recognizes and raises awareness of the myriad barriers Latinas face to preventing cervical cancer: lack of health insurance, stigmas around STIs and sexual health, cultural and linguistic barriers with health care systems and providers, the high cost of health care, fear associated to immigration status, racism and xenophobia.

Thus, while we serve to educate Latinas about the importance of gynecological health and demystify sexual health issues, we also will work year-round to bring down the barriers Latinas face in accessing health care.

This year, we will work to increase federal funding for Title X, the only federally funded family planning program, that provides cervical cancer screening and STI counseling to low-income women. We urge the federal government to support other programs that positively impact Latina health including Medicaid,  Community Health Center grants, funding for immunizations and school-based health programs. We will continue to advocate for access to health care for immigrants, for instance by urging Congress to lift the five-year ban for qualified legal immigrants from accessing means-tested benefits under Medicaid.

In 2012, there will be many opportunities to reduce health disparities and increase Latinas’ access to health services. Beyond January, we hope that our elected officials will not only speak about cervical cancer awareness, but work work us to ensure Latinas live cervical-cancer free.

For more information, please visit NLIRH’s resources on cervical cancer.

Commentary Abortion

Latinx Must Use Votes to Fight Hyde Amendment

Cristina Aguilar, Jessica González-Rojas, Laura Jimenez & Maria Teresa Kumar

More than 27 million Latinx are now eligible to vote, and that number can help determine who takes office and what abortion policies they enact.

The first woman known to die of an unsafe illegal abortion after the Hyde Amendment was a Latina. A struggling 27-year-old college student with a young daughter, Rosie Jimenez died from septic shock in October 1977—with a scholarship check earmarked for school in her purse. Jimenez had been refused coverage because, just months before, Congress had enacted the Hyde Amendment banning use of federal Medicaid funds for abortion except in cases of rape, incest, or life endangerment.

As we enter this Latina Week of Action for Reproductive Justice (today through August 7), the Hyde Amendment continues to deny pregnant people the chance to make the best decision for themselves and their families. And because our communities are hard-hit by abortion restrictions, Latinx must play a role in our electoral process to repeal Hyde and replace other anti-abortion measures with policies that truly support all families.

A 2011 study found that more than 70 percent of Latino registered voters believe that we should not judge someone who feels they’re not ready to be a parent. Unfortunately, this sentiment is not echoed by many legislators in Congress and throughout the country, who too often design policies precisely to put abortion care out of reach.

While the recent Whole Woman’s Health v. Hellerstedt Supreme Court struck down medically unnecessary restrictions in Texas, abortion access remains a challenge for many Latinx across the country. The Hyde Amendment has a disproportionate impact on low-income people of color who already face numerous health-care disparities and often do not have the money to compensate for insurance gaps.

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Withholding Medicaid coverage for abortion has an especially devastating effect in our communities, where enrollment is high; in 2012, 29 percent of Latinx adults and children nationwide received benefits from the program, and in some states such as Texas, more than half of Medicaid participants were Latinx.

Whether it’s public or private, health insurance must cover the services we need. When it doesn’t, the scramble to pay for an abortion has the potential to push families further into poverty. Already, too many of us are just scraping by while living with the stresses of a broken immigration system that divides families, structural racism, and lack of educational and employment opportunities.

Our communities need laws to ensure that health plans provide abortion coverage—not the Hyde Amendment nor legislation that claims to protect women while closing clinics or shaming those who provide and seek abortions.

Abortion is health care. And the ability to obtain health care should not be predicated on what type of insurance benefits you have, how much money you make, or whether you live in a state that allows public funds to pay for abortions.

It is time that we push back. Together, we can harness our power to advance positive policies that will make a difference. Latinx comprise a critical voting bloc that can significantly influence electoral outcomes; according to the Pew Research Center, an unprecedented number—27.3 million—of Latinx will be eligible to vote in the upcoming election.

But this only matters if we show up at the ballot boxes. We need to hold our elected officials accountable when they don’t consider the needs of our families. By lifting our collective voices and our votes, we can sway who holds office and makes policies.

This election, the health, rights, and dignity of our families are at stake. We cannot afford to sit out voting. It is an opportunity to make sure that those who are charged with representing us stand with our families. We owe it to Rosie Jimenez and the daughter she left behind. We owe it to ourselves.

