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Health education helping refugees live and thrive in Georgia

Jubilee Partners in Comer helps refugees from many countries get medical care locally.

Jubilee Partners in Comer helps refugees from many countries get medical care locally.

Pa Saw Paw and Eh Kaw Htoo arrived in the United States seven years ago, bringing with them two children.

They’re originally from the Southeast Asian nation of Myanmar, also known as Burma, but they lived in a refugee camp in neighboring Thailand for 20 years. Their ethnic group, a Christian minority known as the Karen, have been frequent targets of war and persecution in Myanmar for decades.

The family’s first two months in America were spent living in a cabin at Jubilee Partners, a self-described Christian service community in Comer, in Madison County.

Georgia has become home to many refugees, from many different countries. That’s especially true in the melting pot of metro Atlanta, but some have settled in small towns and rural areas.

For recently arrived refugees, there’s much that’s new about life in the Peach State. The Karen, for instance, had not seen in-house thermostats in their remote tropical homeland.

But American ideas about health and nutrition, and the complexities of the U.S. health care system, are often equally unfamiliar to refugees. The clipboard questionnaires at doctors’ offices and the elaborate check-in procedures at hospitals — which Americans take in stride — can seem bewildering to a newcomer.

 

Learning the essentials

 

For 36 years, Jubilee Partners has been giving newly arrived refugees a safe place to live, teaching them basic English skills, and helping them learn to deal with strange new gadgets and practices.

Jubilee’s basic training for new arrivals lasts for two months and involves spending up to 18 hours a week in English classes. The refugees learn how to set a thermostat, how to cook on a gas stove and many other life skills.

YouTube Preview ImageBecause there’s not much work in Madison County, many refugees complete the training and then head for Atlanta’s growing Karen community.

But city life can be hard, and the promise of a good job does not always pan out. Some Karen bounce back to the Comer area, where others had already chosen to remain after resettlement.

One of Jubilee’s founders, Don Mosley, estimates that more than 10 percent of Comer’s population are people who arrived as refugees.

Jubilee Partners helps refugees get preventive care and medical treatment, which often means sending a translator to help families enroll in Medicaid, obtain care or fill prescriptions.

Jennifer Drago, refugee health coordinator for Jubilee Partners, is a key resource for each group of refugees passing through Jubilee. She acts as a link between refugees and the health care system.

Pa Saw Paw knows from experience that navigating the American health care system can be intimidating for people from her culture. She worked with Jubilee Partners as a translator for about three and a half years, and much of her work was in health care settings.  She now works part time at a school in Madison County and lives with her family in Comer.

“Here it’s hard, I think, hard for my people. That’s why they ask me to go along with them to clinic,” she says. “Some people, even though they speak a little bit of English, they don’t have a high education like that and so they don’t know how to fill out the form.”

In addition to difficulties with deciphering insurance, medical history, and intake forms, refugees face other health-related challenges upon their arrival in the United States.

 

More choices — good and bad

 

Many of the Karen people who have been granted asylum were previously on the move for years, or living in resettlement camps where conditions were challenging. The maintenance of a really healthy lifestyle was often a luxury they couldn’t afford.

Upon arrival, they need to get blood work done to test for a variety of toxic environmental exposures. They also need to be tested for tuberculosis.

Jennifer Drago of Jubilee Partners

Jennifer Drago of Jubilee Partners

Drago can assist with family planning, connecting people with mental health resources, understanding and managing chronic conditions such as hypertension, explaining how to take medications, and a variety of other needs.

Karen refugees also struggle with proper nutrition. “They’ve come from a place where they’ve lived on rationed food, mostly two meals a day of rice,” says Drago.

The United States, where food is much more abundant, but not necessarily healthful, can be a dangerous new world. “They come here and are bombarded with food but not understanding how food can be bad for you,” she says.

Karen people continue to keep their traditions alive in Comer. They gather together for major celebrations, but also work to be a part of the local community, despite the challenges they face when they get here.

