Health promotion and education mural in Policlinico 30th de Noviembre, Santiago de Cuba.
A. Kilolo Harris, MPH candidate
Kilolo’s internship focused on identifying social and cultural determinants that impact the health status, health behavior, beliefs and attitudes of Afri-Cubans. The province of Santiago de Cuba , where she conducted preliminary research, has the third-largest population of African descendents of the Latin American countries.
The primary level of health care delivery is at a doctor’s office/home called a consultorio. Health care delivery is divided into three levels: primary, secondary and tertiary, with the primary level expected to solve approximately 80% of the health problems of a given population and to connect this with health promotion and protection. Focus programs include maternal health, elderly, transmittable and non-transmittable diseases. Prevalent health conditions in Santiago are hypertension and diabetes; in 1998 1 in 3 Cubans over age 15 suffer from hypertension and in 1996 the seventh leading cause of death was diabetes. The Special Period (meaning the economic crisis brought on by the end of the Soviet era and the U.S. economic embargo) and efforts to stabilize it have created social and cultural determinants that impact health status, such as engaging in high-risk behaviors such as smoking, drinking (rum) and risky sex.
Kilolo lived at a consultorio and had direct contact with doctors as well as families, social workers, tourist workers, non-tourist workers, academics in public health and others for research purposes. She felt her experience in Cuba enabled her to apply public health research and cultural competence skills, obtain knowledge about Afri-Cubans, identify determinants in health and illness, and assess internal and external forces affecting this population.
Read Kilolo’s full report here Kilolo Harris