Immigrant Health: Shamans, ‘Soul Calling’ and the Uninsured – Jennifer Hirsch & Emily Vasquez
Jennifer S. Hirsch & Emily Vasquez
Mailman School of Public Health, Columbia University
What a bitter irony to read about hospitals’ growing willingness “to consider patients’ cultural beliefs and values.” In “A Doctor for Disease, a Shaman for the Soul” (September 19, 2009) the New York Times describes the integration of Shamans and their traditional healing practices, including “soul calling” and chanting, at a hospital in Merced, California, that serves patients from a local Hmong community. The program, meant to build understanding between the Hmong and the medical establishment, exemplifies an approach “being adopted by dozens of medical institutions and clinics across the country that cater to immigrant, refugee and ethnic-minority populations.”
Cultural sensitivity is certainly an improvement over cultural insensitivity. Any real commitment, however, to improving immigrant health would start by considering the critical role of immigrant workers in our economy and the logical corollary that those contributions ought reasonably to be rewarded with the right to purchase health insurance. Moreover, the concentration of immigrant workers in our nation’s most dangerous jobs in the fields of construction and agriculture means that they suffer disproportionately from under-funded enforcement of existing occupational safety and health regulations. In the case of Latino immigrants, the Pew Hispanic Center reported in September that 28 percent of Hispanic adults living in the United States who are legal permanent residents or citizens are uninsured. Of those who are not citizens or legal permanent residents, nearly two out of three are uninsured (compared to 17 percent of the adult population of the United States who lack health insurance).
“Certified shamans” are fine, but the majority of immigrants would be better served by attention to the living and working conditions that put their health at risk and by a less hypocritical conversation about their exclusion from the health care system.
Jennifer S. Hirsch, PhD, is Associate Professor in the Department of Sociomedical Sciences at the Mailman School of Public Health of Columbia University. Her research focuses on gender, sexuality, and reproductive health, U.S.-Mexico migration and migrant health, and the applications of anthropological theory and methods to public health research and programs. Her books include the 2003 landmark volume, A Courtship After Marriage: Sexuality and Love in Mexican Transnational Families, which explored changing ideas and practices of love, sexuality and marriage among Mexicans in the U.S. and in Mexico, and two edited volumes on the comparative anthropology of love (Modern Loves, edited with Holly Wardlow, and Love and Globalization, edited with Mark Padilla, Richard Parker, Miguel Muñoz Laboy, and Robert Sember). She is also lead author of the forthcoming The Secret: Love, Marriage and HIV, which presents findings from a recently completed NIH-funded comparative ethnographic study that explores the factors that put married women at risk for HIV infection in five countries: Mexico, Nigeria, Uganda, Vietnam, and Papua New Guinea.
Emily Vasquez is pursuing an MPH at Columbia University’s Mailman School of Public Health. She is a graduate of the University of North Carolina at Chapel Hill where, as a Public Policy major, she focused on immigrant social policy. She was awarded a U.S. Student Fulbright grant in 2006 to study the impacts of international migration on migrant-sending communities in Paraguay.
Hirsch, Jennifer, and Emily Vazquez. 2009. Immigrant Health: Shamans, ‘Soul Calling’ and the Uninsured. AccessDenied: A Conversation on Un/authorized Im/migration and Health. Accessed (date) at https://accessdeniedblog.wordpress.com/2009/12/01/immigrant-health-shamans-‘soul-calling’-and-the-uninsured/