“[It’s] hard stuff but I’m often amazed at the ones who can make it,” Drago says.

 

Lauren Schumacker is pursuing her master’s in health and medical journalism at the University of Georgia. She also holds a certificate in culinary arts and enjoys writing about all things food-related.

 

A strange disease that can turn a young life inside out

Alopecia areata is an autoimmune disease that's defined as the loss of hair on the scalp and elsewhere on the body. Photo courtesy of the National Alopecia Areata Foundation

Alopecia areata is an autoimmune disease that’s defined as the loss of hair on the scalp and elsewhere on the body. Photo courtesy of the National Alopecia Areata Foundation

Johnnie Umoh wanted to fix what had happened to his teenage daughter, but he felt helpless because he didn’t understand her disease.

He also wanted to protect her from what might lie ahead, because so much had happened already. She had rapidly lost all her hair, with no certainty it would ever grow back permanently.

Alexis, 14, a freshman at Westside High School in Augusta, has alopecia areata. Her hair began falling out at age 9.

Alopecia areata is a highly unpredictable condition that attacks millions of Americans.

The autoimmune disease is defined as the loss of hair on the scalp and elsewhere on the body. It causes hair follicles to produce very small or no visible hair above the skin’s surface.

Hair can grow back in — or fall out again — at any time. The disease can progress to total loss of hair on the scalp, and sometimes on the face and body as well. There is no cure.

Alopecia areata is not related to male or female pattern baldness, the common kind of hair loss seen in adults. Instead, it’s a real disease, and it affects people regardless of racial background, sex or age. It can be particularly tough when it hits the young.

 

Parents rally round daughter

 

Alexis is a cheerleader for her school, and she dreams of becoming a doctor someday.

Her mother, Patricia, remembers her daughter with curly hair and ponytails. When Alexis developed bare spots on her scalp, and eventually lost all her hair, Patricia feared the girl might have cancer.

Since Alexis’ diagnosis of alopecia areata, Patricia and Johnnie no longer see their daughter as ill, but rather in need of support from family and friends.

Danielle Daniely

Danielle Daniely

But this disease has not been easy for Alexis. Having to face the reality of living with alopecia areata as a teen, Alexis actually considered suicide at one point, her parents say.

Knowing Alexis’ feelings of grief and fear, the Umoh family became proactive in seeking help for her. They attended an alopecia areata support group in February at Georgia Regents University’s Cancer Center in Augusta.

Her support entourage included her parents, brothers and sister, friends, teachers, guidance counselor and her cheerleading coach.

At the support meeting, other individuals with alopecia areata and parents of children with the disease gathered around a long table with Danielle Daniely, 34, a self-titled “alopecian” who organized the group and has lived with the disease most of her life.

Daniely was diagnosed at age 8, and remembers having more quarter-sized bald spots on her head than hair. By age 25, left with only a “Mohawk” cluster of hair on top of her head, she decided to shave her head completely. Her hair has never grown back.

 

Hair replacement devices

For people who lose their hair, there have long been substitutes, and today such devices are often much more sophisticated and realistic than the traditional wig.

Alexis, the teenager, wears a deep black cranial hair prosthesis, which provides hair long enough to touch over her shoulders and long bangs that cover her eyebrow area.

The unit was donated to Alexis by the Hair Club for Kids at no cost to her family.

Her parents say they are concerned about how Alexis will be able to handle the cost of a prosthesis when she turns 18 and is no longer eligible for a free one.

Parents of children with alopecia areata still hope the children’s hair will grow back naturally, which is possible, or that a treatment or cure will be found.

But any medical solution has proved elusive.

“The FDA has no approved treatment for alopecia areata,” says Gary Sherwood, spokesman for the National Alopecia Areata Foundation (NAAF). “There are some dermatologists who have found success growing back a patient’s hair within their practices, but nothing 100 percent of the time,” he says.

