Dorothy: [00:00:00] What’s killing Texans? Our topic today is deep. Today’s guest, Camerino Salazar shares his thoughts about a situation that many of us are totally unaware. Dr. Salazar has spent decades in research and as he explains these different themes you’re about to hear, especially those around death by abandonment, they are heavy and layered. At its core, his message falls somewhere between a public warning and a prayer. He tells us with facts to back up his observations. That when public systems like healthcare, mental health services, and schools are dismantled, are defunded, people don’t just lose access. They lose hope, and in too many cases, they lose their lives. You may strongly disagree with him or some of what he says may make you feel uncomfortable, but [00:01:00] my deepest wish is that our conversation helps spark reflection, dialogue and that someday maybe, we as human beings will find a common ground.
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Nino, thank you so much for being with us today, and especially for coming in on your holiday. And you, you were, you live in San Antonio, driving here, [00:02:00] doing things with your daughter. So really, really appreciate you coming in.
Camerino: No, I appreciate the time as well. So I’m glad it worked out.
Dorothy: So glad it did. Yes. So now I want you to explain to us exactly where are you right now in your career.
Camerino: Well, currently, um, I just recently completed my PhD. Uh, out of the University of Texas at San Antonio. It was in demography, which is really the study of how populations grow. Um, you know, births deaths. And then right now I’m actually with another organization, uh, they’re called Health Resources in Action based outta Boston. So it’s a virtual, uh, position. And so I’ve been with them for a little bit over three and a half years now.
Dorothy: So before that, you were in the public health sector for quite a while, right?
Camerino: I grew up in the public health sector. I, um, started at the medical school there in San Antonio as a research associate. Uh, and then transitioned over to University Hospital, which is a, uh, the county hospital. Uh, spent about 16 years there before moving over to health [00:03:00] Resources in action.
Dorothy: So what, what attracted you to either of those areas?
Camerino: I think it was just been always a passion for, um, you know, looking to improve community health. Um, you know, my mom was a school teacher down in Brownsville, Texas. Um. I know she always encouraged us to continue to school and, uh, the value of helping others, you know, really through, you know, our religious upbringing as well. And so I think tying all those three or those two together, for me, I wanted to somehow find a way to, um, to help others. Uh, and I think through the public health arena that I hope through my work, through, um, you know, uh, the information that we do in terms of analysis that we’re helping others in terms of legislation, in terms of policy to really, uh, make us a healthier state.
Dorothy: So you are a native Texan?
Camerino: I am a native Texan, yeah. Um, second generation. Uh, now. But like every, you know, the majority of people that arrive here, uh, my [00:04:00] family came from Mexico from the revolution of 1910. So I tell, I was telling my daughter now, he says, we’ve been here, you know, about 110 years now. But like what we see now, there’s upheaval in other areas and then people come and they try to make a better life for themselves. And you know, again, that’s what we tried to do.
Dorothy: And what is it that you do for The Rose?
Camerino: Oh, for The Rose, my, the other hat that I wear, I’m actually the evaluator I was, I worked with Anna McAndrew at the, at University Health when she was there in San Antonio. And then we stayed in connection and I think The Rose at the time was looking for an evaluator for one of their, uh, cancer prevention research projects. And so I threw my hat in the ring and you know, like the rest they say the rest is history.
Dorothy: Right.
Camerino: But I’ve thoroughly enjoyed being a part of the organization virtually as well.
Dorothy: Yeah.
Camerino: Um, but it’s been, you know, you have a wonderful team here that you’ve assembled, so really enjoy that.
Dorothy: So, and Anna is our senior grant writer and certainly has brought so many opportunities to us and, and been very successful. Explain to our listeners what an [00:05:00] evaluator actually is. Are you an auditor? Are you a coach?
Camerino: Interestingly enough, evaluator can play many roles. I think, uh, you, you’ve hit the nail on the head. Uh, we are there to look at the program and what we say is like to evaluate, to see, you know, where are the opportunities, how well is the program working?
Is it, is it being effective in terms of, you know, your goals and objectives for the, the, the services that you’re providing. And so for us, we take a very, we try to take a very neutral approach to identify, you know, where, where there strengths of the program, where there’s opportunities. And then we try to then, you know, uh, through information and data that we provide, in this case, through the surveys we’re collecting for the, the program, we try to tell the story of, you know, again, how well are those services being delivered and received by the community.
Dorothy: And of course we’re talking about the underserved.
Camerino: The underserved, yes.
