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Stories of Strength: Chicago Latin@S' Navigation of Health, Well-Being, and Chronic Disease

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Stories of Strength: Chicago Latin@S' Navigation of Health, Well-Being, and Chronic Disease University of Kentucky UKnowledge Theses and Dissertations--Anthropology Anthropology 2018 STORIES OF STRENGTH: CHICAGO LATIN@S' NAVIGATION OF HEALTH, WELL-BEING, AND CHRONIC DISEASE Lilian L. Milanés University of Kentucky, [email protected] Digital Object Identifier: https://doi.org/10.13023/etd.2018.279 Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Milanés, Lilian L., "STORIES OF STRENGTH: CHICAGO LATIN@S' NAVIGATION OF HEALTH, WELL-BEING, AND CHRONIC DISEASE" (2018). Theses and Dissertations--Anthropology. 33. https://uknowledge.uky.edu/anthro_etds/33 This Doctoral Dissertation is brought to you for free and open access by the Anthropology at UKnowledge. It has been accepted for inclusion in Theses and Dissertations--Anthropology by an authorized administrator of UKnowledge. For more information, please contact [email protected]. STUDENT AGREEMENT: I represent that my thesis or dissertation and abstract are my original work. Proper attribution has been given to all outside sources. I understand that I am solely responsible for obtaining any needed copyright permissions. I have obtained needed written permission statement(s) from the owner(s) of each third-party copyrighted matter to be included in my work, allowing electronic distribution (if such use is not permitted by the fair use doctrine) which will be submitted to UKnowledge as Additional File. I hereby grant to The University of Kentucky and its agents the irrevocable, non-exclusive, and royalty-free license to archive and make accessible my work in whole or in part in all forms of media, now or hereafter known. I agree that the document mentioned above may be made available immediately for worldwide access unless an embargo applies. I retain all other ownership rights to the copyright of my work. I also retain the right to use in future works (such as articles or books) all or part of my work. I understand that I am free to register the copyright to my work. REVIEW, APPROVAL AND ACCEPTANCE The document mentioned above has been reviewed and accepted by the student’s advisor, on behalf of the advisory committee, and by the Director of Graduate Studies (DGS), on behalf of the program; we verify that this is the final, approved version of the student’s thesis including all changes required by the advisory committee. The undersigned agree to abide by the statements above. Lilian L. Milanés, Student Dr. Ann E. Kingsolver, Major Professor Dr. Sarah Lyon, Director of Graduate Studies STORIES OF STRENGTH: CHICAGO LATIN@S’ NAVIGATION OF HEALTH, WELL-BEING, AND CHRONIC DISEASE DISSERTATION A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the College of Arts and Sciences at the University of Kentucky By Lilian Luisa Milanés Lexington, Kentucky Advisor: Dr. Ann E. Kingsolver, Professor of Anthropology Lexington, Kentucky 2018 Copyright © Lilian Luisa Milanés 2018 ABSTRACT OF DISSERTATION STORIES OF STRENGTH: CHICAGO LATIN@S’ NAVIGATION OF HEALTH, WELL-BEING, AND CHRONIC DISEASE Health inequalities take many forms related to race, gender, socioeconomic status, ethnic, language and many other axes throughout communities around the world. Type two diabetes, high blood pressure, and high cholesterol are examples of conditions (among many others) that disproportionately affect Latino@s in the U.S.. The research of this dissertation is based on fieldwork conducted throughout several predominantly Latin@ neighborhoods in Chicago, IL. This dissertation examines how Latin@s in Chicago navigate health and well-being, and how they engage in agentive strategies in the face of chronic disease. I recorded individual life histories and semi-structured interviews, focus groups, and participant observation at various community events and settings. The stories of these Chicago Latin@s are shared here in an effort to de-homogenize the depiction of Latin@s in the U.S. by paying attention to local narratives, and especially to those related to living with chronic disease. KEYWORDS: Health inequities, Latin@s, Chicago, U.S. Lilian Luisa Milanés May 3, 2018 STORIES OF STRENGTH: CHICAGO LATIN@S’ NAVIGATION OF HEALTH, WELL-BEING, AND CHRONIC DISEASE By Lilian Luisa Milanés __Ann E. Kingsolver, Ph.D._ Director of Dissertation ___Sarah Lyon, Ph.D.