One of five people with alopecia areata report having another family member with the disease. Photo courtesy of the National Alopecia Areata Foundation

One of five people with alopecia areata report having another family member with the disease. Photo courtesy of the National Alopecia Areata Foundation

Daniely set her own course to enter into the medical profession and to study autoimmunity. She is a biological safety officer at GRU and holds a doctorate in genomic medicine.

“One out of four people have the predisposition markers for alopecia areata, and the disease can be triggered by hereditary or environmental factors,” she says.

Daniely says the disease occurs when a person’s autoimmune system is over-functioning. It sees hair follicles as a threat to the body and therefore destroys their growth.

NAAF says one of five people with alopecia areata report having another family member with the disease.

Funding for research has been slow. “If the majority of the population is needing funding for, for example, diabetes or cardiology research, there is plenty of funding,” says Daniely, “but there is not a wealth of funding for alopecia areata or other skin diseases.”

NAAF in 2012 created the Alopecia Areata Legislative Liaison Program to advance research and support for a treatment development program.

Liaisons from 11 states joined NAAF staff members in Washington to support a 2015 allocation for $32 billion to be used by the National Institutes of Health for alopecia areata medical research, including a research grant to Columbia University from the National Institute of  Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

In addition, NAAF is requesting that the federal Centers for Medicare and Medicaid Services rewrite its current policy to make Medicare benefits available to patients who require a cranial hair prosthesis as a result of alopecia areata.

At the moment, Medicare covers the cost of such a prosthesis only for “secondary alopecia” — when an individual experiences hair loss as a result of chemotherapy.

 

Seeking a change in policy

 

For now, individuals face the health care costs of treating alopecia areata and, if the individual chooses, wearing a cranial prosthesis.

“You need to work with your dermatologist to express the medical necessity of having hair in society,” said Labrisha Doran, who works in the health insurance industry and is also an NAAF alopecia support group leader in Atlanta. She said there is health care coverage for treating alopecia areata and money available for cranial prostheses if the treatment and equipment is “in network.”

Private insurers take their cue from government services like Medicare and Medicaid, says Sherwood. “Again, they may provide a cranial prosthesis for someone going through chemo but don’t always provide one for alopecia areata,” he said.

Health insurance companies are looking at alopecia areata as a “rest of your life” ongoing expense, and that is discriminatory, says Sherwood. “We are trying to change that.”

Individuals face the health care costs of treating alopecia areata and, if the individual chooses, wearing a cranial prosthesis.

Individuals face the health care costs of treating alopecia areata and, if the individual chooses, wearing a cranial prosthesis.

If cranial prostheses are not available through insurance or a private organization, specialty salons can be of service to individuals with alopecia areata.

One is Jentis Studios in Marietta. Owner Curtis Jones says his salon can create a full cranial hair cap for a client who has complete hair loss, or “toppers” for a client with only patches of hair loss on the scalp.

The cost involved with custom hair units are based upon the expected longevity of the unit purchased, says Jones. It can range from hundreds of dollars for a unit that will last for two or three months, to thousands of dollars for a premium custom hair unit to be used for a lifetime.

Jones says his personal reward is when he sees the face of a client with alopecia areata after the hair unit is placed for the first time. “It is remarkable how great an individual feels when they look into a mirror and see hair on their head again,” said Jones.

To offset the expense of a cranial prosthesis or hair unit, NAAF offers the Ascot Fund for up to $500 once every 12 months. There are two requirements: a need for financial assistance and a diagnosis by a doctor that the individual has alopecia areata.

 

There are four other alopecia areata support groups in Georgia, in Atlanta, Gwinnett County, Dawsonville and Ringgold. In Atlanta, contact Labrisha Doran at (678) 521-2109; in Gwinnett County, contact Aaron Williams at (678) 367-1090; in Dawsonville, contact Jessica Faulkner at (770) 362-2206; and in Ringgold, contact Sara Bello at (706) 841-0268.  

