Tania Pacheco-Werner stood in front of dozens of health care providers at the Fresno Adolescent Sexual Health Conference last week and asked them to say one word in unison : “racism.”
“Oppression within sexual health exists. I see it in the numbers, but you see it in practice. So how do we start changing some of this?” said Pacheco-Werrner, a sociologist for the Central Valley Health Policy Institute at Fresno State.
Health disparities are nothing new in Fresno County, which has among the highest rates of teen pregnancy and sexually transmitted diseases in the state. Fresno’s poorest zip codes have higher teen birth rates than nearby wealthier neighborhoods, and nearly 75 percent of Fresno County’s teen mothers are Latina. In addition, the state’s young black women are up to five times more likely to contract certain sexually transmitted diseases, compared to young white women.
There are some systems that are at work that have made it so that our young people of color and our young people in inner-city have a different health outcome than other folks.
Tania Pacheco-Werner, Central Valley Health Policy Institute
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But Pacheco-Werner said she doesn’t like to use the word “disparities” because “it makes it sound like it’s an accident.” She urged providers to rid themselves of any biases that may make young people not want to return to a clinic or make them afraid to seek help.
“There are some systems that are at work that have made it so that our young people of color and our young people in the inner-city have a different health outcome than other folks,” she said. “The process by which we get to where we need to be, by lowering those numbers, by closing those gaps and disparities, comes from understanding how the practice of sexual health services, of science creation, is molded by how I’m thinking about things.”
Pacheco-Warner offered some simple advice to combat that: “Listen to those young people … they can provide you with a myriad of understanding that no textbook, website or manual can provide.”
Joe Prado, of the Fresno County Department of Public Health, said the conference, which focused on school-based sex education and increasing access to services for youth, had perfect timing, pointing to national debates over reproductive health care.
Ensure that every adolescent has the freedom to make a choice on his or her health care without prejudice.
Joe Prado, Fresno County Department of Public Health
“It’s a time for us to really refocus and be intentional with our service delivery models. As we experience leadership at national and local levels that drives division within our communities, and is not accepting of every adolescent, we as a community must assure that we adopt practices and policies that are supportive of every adolescent that comes through the door,” Prado said. “Ensure that every adolescent has the freedom to make a choice on his or her health care without prejudice.”
Satvinder Dhaliwal, an epidemiologist with the Department of Public Health, said there are a lot of factors, including poverty, air quality and health-care access, that contribute to such disparities. While there’s no one answer for why that is, acknowledging the disparities is a start, she said.
“We see those disparities in STIs, and we see them again in the teen birth rates. The point is the disparities continue to exist,” she said. “It’s really important to consider what else is happening in that individual’s neighborhood. What’s the crime like? What’s the poverty like? What other health conditions could they be experiencing that maybe is making STI and pregnancy prevention less of a priority to them?”
See The Bee’s ongoing series on teen pregnancy and sex education here.