______ Director of Graduate Studies ________May 3, 2018____ Date Esta disertación la dedico a toda mi familia. Especialmente a Juan Andrés, Leonardo Emanuel, y Rosario Chávez, por todo su apoyo y fuerza para seguir adelante. ACKNOWLEDGMENTS First and foremost, thank you to each and every person who took the time to sit down and talk with me, and teach me how they navigate their health and well- being. In particular, I am so appreciative of my dear friend “Ms. Yaly”, for helping to connect me with so many residents and teaching me about living in the NW of Chicago. Thank you for helping me organize my research and watch or hold Leo when I needed an extra hand. Thank you to las muchachas del sur. You are the lifeblood of the family and have taught me so much about motherhood, being a spouse, a comadre, and friend. Thank you for opening your homes and lives to me as I began adapting to life in Chicago. Thank you to “Doña Nancy”, for sharing your heart and passion with me since day one. Your dedication to the community, to follow your dreams and your happiness for the betterment of your and your family’s life is so uplifting. To las mujeres del centro, thank you for your encouragement, suggestions and help to launch my data collection and teach me what resilience truly means. I am so grateful and honored to have had this opportunity to work with my advisor and mentor, Dr. Ann E. Kingsolver. In the two short years under her mentorship I was able to finish conducting fieldwork, write this dissertation, apply for academic positions, and land my dream position. Thank you for all the time you have dedicated to all of your advisees, especially when running on borrowed time. Thank you for believing in me when I did not believe in myself. Thank you for showing me first-hand, how quality, collaborative, and engaged ethnography is done. You are the essence of mentorship. Your patience, kindness and prestige are what I hope to embody as an academic, scholar and activist. iii Thank you to Sarah Lyon for making this mentorship relationship possible. I appreciate all of the work you have been doing to see me, along with all anthropology graduate students, succeed through this program. Thank you to Deb Crooks for remaining on my committee through retirement and opening the world of biological anthropology to me. Thank you to Ana Liberato for your mentorship throughout my time at UK, and for being a little piece of home for me when I felt most lost. This dissertation writing experience was completely transformed by the weekly writing group meetings with my colleagues and fellow Kingsolver advisees, and I am so thankful for being part of this community. To my dear friends and colleagues Céline Lamb and Sneha Thapa for constantly reminding me and motivating me to achieve my own greatness. To Veronica Miranda for advising me through so many phases of this Ph.D. process. To my husband Juan, for your tough love and insistence on the very best constantly propel me forward. You inspire me to do better each day. To my son Leonardo, thank you for your patience and for constantly teaching me the most important things in life. To my mother, thank you for always giving so much, for being the trail-blazer you are and for guiding me through each of these steps, especially when I did not know what to ask. To my father, an honorary medical anthropologist, words cannot express how grateful I am for everything you have taught me, and continue to teach me, in life. To all of my abuelas, abuelos, tias, tios and primos, and all my family and friends who have supported me in one form or another. This is for us. We did it! iv TABLE OF CONTENTS Acknowledgments …….………...………………………………………………...… iii List of tables ……………………..…………………………………………………. vii List of figures ……………………………………………………………………… viii Chapter One: Introduction …………………………………………………………… 1 Dehomogenizing Latin@ representations in the U.S. ……….....…….……… 7 Meanings of health and chronic disease ……..………………………….….. 12 Theoretical positioning: translocal intersectional experiences of health ….... 21 The city of neighborhoods …………………………………..…….……...… 29 Methodology ……………..…………………………….……………...…… 35 Overview of chapters ………………………………….…………….……… 50 Chapter Two: Social landscapes of Chicago-the segregated city ………..………… 54 Latin@s and the state in Chicago: then and now ………………………… 54 Differences throughout NW and SW community areas ….….…………… 86 Chapter Three: Azúcar, presión y colesterol: ‘Yo no tengo problema ninguna’ [sugar, pressure, and cholesterol: ‘I don’t have any problem’] ……………………..….. 110 The dangers of Latin@ homogenization ……..…………..……..………… 111 Metabolic syndrome and definitions of health …………...……..………… 115 Strategies and tactics: overall data analyses and discussion ….…...…...…. 124 Latina mothers’ navigation of health and well-being ……...……...….…… 141 Conclusions ………………………………………………………..……… 157 Chapter Four: Engagement with biomedicine …………..………………………… 160 Shifting health policies in the post-ACA climate .….……………...……… 160 Biomedical facilities .……………..….……………………………………. 168 The clinician-patient relationship …...……...……………………...……… 175 Biomedical treatment: ‘La medicina le esta hacienda mal’ [The
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