For more information about the Augusta Alopecia Areata Journey support group, contact Danielle Daniely at (706) 495-4174 or email alopeciajourney.augustaga@ gmail.com. The Augusta group will meet once a month at the GRU Cancer Research Center, 1411 Laney Walker Blvd., Augusta, Ga 30912. Watch for dates and time on their Facebook page at https://www.facebook.com/ AlopeciaJourneyAugustaGA.  

For more information about the National Alopecia Areata Foundation (NAAF) and its programs, conferences, research and legislative efforts, go to naaf.org or call (415) 472-3780 or email info@naaf.org.

 

Sharon Dunten is a freelancer writer and photographer based out of Atlanta.  She is also the president of the Society of Professional Journalists – Georgia.  

 

Understaffing among Georgia’s school nurses: A quiet crisis

School nurse Sally Boswell examines a Greene County student

School nurse Sally Boswell examines a Greene County student.

Sally Boswell is the first person many low-income families in Greene County call when their child gets sick.

She hears about everything from acute ear infections to chronic conditions such as diabetes. Boswell helps parents, grandparents or guardians decide whether their child needs to see a doctor.

She is the only school nurse for the county’s 2,300 public school students. Despite the long economic downturn and resulting budget cuts, she has stuck with her passion for nursing.

Greene County

Greene County

Thanks to Lake Oconee, built in 1979, historically rural Greene County has attracted tourists and some very affluent residents in recent decades. Today it is listed as one of the wealthier counties in the state, with a median income of about $42,500. But poverty remains, and the number of Boswell’s students who are on Medicaid or are uninsured is high.

School funding for nurses and health care workers in Georgia varies by locale. Georgina Howard, director of the School Health Nurse Program at the Georgia Department of Education, says, “In Georgia, we’ve made some progress, but we aren’t fully staffed.  It’s left up to the district how they want to do their staffing.”

The current recommendation from the National Association for School Nurses is to have 1 nurse per 750 students. Georgia’s 2,264 public schools serve 1.7 million students, so the recommended number of nurses for the state is 2,267.

But as of October 2014, there were only 1,555 licensed nurses who work in the state’s schools, Howard said. That leaves a shortage of more than 700.

Problems to confront

In neighboring Morgan County, with a median income at about $47,700, there are four nurses for about 3,200 students. “Morgan County has a school nurse at every school; primary, elementary, middle, and high school,” says Leah Ainslie, who worked in Greene County before she became the nurse manager for the local public health department in Morgan.

Many students at Union Point STEAM Academy have asthma or diabetes.

Many students at Union Point STEAM Academy have asthma or diabetes.

“[The] purpose of the school nurse is to keep children well, so the children can learn.  If you don’t have anyone there to do that, then the kids aren’t learning,’’ says Ainslie.

Being the only school nurse in Greene County, Boswell barely has time to drive 10 minutes between the county’s one pre-school, two elementary schools, one middle school and one high school. The constantly shifting medical needs of students dictate what she does from one day to the next.

“When I started, we had four registered nurses and we ran a program, a true comprehensive nursing program,’’ Boswell says. “We did things like CPR classes for the bus drivers, we were able to do certain programs for not just the students, but for the faculty.”

Now, her attention is solely focused on the health of the students.  In early February, the hot spot was Union Point STEAM Academy, a K-7 elementary school that focuses on science, technology, engineering, the arts and mathematics.

“I’ve got little kindergartners who are horrible asthmatics, and all of the diabetics at the elementary level are here,” Boswell says.  “I have to be here to do insulin every day.”

Every day is different, but busy

Between administering breathing treatments and monitoring insulin levels, Boswell uses her qualifications as a pediatric nurse practitioner.  She catheterizes a wheelchair-bound student, diagnoses an ear infection in another student, and lines up a doctor’s appointment for a third.

Boswell’s job has become much more than keeping kids well.

When a family member can’t come to pick up a sick child, she will even give the youngster a ride home (with parental permission,  of course).

