Rosales, Cecilia

The purpose of our evaluation is to provide an example of how public health schools can use service-learning courses to teach students about health equity. By ensuring that the future workforce has a comprehensive understanding of regions such as the U.S./Mexico border, students will be better equipped to provide public health services. Specifically, our objectives were to (1) understand how student perceptions of the border evolve during the 1-week Border Health Service-Learning Institute (BHSLI) course and (2) understand how the service-learning experience impacted students’ proposed personal and professional goals. Using BHSLI student journals collected over 9 years, we conducted a qualitative investigation to evaluate students’ experiences of the service-learning course. Our findings suggest that BHSLI offered opportunities for advancing dialogue about health equity. Because BHSLI is immersive, it showed students a reality that they would not normally encounter. In reflecting on these new experiences, students were not only encouraged to question systems and policies but also made accountable to act upon the insights they gained. We found that BHSLI was a space for critical consciousness building, for shifting paradigms. Students learned how to intervene in real time to make change around public health issues. Service learning could be a practice-based solution to help public health students learn about health equity, especially in historically marginalized regions such as the U.S./Mexico border.

Hispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648) participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, based on self-report and a glucose testing, was 21%; much higher than rates reported for U.S. adults overall, for all Hispanic adults, or for Mexican American adults specifically. Acculturation markers and social determinants of health indicators were only significantly related to diabetes in models not accounting for age. Older age, greater BMI (>30), greater waist-to-hip ratio as well as lower fruit and vegetable consumption were significantly related to increased likelihood of diabetes when all structural, cultural, behavioral, and biological factors were considered. Models with sets of behavioral factors and biological factors each significantly improved explanation of diabetes relative to prior social ecological theory-guided models. The findings show a critical need for diabetes prevention efforts in this community and suggest that health promotion efforts should particularly focus on increasing fruit and vegetable consumption.