Question

According to the assigned article, "Health Disparity and Structural Violence: How Fear Undermines Health Among Immigrants at Risk for Diabetes," (https://www.ncbi.nlm.nih.gov/pubmed/24052924) narratives tell the story of the interconnectedness between fear and health. Thematically, the issue of fear is 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?

Answer 1

"Anger, hatred and fear is bad for our health."

- Dalai Lama

Diabetes is related with a reduction in life expectancy and high morbidity due to specific complications associated with microvascular and macrovascular disease and low quality of life. Fear is never directly related to the outcomes of diabetes but it affects in an unseen manner. The recognition and acceptance of a person is important in the series of disease progression. The cooperation of patients with the healthcare providers evolve ways to manage the case. These decision about making a health choice depends on various context and determinants of health.

A structural violence can be described as a form of violence in which a social structure may harm people from preventing them from meeting their basic needs. These structural forces simultaneously inhibits the peoples access to healthcare facilities and creates fear among the immigrants at risk for diabetes. There are several fears faced by these patients suffering from or at risk of developing diabetes.

• Fear of life itself: As the disease is considered to bring severe complication and reduce the quality of life, it creates a fear in their minds .
• Fear of complications: The disease requires various lifestyle modifications in order to bring an effective change. The complications may be severe affecting almost the major vital organs and sometimes causes life long debility.
• Fear for work : The disease creates a fear in their minds about the socioeconomic and occupational status. The impact of the disease often influence their social, economic and occupational life situations.
• Fear for family: Diabetes is considered to have genetic predisposition from a parents to children. This may create a burden on individual even to start a family.
• Fear of deprivations and social stigma: The patients often do not like to accept the fact that they are suffering from diabetes with the thought that what society would think if they discovered their secret. Often they are un cooperative with the thought of being deprive from food.

Although these fear did not directly affect the diabetes outcome but to some extend it tend to affect the recognition and acceptance of the disease and eventually affecting health.

The causative factors of diabetes are multidimensional due to which preventing it or treating it promptly is rarely effective. These disparities among the individual whether its or structural, inhibits the actual potential or skill or capacity to live. The health disparities create inequity, often deciding who will live and who will die- effecting the poor and immigrants. These disparities are structural as its present in our political and economic organizations of the modern world which are violent as they cause injury to people. The structural inequity limits the person's ability to make health choices that ultimately effects the outcome of the disease. They are offered health promoting choices. Thus to conclude the structural violence perpetuates health disparity.