On a recent morning at 8:30, students swarmed in and out of her small office.  One child’s arms were covered with what appeared to be insect bites, and an itchy and swollen rash was forming. Another was reporting for his asthma inhaler treatment, and two hovered over a single toilet for fear they were going to vomit.

“I am certainly the child’s advocate” on medical issues, says Boswell. “With 2,300 students and knowing their families, and where they come from . . . I think that I help the continuity of care.”

 

Ansley Stewart is pursuing her master’s degree in journalism at the University of Georgia.  She is a freelance writer, musician, and also works full time at UGA.  

 

Computer technology with a storied history joins fight against cancer

Ken Jennings, a "Jeopardy!'' champion, lost to IBM's Watson in a 2011 match

Ken Jennings, a “Jeopardy!” champion, lost to IBM’s Watson in a 2011 match. Photo courtesy of IBM.

IBM’s Watson computer technology made headlines with a victory over human contestants on the game show “Jeopardy!” in 2011.

Now the artificial intelligence computer system is winning over scientists with its other potential applications, including health care.

“Physicians cannot possibly read every journal to stay current with the latest advances,” says Ashok Goel, a professor in the School of Interactive Computing at Georgia Tech.

Cancer research is listed among the top medical topics demanding greater focus from professionals, because experts say that amount of medical information available doubles about every three years.

Goel believes there’s a better way to get the right information to the right physician using Watson, which has joined his team of students at Georgia Tech. He, his students and Watson are beginning this semester with biology basics.

In January, Goel and Georgia Tech revealed that Watson might be able to help with the overwhelming surfeit of knowledge, requiring the attention of scientists and computer experts engaged in computational work.

 

So much to read and digest

 

Ashok Goel

Ashok Goel. Photo courtesy of Rob Felt/Georgia Tech

Goel is betting on Watson to help in a multitude of ways — first delving deeply into biology with his students and later working with oncology data. Goel is one of the handful of professors in the nation who has extraordinary access to Watson.

He hopes the future is close at hand.

“We may be able to take 20 years of research and reduce it to two years with Watson’s help,” states Goel. Given the complexity of medical decision-making, Watson has the potential to save lives and dollars.

“One of my former Ph.D. students is a computer scientist in the Watson Research Center at IBM,” says Goel. He is referring to J. William Murdock, who is part of the IBM team that applies technology to real-world applications such as health care.

Goel says there may be as many as 800 million biology articles that need to be consulted, including articles on cancer-related treatment and outcomes. According to IBM, Watson can extract patient case attributes and find clinical similarities, then provide a supporting rationale for treatment options in a much shorter time than humans can.

For now, Goel and his students are looking at biology-related implications. And they are hoping to support oncology work with upcoming government funding.

Two other prominent institutions taking advantage of this unique IBM arrangement are Carnegie Mellon and MIT. According to IBM, some of the nation’s leading technology institutions have launched cognitive computing courses with Watson’s help.

 

Watson at work

 

When interviewed, Goel speaks with exuberance about loading Watson with biological knowledge for the current semester. This includes public domain articles and relevant data from open-access journals.

“Students need that information to be readily accessible as they design problems and, with Watson’s help, develop practical and new solutions for the world,” Goel says.

For example, Goel explains the biology work this way: “What if you were living in a desert country, like Namibia, Africa? What if you needed to increase the water supply for a serious drought in Namibia? In fact it could easily be an area in the U.S.”

As Goel notes: “There are many solutions.” And he says nature has provided some amazing answers that might work out to be more cost-effective than the obvious response — shipping water to a drought-stricken area from somewhere else.

He hopes this creativity will go far beyond the classroom and feature student entrepreneurship.

watlogoFor example, Goel talks about a small organism from nature, the Namibian beetle. This beetle, he says, uses tiny ridges on its back to collect water from fog. With enough data and background information, can scientists and engineers do that?