Culture & Conversation Human Rights

Let’s Stop Conflating Self-Care and Actual Care

Katie Klabusich

It's time for a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities.

As a chronically ill, chronically poor person, I have feelings about when, why, and how the phrase “self-care” is invoked. When International Self-Care Day came to my attention, I realized that while I laud the effort to prevent some of the 16 million people the World Health Organization reports die prematurely every year from noncommunicable diseases, the American notion of self-care—ironically—needs some work.

I propose a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities. How we think about what constitutes vital versus optional care affects whether/when we do those things we should for our health and well-being. Some of what we have come to designate as self-care—getting sufficient sleep, treating chronic illness, allowing ourselves needed sick days—shouldn’t be seen as optional; our culture should prioritize these things rather than praising us when we scrape by without them.

International Self-Care Day began in China, and it has spread over the past few years to include other countries and an effort seeking official recognition at the United Nations of July 24 (get it? 7/24: 24 hours a day, 7 days a week) as an important advocacy day. The online academic journal SelfCare calls its namesake “a very broad concept” that by definition varies from person to person.

“Self-care means different things to different people: to the person with a headache it might mean a buying a tablet, but to the person with a chronic illness it can mean every element of self-management that takes place outside the doctor’s office,” according to SelfCare. “[I]n the broadest sense of the term, self-care is a philosophy that transcends national boundaries and the healthcare systems which they contain.”

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In short, self-care was never intended to be the health version of duct tape—a way to patch ourselves up when we’re in pieces from the outrageous demands of our work-centric society. It’s supposed to be part of our preventive care plan alongside working out, eating right, getting enough sleep, and/or other activities that are important for our personalized needs.

The notion of self-care has gotten a recent visibility boost as those of us who work in human rights and/or are activists encourage each other publicly to recharge. Most of the people I know who remind themselves and those in our movements to take time off do so to combat the productivity anxiety embedded in our work. We’re underpaid and overworked, but still feel guilty taking a break or, worse, spending money on ourselves when it could go to something movement- or bill-related.

The guilt is intensified by our capitalist system having infected the self-care philosophy, much as it seems to have infected everything else. Our bootstrap, do-it-yourself culture demands we work to the point of exhaustion—some of us because it’s the only way to almost make ends meet and others because putting work/career first is expected and applauded. Our previous president called it “uniquely American” that someone at his Omaha, Nebraska, event promoting “reform” of (aka cuts to) Social Security worked three jobs.

“Uniquely American, isn’t it?” he said. “I mean, that is fantastic that you’re doing that. (Applause.) Get any sleep? (Laughter.)”

The audience was applauding working hours that are disastrous for health and well-being, laughing at sleep as though our bodies don’t require it to function properly. Bush actually nailed it: Throughout our country, we hold Who Worked the Most Hours This Week competitions and attempt to one-up the people at the coffee shop, bar, gym, or book club with what we accomplished. We have reached a point where we consider getting more than five or six hours of sleep a night to be “self-care” even though it should simply be part of regular care.

Most of us know intuitively that, in general, we don’t take good enough care of ourselves on a day-to-day basis. This isn’t something that just happened; it’s a function of our work culture. Don’t let the statistic that we work on average 34.4 hours per week fool you—that includes people working part time by choice or necessity, which distorts the reality for those of us who work full time. (Full time is defined by the Internal Revenue Service as 30 or more hours per week.) Gallup’s annual Work and Education Survey conducted in 2014 found that 39 percent of us work 50 or more hours per week. Only 8 percent of us on average work less than 40 hours per week. Millennials are projected to enjoy a lifetime of multiple jobs or a full-time job with one or more side hustles via the “gig economy.”

Despite worker productivity skyrocketing during the past 40 years, we don’t work fewer hours or make more money once cost of living is factored in. As Gillian White outlined at the Atlantic last year, despite politicians and “job creators” blaming financial crises for wage stagnation, it’s more about priorities:

Though productivity (defined as the output of goods and services per hours worked) grew by about 74 percent between 1973 and 2013, compensation for workers grew at a much slower rate of only 9 percent during the same time period, according to data from the Economic Policy Institute.