Dorothy: Medically underserved.
Camerino: Right.
Dorothy: And, uh, most of these people are below the 200% of poverty level, which we all know is very, very little income. [00:06:00]
Camerino: Right.
Dorothy: Uh, and many, many are coming to us because they have a concern or we’ve educated them about this is why it’s important and they’re responding. But there’s still so much work to do. I mean, you know, this has been a long time trying to, to make all that happen, but there’s still.
Camerino: Right.
Dorothy: Still work.
Camerino: Those opportunities still remain. Yes.
Dorothy: Now I wanna go to your article about “What’s Killing Texans.” You, you know, I was re I’ve re read it several times and uh, every time I see something different and then I think, you know, you’re very factual in this article and we’re certainly gonna put a link to it in our show notes. But there’s also this passion that keeps coming up, just kind of bubbles up so. Uh, talk a little bit about that. What was your, explain how it came about, but what was your goal in really digging that deep? [00:07:00]
Camerino: I think in, in writing the article, um, you know, on, you know, um. You know, “What’s Killing Texans?” I think at the, on the, you know, part of the work that you mentioned, I’ve been in the area of public health for many years, um, really on the applied side. Uh, and not necessarily on, on the policy side, but in the school, uh, in the program, I was, um I just graduated from, we were encouraged to use information to al to also advocate. Advocate for policies that, um, we hope will, um, elevate community health and wellbeing. And so when I was writing this, uh, again based primarily on my dissertation work. I, I think the, like you mentioned, the passion or the energy that kind of was kind of flowed through the article, or, or I think attempted to do that, is to really tell a picture of what’s been happening, um, you know, for decades now in Texas and what is a result of, um, some of the legislation that’s put been put in place.
And [00:08:00] like you mentioned before, we, we started to air, um, oftentimes policy is very, um. It can be very difficult for people to understand. Um, but policies are, you know, from the, the seat belts we use to where we can smoke when people, you know, uh, what areas they can, they can smoke, you know, so there’s things that we sometimes see that we can, that are tangible, but other things, um, like the long-term effects of policies, um, that we see when people begin to, um, die in higher numbers as a result of certain causes. Well, that’s a little bit harder uh, to nail down.
Dorothy: So give us some examples of that you used in your article.
Camerino: So, in, in the examples I, I mentioned first and foremost, um, what we’ve seen in Texas is about 150% increase in deaths from three causes. Suicides, alcohol related, uh, conditions such as cirrhosis of the liver, um, and, uh, I think drug [00:09:00] overdoses, if those are the three Suicides, alcohol and drug overdoses. And so when I started researching this, I first began with really drug overdoses. Where in the, in Texas, um, Texas has never been at the very top in terms of high drug overdose rates, like other parts of the country, like on the east coast or like, even in West Virginia or these other areas. But I became so interested, interested in this because I, I began to see these little blips and increases, uh, over the years. Um, and so the first, uh, writing really was in entailed opioids. And that I found that out the overall, the, the drug overdoses in Texas, about half were attributed to opioid overdose deaths. And so then that got me interested in looking at these other two causes, which is what two economists out of Princeton first researched and looked at was these three causes of death. So my thoughts were, well, what’s happening in other parts of the country? Is it happening here in Texas? And so again, [00:10:00] in my work, I find that in the last 20 years, um uh, in terms of data we’ve, that, that we’ve looked at or have looked at, these three causes have elevated, but especially they’ve been elevated or, um, we’ve had higher number of deaths occur among those that are in the economically distressed areas of our state.
Um, non-Hispanic whites in particular, uh, and middle age. Uh, uh, non-Hispanic whites. Um, but it’s also now impacting Hispanics and blacks, which generally had lower rates of death from these causes. But we began to really see that. Um, and so then I guess the, the other, I think piece to that is, you know, why has this been happening?
Um, and so that’s where I, that’s where I tie in or try to tie in that, um some of the legislation, uh, that has, uh, been implemented over the, over several years has really, um, had a detrimental effect on our [00:11:00] health on Texas Health. Um, and the other pieces to that is, well, what examples would you say? Well, we have some of the highest, uh, uninsured rates in, in the nation. Uh, I think we’re about 20% now and continue about one in six Texans is uninsured. Um, Texas has refused to accept Medicaid, uh, or expand Medicaid. So we’ve left about 1 million people uninsured. Um, and those again are estimates.