In other words, with the right research and resources, will they lead our next generation to natural solutions using fog? “If so, can we help replenish the world’s limited supply of water,” asks Goel?

Goel has enthusiastically shared such ideas on TED Talks and other public forums. To help explain biological concepts in ways that are useful and applicable to engineers and their projects, Goel and his team are developing an interactive online repository — the Design by Analogy to Nature Engine (DANE). This will serve as a dynamic and editable resource for both academics and industry.

According to IBM, health care and business professionals share their perspectives on the promise of Watson’s transformative technology, and its ability to completely change how patients interact with caregivers and consumers.

By partnering with top educational institutions across the country, the Watson Group empowers students from a wide range of disciplines for careers to move the “cognitive era” forward. This includes the IT developers who create the cognitive apps, entrepreneurs who commercialize the apps, and the business professionals who use them every day to succeed.

 

What’s ahead at Georgia Tech

 

Goel says Georgia Tech will “use interactive technology to read and understand articles that address targeted cancer therapy.” This is a complex process.

Ashok Goel (seated) with colleagues at Georgia Tech

Ashok Goel (seated) with colleagues at Georgia Tech

One scenario might include a cancer researcher who will select several biology articles or abstracts describing a model of acquired drug resistance in a specific type of cancer (such as lung cancer).

Using Watson, the researcher will have multiple corresponding functional models (from other cancer types) that can provide a detailed comparison, including what is similar, what is different and what is unknown.

In the future, Watson may be able to fill in some of our knowledge gaps about cancer. The American Society of Clinical Oncology currently estimates that by 2025, demand for oncology services will grow by 42 percent, while the supply of oncologists will only grow by only 28 percent — suggesting a serious deficit.

Health care professionals are already talking about Watson’s cognitive capabilities and how it is allowing them to personalize patient care in a way that’s never been possible before.

 

Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.

Teen pregnancy programs: How Hall County is reaching out

Crystal Gonzalez of Hall County, a 17-year-old sophomore, continued to attend school while preparing for the arrival of her baby boy,

Crystal Gonzalez of Hall County, a 17-year-old sophomore, continued to attend school while preparing for the arrival of her baby boy,

“My life is over! How am I going to do this?”

Crystal Gonzalez says those thoughts went through her mind when she found out at a routine sports physical that she was five months pregnant.

Gonzalez, a 17-year-old sophomore at West Hall High School, delivered her son Feb. 11.

Gonzalez’s baby was born with spina bifida. That’s a type of neural tube defect that occurs when the neural tube doesn’t close all the way on the baby’s spine, which could cause mental or physical health issues as the baby develops.

She had a scheduled C-section to protect her baby’s spine during delivery. After delivery, Gonzalez and the baby were taken to Atlanta for surgery on his spine.

With the operation behind him, Gonzalez’s son will now undergo physical therapy and get braces to straighten his legs as he continues to grow and develop.

In Georgia, the teen pregnancy rate among all races has dropped from 28.0 (per 1,000 females) in 2010 to 21.3 in 2012 and has dropped among the Hispanic population from 53.0 in 2010 to 29.8 in 2012.

Despite these declining rates across all races over the years, teen pregnancy continues to be an issue in Hall County. That’s particularly true among the Hispanic population.

In 2012 in the county, there were a total of 76 pregnancies among girls 15 to 17. Records list 26 of the girls as white, 5 black and 45 Hispanic.

The overall birth rate among Hispanics 15 to 17 was 33.6 in Hall County in 2013. In 2010 it had been measured at 45.4.

Adds Becky Burrow of Teen Pregnancy Prevention: “About 65 percent of the pregnant girls [whom I work with] are Hispanic and the other 35 percent are Caucasian or black.”

 

Abstinence education and other advice

Like many Georgia counties, Hall has seen big demographic changes in the past few decades. Once mostly white with a small but significant black population, it now has a large number of Hispanics. Because this ethnic community is disproportionately made up of new arrivals, some of whom are foreign-born and have limited English, traditional outreach services have lagged.

