The Sweet Journey

Target population: Latinxs livng with diabetes in San Antonio, TX.Purpose of this page: to collectively portray the struggles, strength of resilience from the community, efforts the city is making to alleviate diabetes, and future efforts San Antonio can make. Future efforts of photovoice projects will harness San Antonio's rich art culture as well as empowering individuals diagnoised with diabetes. Studies show building self-efficacy will feed autonomous self-regulation (Deci, 1992; Senecal, Nouwen, & White, 2000).   

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Photovoice Goals

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Support Groups and Photovoice. 

Many interventions have been made by government officials and national organizations focused on health, physical activity, and nutrition. But there is an accessible component that can help decrease diabetes with Latinx’s in San Antonio through the use of photovoice. 

Photovoice is a way for a community to “voice” their perspective on the concerns and strengths by first identifying needs, representing them, and then highlighting them to inform policy makers, enhance community participation, and empower the community. In relation to diabetes and obesity; photovoice has been used for Type 1 diabetes in adolescence, Type 2 diabetes in older adults in rural counties, and to assess healthy eating habits with adolescence to help policymakers develop policies that will serve the needs identified by the communities (Fritz, 2015; Necheles et al., 2007; Yankeelov et al., 2015; Yi-Frazier et al., 2015). 

Common themes consisted of diabetic care/management (scheduling, medication, diet, exercise, etc.), personal and community resilience, support systems (groups, family, and friends), life with diabetes, and environment (infrastructure and access to healthy foods at stores) (Fritz, 2015; Necheles et al., 2007; Yankeelov et al., 2015; Yi-Frazier et al., 2015). 

Results have shown an engagement and understanding from researchers and policymakers to better assist individuals with diabetes and adjust or develop policies based on photovoice presentations (Fritz, 2015; Wang & Burris, 1997; Yankeelov et al., 2015).

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Community movements: 

In photo - Red cross: The Metropolitan Health District Strategic Plan for 2017 - 2019 is to achieve “health equity” which is “achieved when every person has the opportunity to ‘attain his or her full health’ potential regardless of socioeconomic circumstances” in particular focusing on areas with the highest health disparities.

Two of the strategies the Office of Health Equity will be implementing are: training the workforce to become culturally competent and “increase and expand the Diabetes Prevention Program...with a focus on Hispanics, Latinos, and African Americans”

In photo- ”x” over the sugar packs -Bexar Healthy Beverage Coalition - “Sugar Packed”

In photo- “x” over the Bic lighter to indicate the new 21 and over tobacco law.

In photo- the vegetables, bike gear, Collaboration with YMCA of Greater San Antonio and the San Antonio Metropolitan Health District

The Bold Goal Collaborative is a group of partners (organizations, physicians, and clinicians) throughout United States, Texas, and San Antonio to help specifically the San Antonio community become 20% healthier by 2020. 

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Resilience through: community (family and friends). This photo shows a colorful, collective group of flowers breaking through the cracks of oppression, stigma, stereotypes, and symptoms. 

This photo portrays the ultimate strength people living with diabetes have, “the fact that they show up (to appointments) despite the barriers they have as well as the symptoms from the diagnosis itself: fatigue, depression, body aches, and other internal effects."

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Photo of a Latina eating a sandwich. The bread has tire track marks over it to illustrate the systematic-oppression Latinxs experience. The sandwich is filled with money to portray where the money is spent, which is non-nutritious food. A watch to indicate the little time low-income Latinxs have due to multiple jobs and caring for family members, the female is representative of the common role Latinas play in their family by working (sometimes multiple jobs) while also caring for their family members (children, elderly, and significant other). Also known as the “second shift”. 

"Health inequities are reflected in the difference in length and quality of life; rates of disease, disability, and death; severity of disease; and access to treatment (COSA, 2017). In 2014, one in five individuals in Bexar County did not tend to their health needs because of cost. The underinsured and uninsured are less likely to obtain “preventative care and are more likely to be diagnosed in a later stage of a disease”

Individuals who are low income have a lack of the essential resource needed to obtain proper, preventative, medical care such as: access to time (appointments are during working hours), reliable transportation (versus public bus transportation resulting in multiple bus stops and transfers), language barriers (refer to Prevalence and History), lack of insurance, restricted cellular service available minutes to schedule/reschedule appointments (i.e. wait-times over the phone), affordable childcare to attend medical appointments.

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This photo represents food and culture in San Antonio, TX. In the Latinx culture food and celebration mean community, love, acceptance, tradition, and ancestry. Pan Dulce and tacos are delicious, filling, and cost very little but there is close to zero nutrition, high in sugar, and calories.  

In 2013 the COSA Metro Chronic Disease Prevention Program gathered the following:16% of Hispanics were diagnosed with Type 2 diabetes compared to 12% of Black and African American and 6% White.

In 2014, 14.2% of adults in Bexar County were diagnosed with Type 1 and Type 2 diabetes.

In 2015, 1.9 million people lived in Bexar County. Of these individuals: 59.5% were Latinx, median age was 33 years of age, 83% graduated from high school, 27% graduated with a Bachelor’s, 17% did not complete high school, 17% lived below the poverty line with 25% children living in poverty The Center for Disease Control (2013) reported higher rates of diabetes among Latinxs, individuals without a college degree, and with lower household income.