It’s no wonder we don’t sleep. The Centers for Disease Control and Prevention (CDC) has been sounding the alarm for some time. The American Academy of Sleep Medicine and the Sleep Research Society recommend people between 18 and 60 years old get seven or more hours sleep each night “to promote optimal health and well-being.” The CDC website has an entire section under the heading “Insufficient Sleep Is a Public Health Problem,” outlining statistics and negative outcomes from our inability to find time to tend to this most basic need.

We also don’t get to the doctor when we should for preventive care. Roughly half of us, according to the CDC, never visit a primary care or family physician for an annual check-up. We go in when we are sick, but not to have screenings and discuss a basic wellness plan. And rarely do those of us who do go tell our doctors about all of our symptoms.

I recently had my first really wonderful check-up with a new primary care physician who made a point of asking about all the “little things” leading her to encourage me to consider further diagnosis for fibromyalgia. I started crying in her office, relieved that someone had finally listened and at the idea that my headaches, difficulty sleeping, recovering from illness, exhaustion, and pain might have an actual source.

Considering our deeply-ingrained priority problems, it’s no wonder that when I post on social media that I’ve taken a sick day—a concept I’ve struggled with after 20 years of working multiple jobs, often more than 80 hours a week trying to make ends meet—people applaud me for “doing self-care.” Calling my sick day “self-care” tells me that the commenter sees my post-traumatic stress disorder or depression as something I could work through if I so chose, amplifying the stigma I’m pushing back on by owning that a mental illness is an appropriate reason to take off work. And it’s not the commenter’s fault; the notion that working constantly is a virtue is so pervasive, it affects all of us.

Things in addition to sick days and sleep that I’ve had to learn are not engaging in self-care: going to the doctor, eating, taking my meds, going to therapy, turning off my computer after a 12-hour day, drinking enough water, writing, and traveling for work. Because it’s so important, I’m going to say it separately: Preventive health care—Pap smears, check-ups, cancer screenings, follow-ups—is not self-care. We do extras and nice things for ourselves to prevent burnout, not as bandaids to put ourselves back together when we break down. You can’t bandaid over skipping doctors appointments, not sleeping, and working your body until it’s a breath away from collapsing. If you’re already at that point, you need straight-up care.

Plenty of activities are self-care! My absolutely not comprehensive personal list includes: brunch with friends, adult coloring (especially the swear word books and glitter pens), soy wax with essential oils, painting my toenails, reading a book that’s not for review, a glass of wine with dinner, ice cream, spending time outside, last-minute dinner with my boyfriend, the puzzle app on my iPad, Netflix, participating in Caturday, and alone time.

My someday self-care wish list includes things like vacation, concerts, the theater, regular massages, visiting my nieces, decent wine, the occasional dinner out, and so very, very many books. A lot of what constitutes self-care is rather expensive (think weekly pedicures, spa days, and hobbies with gear and/or outfit requirements)—which leads to the privilege of getting to call any part of one’s routine self-care in the first place.

It would serve us well to consciously add an intersectional view to our enthusiasm for self-care when encouraging others to engage in activities that may be out of reach financially, may disregard disability, or may not be right for them for a variety of other reasons, including compounded oppression and violence, which affects women of color differently.

Over the past year I’ve noticed a spike in articles on how much of the emotional labor burden women carry—at the Toast, the Atlantic, Slate, the Guardian, and the Huffington Post. This category of labor disproportionately affects women of color. As Minaa B described at the Huffington Post last month:

I hear the term self-care a lot and often it is defined as practicing yoga, journaling, speaking positive affirmations and meditation. I agree that those are successful and inspiring forms of self-care, but what we often don’t hear people talking about is self-care at the intersection of race and trauma, social justice and most importantly, the unawareness of repressed emotional issues that make us victims of our past.

The often-quoted Audre Lorde wrote in A Burst of Light: “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”

While her words ring true for me, they are certainly more weighted and applicable for those who don’t share my white and cisgender privilege. As covered at Ravishly, the Feminist Wire, Blavity, the Root, and the Crunk Feminist Collective recently, self-care for Black women will always have different expressions and roots than for white women.

But as we continue to talk about self-care, we need to be clear about the difference between self-care and actual care and work to bring the necessities of life within reach for everyone. Actual care should not have to be optional. It should be a priority in our culture so that it can be a priority in all our lives.

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