The county needs more programs geared toward reaching the Hispanic population in attempts to prevent teenage pregnancy, local officials say.

Hall County

Hall County

“I had discussed the hopes of that [having programs to reach the Hispanic population] among some of the counselors in the high schools in the community,’’ says Natalie Vazquez, a family partner for the Early Head Start Program. “There needs to be a stronger prevention for the Hispanic community.”

“We know there is a problem [among the Hispanic population] and I feel like a lot of these kids need some good mentors out of the Hispanic community to step up and say, ‘Hey guys, there’s a better way to do this,’ but that has not happened,” says Burrow, the pregnancy counselor.

Gonzalez and other pregnant teenagers at her school meet with Burrow for lessons on how to take care of themselves during pregnancy, how to be good mothers and how not to get pregnant again until they are financially ready. They receive encouragement and resources to help them finish high school.

Teen Pregnancy Prevention Inc.’s counselors believe that girls who are at ease with their bodies, who have good self-esteem and goals they want to accomplish are less likely to engage in early sexual activity and risk unplanned pregnancy. Burrow says sex education is 95 percent from the waist up (body image, self-esteem, having goals in life, making good choices) as opposed to the actual physical part of sex education.

Teaching abstinence is a requirement for sex education in Hall County schools. Burrow agrees with that, but also says, “You have to give them explanations as to why they shouldn’t [engage in premarital sex], not just why they can’t. Any time you tell a teenager that they can’t do something, that’s the first thing that they want to do.”

Whether the young people learn about sex in school or at home, parents play an important role in teen pregnancy prevention.

“It is important for parents to educate their children about sex and relationships so they can make informed choices about actions that affect their lives,” says Dave Palmer, public information officer/risk communicator for the local public health district. “If parents become partners with their child’s school, together they can help their child through this sometimes confusing and difficult stage of life.”

Gonzalez’s mother is planning to help raise the baby and has been supportive, both financially and emotionally, during this time.

 

Feeling ready, but not ready

In recent times, attitudes toward sex have changed drastically in many countries, including the United States and the Latin American nations where Hall’s Hispanics have their roots. Vasquez says young Hispanics’ current attitude toward sex is reflected in their attitude toward an age-old ritual — the Quinceañera.

As Vazquez notes, a girl’s Quinceañera, when she turns 15, is a big celebration in Hispanic culture. It signifies that the girl has become a young woman.

Crystal Gonzalez during her pregnancy

Crystal Gonzalez during her pregnancy

In traditionally conservative Hispanic societies, crossing this threshold of womanhood allowed a teenager to attend social events, begin dating and start looking ahead to marriage. Officially, the elaborate ceremony is still viewed that way. But among young people today, it’s often seen as a sign that a girl is ready to become sexually active.

“Culturally, it’s a humongous thing,” Vazquez says. “Most girls want to wait for that celebration before they choose to say, ‘OK, now I can do it [have sex] because my friends have been doing it,’ or ‘My boyfriend has been pressuring me, but now I’ve already had my Quinceañera or my Sweet 16 [party], so I don’t have to worry about there being consequences.’”

Gonzalez, the 17-year-old new mother, generally agrees. “The age of 16 is a usual age for a Hispanic girl” to become sexually active nowadays, she says. “After your Quince, when you become a woman, you think it’s OK for you to do it, and you think that . . . [the relationship is] going to last forever, and it’s not.”

Before becoming pregnant, Gonzalez didn’t put any stock in her school’s teaching about sexual abstinence. But now that she has experienced one of the many possible consequences of being sexually active at a young age, she has a different outlook.

When asked what she would tell her peers now, Gonzalez says, “It might be great in the moment, but it’s not worth it. . . . It’s still better to wait until after marriage.”

 

Rebekah Ryan, born and raised in Hall County,  is currently seeking a master’s degree in public relations from the University of Georgia.

 

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