Um, uh, we’ve had to close several rural hospitals. I think since 2005 we’ve had about 25 hospital closures in rural Texas. Um, and so what that happens is, especially in the area, in those counties that are already underserved, um, those support systems are not there. And so someone’s looking for help, looking for preventive health, looking for, uh, certain types of services. They’re, um, they’re very hard to come by. They have to travel miles, uh, oftentimes to another county, uh, to receive those services. So those [00:12:00] are, I think, um, some of the drivers, um, you know, that, that I was able to identify, you know, through my research.
Dorothy: Okay. So let’s go a little bit deeper. You referred several different, uh, times to this book, dying of Whiteness. And we’re having a hard time understanding how closing a rural hospital inadvertently, or deliberately or whatever, can actually hurt the white community.
Camerino: So.
Dorothy: Yeah, you gotta use real little words for this.
Camerino: Very small. Yeah. So Jonathan Metzl, um, in his book, I first read it when I was taking, uh, my early courses in the PhD program that I was in, and our professor had encouraged us to early on, begin to identify a subject that we might find interesting that we could then expand on. Well, I happen to, to come upon, uh, Jonathan Metzl’s book, and so I started reading it and could not put it down. And really what [00:13:00] Jonathan Metzl does is he does, he does a case study, right? He does like a, a deep dive into three states. Uh, Missouri, Tennessee, and Kansas, and he looks at ’em in terms of, in the span of about six or seven years. Um. And for example, in mis in Missouri, um, they, he looked at, uh, gun laws. And how, uh, over time, over, over several years, they began to really remove a lot of the, the gun legislation that had been there, um, in terms of, uh, gun safety, firearm safety, however you wanna term it.
But they really started to, the legislate, the state legislator began to pull back, uh, a lot of those, um support systems in terms of the gun legislation. And so they had like the permissive gun laws, uh, such as, uh, carry, conceal, uh, the Castle Doctrine where you could, um, you know, uh, shoot someone an intruder in the very, in your very home, you know? [00:14:00] Um. And so it, it had all these mechanisms, uh, tied to, um, again, gun gun legislation. In Tennessee, it was really, um, the Medicaid expansion where the state legislator began to really find ways they needed to reduce or, um, uh, offset some, some budget deficits. So they began to really reduce the Medicaid expe, uh, Medicaid roles, um, and really cut back on mental health services, uh, in that state.
And then lastly, Kansas. Uh, what Kansas did was Kansas at one point was one of the highest performing education systems in the nation. But again, the governor and the state legislature began to really look at education as, um an opportunity to cut back and roll back, uh, some of the services because they again, needed to cover some of their budget, uh, shortfall.
So they began to really curtail, uh, the amount of money that was being allocated to these schools. And so, [00:15:00] um, in time what they begin to begin to see was the standardized scores, which of course, we all like to, you know, states like to really compare themselves against, or state legislatures like to compare themselves. The scores began to decline. Uh, dropout rates began to increase in these, in these, um, schools. And when, where Kansas was one of the highest performing, one of the highest performing systems in the nation, uh, it began to fall dramatically. But what Metzl also found was across all these three states that he looked at, he also noticed, um, that the health uh, of these populations also began to elevate in risk. And what he noticed was that deaths from drug overdoses, um, suicides, firearm or homicides, um, and, uh, and alcohol related conditions as well, that in these three states, he also noticed that, um, these began to increase. Uh, and so in, in Missouri, um, [00:16:00] you know, you know, he noticed homicide rates started to increase, but in particular, suicides rates, especially in non-Hispanic, white, uh, and, uh, males. Um, um, but very similar in these other states that, um, you’ll also begin to see these types of, of, uh, increases in the population in terms of these types of deaths. Um, so the next question then was he held, uh, conversations in these communities, uh, with individuals to ask them well. It looks like legislate.
The, the state legislature has voted against, uh, Medicaid expansion, has really, uh, encouraged or, uh, done away with a lot of the, the gun laws in your state. Um, it looks like they’ve rolled back education funding to your schools. Do you support this? And so what he finds is overall the, um, the communities that he interviewed, uh, were very much in support of this. And so he asked them, well, why are you in support of this? Well. [00:17:00] Part of it is he says, we want limited government, government. We feel that when government comes in, they have, they have certain strings attached, and we want limited government. Um, we want, uh, really our, our independence. We don’t, we don’t want to have anything to do, um, you know, with these types of federal resources.
The other piece to that was there was also this impression that, in the example of Medicaid and education was that the funding that was being allocated to, um, to Medicaid and, and health insurance to the economically underserved was really going to other people that really, quote unquote, didn’t deserve it.
