#UMNMCH student Marielynn Herrera (she/her/ella), MPH 2023, wrote this reflection on how her deployment at Centro Tyrone Guzman and background working with family home visiting programs contributed to her career in MCH. 

Background

My trajectory to the MCH program reflected my professional evolution. After completing my undergraduate degree, I placed a high premium on the impact of the work I wanted to do out of a desire to address challenges affecting underserved communities. I found AmeriCorps, which resonated with my values and goals. I spent about a year as a literacy tutor for elementary students in a Latine farmworker community in California, and the next year I worked with survivors of domestic violence in New Hampshire. Subsequently, I had the opportunity to work more closely with survivors of domestic and sexual violence, immigrant and refugee women and their families, and develop programs to advance racial justice.

These experiences led me to develop an intimate picture of complex issues and systems directly impacting these communities and instilled in me a person-centered approach to program delivery and design. Throughout much of this time, I thought I would end up pursuing a law degree. What ultimately convinced me to pursue public health was my experience as a program manager for a family home visiting program, where I witnessed firsthand how health insurance status, geographic location, immigrant status, educational attainment, and other factors impacted the health status of women, children, and families. I became increasingly aware of racial and ethnic disparities in maternal and infant health. I learned of specific policies in Minnesota that create barriers for undocumented women to access healthcare services. Working with these families compelled me to collaborate with various organizations and coalitions to change these structures. I found myself in the completely unexpected position of testifying before the Minnesota State Legislature to advocate for funding for family home visiting programs. I am most proud of collaborating with UnidosMN to mobilize undocumented communities so Minnesota state law could restore access to standard driver’s licenses for all, regardless of immigrant status.

In the Maternal and Child Health (MCH) program at the University of Minnesota, I’ve gained more in-depth knowledge about structural and systemic barriers that undermine health and obtained specific skillsets to analyze these challenges. The program has fortified my passion for health equity and justice.

Working with Centro Tyrone Guzman

My first meeting with program staff at Centro Tyrone Guzman felt as if everything in my career up to this point had come full circle. Centro Tyrone Guzman was in the initial stages of implementing their family home visiting program for Latine families, and they expressed the need to address domestic violence as part of their work with mothers. With their support, I was able to develop a training for early childhood educators on domestic and intimate partner violence and how violence uniquely impacts immigrant populations. I developed a similar presentation for mothers in the program, which emphasized how the criminal justice system addresses domestic violence. This was the first time in years that I gave a presentation entirely in Spanish, so I appreciated the opportunity to address two very different types of audiences.

Dismantling Systemic Barriers to Improve Latine Health

My conversations with early childhood educators at Centro Tyrone Guzman helped spark my research interest in health insurance coverage among Latine pregnant persons and families in the U.S.  My interest was further peaked as I searched for mental health and counseling services for Latine survivors of intimate partner violence in the Twin Cities. I discovered a lack of available services in Spanish and a small net of providers because many participants did not have health insurance. In Minnesota, Latine populations are the largest uninsured racial-ethnic group in the state, comprising 21 percent of those who are uninsured. High uninsurance rates among Latine populations are partly explained by federal rules that restrict the eligibility of immigrants to public health insurance programs. Moreover, Latine populations are less likely to receive health insurance through their employer. Uninsurance rates within the Latine population increase among those reporting that they do not speak English, among low-income Latine households, and among Mexican individuals.

In light of these gross disparities, I have become interested in the following research question: How does lack of health insurance impact the Latine MCH population? One study noted that undocumented women without prenatal care are 7x more likely to have a premature baby compared to insured undocumented women. Research has also found that Latine populations are more likely to report delayed care due to cost. Latine individuals that lack health insurance and experience intimate partner violence may experience a compounding negative impact on their physical, emotional, and economic well-being.  

Recognizing these systemic barriers and the ways in which health is undermined is the first step in the long march toward facilitating equitable healthcare policy and practice for Latine populations. The next key focus must be to advocate that our policymakers provide equal access to healthcare, regardless of immigrant status.  

Biography

Marielynn is a second-year MCH MPH student. Her background is in racial justice programming, family home visiting, and advocacy for survivors of intimate partner violence. Marielynn received her BA in Political Science and Spanish and a minor in Women’s Studies from Purdue University in West Lafayette, Indiana. She is currently a graduate research assistant for a multi-method study utilizing an intersectional framework, Protection at the Intersections for Queer Teens of Color (PIQTOC). In addition, Marielynn is a graduate research assistant for the Institute for Social Research and Data Innovation (ISRDI), where she is working with Dr. Susan Mason and Dr. Julia Rivera-Drew to use the Medical Expenditure Panel Survey-Household Component to study maternal and child health. In her spare time, she enjoys cooking, baking, and spending time with her family and dog. After graduating, Marielynn hopes to pursue a Ph.D. in epidemiology with a focus on population and family health.

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References

Beck, T. L., Le, T. K., Henry-Okafor, Q., & Shah, M. K. (2017). Medical Care for Undocumented Immigrants: National and International Issues. Primary care, 44(1), e1–e13. https://doi.org/10.1016/j.pop.2016.09.005

Health insurance: facts and figures. (n.d.). MN Data. https://data.web.health.state.mn.us/insurance_basic

Henry J Kaiser Family Foundation. (2019, January). The Uninsured and the ACA: A Primer – Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act. In KFF. https://www.kff.org/uninsured/report/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act/

Issue Brief No. HP-2021-2 “Health Insurance Coverage and Access to Care Among Latinos: Recent Trends and Key Challenges” Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. October 2021. https://aspe.hhs.gov/reports/health-insurance-coverage-access-care-among-latinos

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