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Amelie Ramirez

I am director of Salud America! at UT Health San Antonio. I have spent 30 years directing research on human and organizational communication to reduce chronic disease, cancer, and obesity health disparities affecting Latinos.

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Articles by Amelie Ramirez

Introduction & Methods: A Cohesive Culture for Health Equity in Latino and All Communities


diverse people together cohesive culture research review introduction

This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» Abstract Health inequities are persistent in the United States. A widening socioeconomic gap, extensive poverty, and multi-level racism, discrimination, and segregation contribute to inequitable distribution of healthcare, resources, and a significant disparity in mental and physical health outcomes among Latino and other population groups. In a society characterized by income segregation and information “bubbles,” it is easy for those who are more fortunate and/or whose hard work has been amply rewarded to fail to perceive the degree of suffering that is experienced by those who do not share their affluence. There is growing evidence that the ...

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Strategy for Equitable Change: Implicit Bias Training


equal justice trauma implicit bias training

This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» Implicit Bias Training Programs Mitigating implicit bias and promoting inclusivity “is a long-term goal requiring constant attention and repetition and a combination of general strategies that can have a positive influence across all groups of people affected by bias,” and can overlap between domains, according to Marcelin et al. and other researchers (see figure).43,74 Implicit bias training programs, such as those designed by the Kirwan Institute of Race and Ethnicity at Ohio State University, also aim to improve intergroup attitudes and relations, by “rewiring” subconscious associations. The Kirwan Institute has made the first set of ...

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Strategy for Equitable Change: Building Social Cohesion


Diverse neighbors social cohesion intergroup contact cohesive culture research review

This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» Why Social Cohesion is Important The far-reaching effects of poverty have been well documented; the material hardships associated with poverty, including food insecurity and difficulty meeting basic medical and housing needs, lead to worse health outcomes.86 An inability to provide for family members leads to parental stress, which compromises marital and parent-child relationships due to a reduced capacity for warm and responsive interactions. The chaotic home lives and the community conditions characteristic of low SES areas — such as community violence and substandard housing — are linked to worse socioemotional outcomes for children. Poorer ...

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Future Research: A Cohesive Culture for Health Equity in Latino and All Communities


george floyd black lives matter people standing in unity cohesive culture future research review

This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» More Research is Needed on a Cohesive Culture It is important to research the relationship between socioeconomic status and education to identify and reduce the risk factors through the improvement of school systems and the development of intervention programs.5,10 Additional studies are also needed to examine the relationships between implicit bias and health care outcomes. This will provide vital information for the development of interventions that target these implicit biases, which have been shown to contribute to disparities in health care between whites and minority groups such as Latinos. This implicit bias influences individuals’ behavior ...

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Research: In Rural Areas, Latinos Face Poverty and Other Inequities


Latino farmworkers cohesive culture research review

This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» Disparities in Poverty Exist across Geography Disparities in poverty rates also exist across geography: child poverty rates are highest in rural counties, at 23.2%, compared to large urban metro areas (21.2%), smaller metro areas (20.5%), and suburban counties (14.5%). Race/ethnicity and geography intersect as well. The poverty rate among black and Latino children in suburban counties is higher than it is for white children in rural counties.10 The Latino Poverty Rate in Rural Areas Most of the U.S. Latino population was concentrated in the Southwest until the 1990s, when Latino immigrants began to migrate to rural areas in the South and Midwestern ...

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Mechanism of Discrimination: The Problem of System Justification


Latino man and daughter system justification cohesive culture research review

This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» System Justification Is a Key Mechanism People Use to Excuse Discrimination among People of Color, Those in Poverty System justification is the label for a social psychology theory asserting that people will rationalize the status quo, as they believe that the social, economic, and political systems must be fair and advantageous, otherwise they would not be in place.55 In other words, the theory states that there is a general subjective motive justifying the existing socioeconomic order; that motive is partially responsible for creating and maintaining the inferiority of racial/ethnic and other minority groups and is largely implicit; and the motive may ...

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Strategy for Equitable Change: Intergroup Contact Theory


Diverse friends on bikes block party intergroup contact cohesive culture research review

This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» Intergroup Contact Theory At the individual level, the contact hypothesis of social psychology, also called the intergroup contact theory, proposes that members of one group, having incomplete or inaccurate ideas about members of another group, can positively change their beliefs and attitudes toward that group via contact, whether face-to-face or through other interactive methods such as computer-mediated communication.75 Using Intergroup Contact to Address Compassion for Immigrants Joyce and Harwood75 recruited students from communications classes at a large university in Arizona to participate in an intergroup contact study. Of the 147 participants, ...

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Strategy for Equitable Change: Effective Communication


jovenes sanos youth group community advocacy effective communication for cohesive culture

This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» The Power of Effective Communication Strengthening communication is important as well for promoting compassion for those of color and those in poverty. Baron and Jacksteit 84 developed a method to establish productive conversation patterns between people who have difficulty communicating due to negative perceptions or stereotypes, polarizing views, and distrust. The method attempts to facilitate conversations that allow the participants to truly understand each other’s values, concerns and motivations rather than those that devolve into reinforcement of negative stereotypes or assumptions. The so-called Public Conversations Project relies on ...

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Research: Latino Healthcare Coverage Has Improved, But Gaps Remain


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This is part of the Salud America! Achieving a Cohesive Culture for Health Equity in Latino and All Communities: A Research Review» Impact of the Affordable Care Act The Patient Accountability and Affordable Care Act, generally referred to as the Affordable Care Act, or ACA, was signed into law in March 2010. The ACA was designed to expand insurance coverage, improving access to health care. Key provisions were included to benefit those of lower SES, including Medicaid expansion and federal health subsidies for those living at 138% of the federal poverty level, and large subsidies for those at 100% to 400% of the federal poverty level who purchased insurance plans through ACA exchanges. In January 2014, the most impactful ACA provisions took effect, including the expansion of ...

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