And I’m paraphrasing here, but the communities really felt that the newly arrived immigrants, um, those that they consider to be others, you know, other populations that really, um, shouldn’t be receiving these services, that by them legislating against these, these types of, um, or legis making these laws, um, enacting these laws that [00:18:00] by then they would curtail or limit those types of funding services or support for those types of populations. But in reality, what Bessel finds is that when those individuals voted against those very types of laws, that these individuals were the very individuals that tended to suffer from those cutbacks, from education, from healthcare. From these permissive, uh, gun laws, uh, because they actually have it to be very economically underserved themselves. They just, uh, basically almost created this, almost this, um, well, it’s them, but not us. But yet they were also part of that.
Dorothy: It’s almost a boomerang type thing.
Camerino: It’s a boomerang. Yes.
Dorothy: Yes.
Camerino: And so the, there’s always this, the whole thing of like, you voting against your own health interest. Well, in this case, uh, in all those three states essentially that’s what happened. They were really voting against their health interests, but really what they felt firmly was they were voting more as a a framework of, [00:19:00] again, less intrusive government. They felt this was their way of really advocating for themselves, for the communities that they wanted to have as little intrusion from any type of quote unquote government intervention, whatever that might be.
Dorothy: But that doesn’t make a lot of sense, you know? I mean, why would you do that to yourself or why? You know, I know in when we go to rural Texas, it is the white communities that are suffering, right? I, I mean, it’s not, you know, and they, they’re the ones that have to travel. And if we didn’t take our, uh, mammogram bus, there are coach there, they wouldn’t get a mammogram.
It’s that simple. And we’ve found a lot of cancers on first time baseline mammograms. It, it doesn’t make sense. And every one of these, 10 years ago, we could have partnered with a hospital, not anymore.
Camerino: Right.
Dorothy: So now we’re having to find, ’cause those hospitals are gone.
Camerino: Hospitals are gone. Right.
Dorothy: Why, why would we have voted that out? I mean, that doesn’t [00:20:00] make sense.
Camerino: It’s a very complex question. That I think he, um, you know, attempts to answer through his book, uh, in terms of like what’s, what’s influencing these populations to really think or vote in a certain way that, again, at the end places them in harm and at risk. Um, and I think for, and I think very similar to Texas, through my own research, uh, there is, especially in those counties, um, where we have elevated deaths form, again, alcohol suicides and drug overdoses. Um, separately, uh, closely after the election, I looked at the voting turnout, um, for those counties. And, you know, again, we had the recent election, you know, Trump was elected and, um, actually his, his voting, the, the proportion of those that voted for him actually increased.
And so when I was looking at those counties, uh, it was really interesting to see that where you [00:21:00] had, um, those elevated rates of, of, of death, that those counties were extremely conservative. And, uh, I would say on average about 95% voted in favor of Trump, you know, versus the, the Democratic candidate. And so I feel like, or I, I have this, um, idea or con similar to Metzl, is that, in those counties, they were really voting, not, not necessarily for the individual, but more for what he represented, which was limited government, limited. Um, you know, we’re gonna make sure that your money is spent, uh, efficiently. It is not going to go to these other individuals that are, that are taking your, your, your funds and resources.
The other piece to that is. It also hits on what we term racial resentment. So in Jonathan Metzl’s book, it, it really is, you know, there’s this, this argument that there’s this racial resentment. Um, and like he mentioned, especially among the [00:22:00] white electorate, not everyone, but there is, there are pockets where there is a, the general sense that he observed across these states.
The non-Hispanic whites or whites are, had a sense of also losing their place in society. That somehow societies were becoming, communities were becoming more diverse. There was change underway. They felt they were not able to, um, en, you know, have the same, uh, type of status that they once enjoyed. And so there was this risk that something was on the edges, something was coming on the horizon.
And so then. Here comes the political ideology. That’s, that’s almost like, well, we’ll place a hold on that and this is how we’re gonna place a hold in that change. We’re gonna enact and we’re gonna do these things that are taking your resources away. Basically removing your, your sense of power and perceive or perceived power from you.
And so, again, very similar what [00:23:00] me Metzl finds in tho in those, um. In those conversations with communities is a sense of the, of loss. And so that’s almost a reaction. So the question of like, why would they vote against their, their interest, part of it too, he finds is in this complex picture, is there’s a sense of, um, lost entitlement. And as a result there is again a sense that they’re losing their place. Um. In this quote unquote hierarchy in society.
Um, when in reality that’s not happening at all. But really, what? But again, it’s what they perceive. And so when they do that, and then, and then enter the, the poli, the politicians or the, that argue and elevate this, um, this sense of loss. And so what do people do? Well, they go out and vote and they vote for the things that they feel will, will hold things in place. And so Texas I think is again a really interesting case study too. Like I [00:24:00] mentioned in the article, Texas is not in Nestle’s book, but it potentially should be because I think it echoes a lot of the very similarities that you find, uh, in these three other states.
Dorothy: Alright, go way deeper. With me or maybe way shallow. I’m not sure which what it is, but why would, what you’re talking about cause more suicides in a white, middle-aged man.
Camerino: So part, part of the, the reason are the, the, again, tying it to the article in terms of these policies of abandonment and neglect is when these, when these policies are in place and you begin to roll back these support systems, the mental health services disappear. Uh.
Dorothy: For everybody.
Camerino: Social support for everyone. Not only for these indivi, but for everyone. Um, but again, in these deaths of despair, these deaths of three causes, um, very similar, we find in this population, middle aged, non-Hispanic, uh, white males, that there is a sense [00:25:00] of, of loss, the, a sense of they’ve lost their place in society. Um, you know, their work has moved overseas, which happened, which began decades ago, but. You know, the, the piece of, you know, you, you went to Flint, Michigan, and your father, your grandfather, your great-grandfather that worked in the, in the steel mills and in the factories, and then all of a sudden that disappears.
Uh, new technologies come in and so there’s this loss again of, of opportunity or perceived loss of opportunity, perceived loss of, of, you know, where, you know, where do we see ourselves finding ourselves in also a rapidly changing society, not only racially and ethnically, but economically. You know, uh, technologies have come in. And so this slowly begins to, um, and, and again, there’s different theories. Some argue that it’s been long, long term in the making in terms of this loss of opportunities. Uh. Others would argue that really it was the, [00:26:00] the great recession that really elevated this risk among this population, uh, when you had, um, you know, these job losses and insecurity.
But at the end of the day, there is this, this loss of financial insecurity and instability that, that people feel. Um, and then here comes the opioid epidemic. Opioids get introduced. They find their paths into these, this, this constellation ca, of causes. And now you have, you begin to see this uptick in these types of deaths in these populations.
Dorothy: It’s still very difficult to understand.
Camerino: It is a complex.
Dorothy: Yes. Yes. And, and, but it, it sounds like this is a, an attempt to get that control back to get. The power back and not realizing how, uh, far reaching some of these policies could be.
Camerino: Correct.
Dorothy: All the way to really destroying communities.
Camerino: Right.
Dorothy: I mean, that is, that is sad. I think you’re use of the word [00:27:00] abandon. Abandonment. You know that, that’s a strong word. I don’t think anybody can not have some reaction to that. No one wants to be abandoned.
Camerino: Abandoned. Yeah.
Dorothy: But that’s what you’re saying has happened. Texas has abandoned Texans.
Camerino: Texans and, and I think it’s, um, you know, it’s a story of, of law of, again, a, a loss of community, um, isolation. Um, you know, when this book was written, it, it was written right before COVID hit. So at the time he observed already these, these risks that were kind of rising in the population and now post COVID, it’s almost that it has really elevated this sense of, um, risk and again, rising death. You know, we talk about life expectancy.
Life expectancy is really the average number of years someone is expected to live from birth, you know, to death. Uh, and, and, [00:28:00] and the US for a long time had high life expectancy, higher than other industrialized nations. But in the last few years, it has begun to really slow down, if not stutter. And Texas is an example.
Uh, and these other states where, you know, Texas, um, has a life expectancy of about 78.5 years, which you would say it’s a lot of years. It’s a good, it’s a good, uh, period, but it’s, it’s life expectancy is lower than other states like Kinetic and in Hawaii and Rhode Island and Minnesota. Which often experience about three and a half to almost four years of life expectancy greater.
And in those states, what you find is you have greater support systems, more investment in healthcare, mental health resources, uh, pub prevention, uh, Uh, prevention services, uh, while these other states that have experienced lower life expectancy. And I’ll throw in Alabama, Mississippi, Louisiana, some of the lowest states in the nation with [00:29:00] life expectancy. Um, they also have um, really an erosion of social support for those populations, especially the most economically underserved, Uh, that we provide or that we’re trying to, to, to reach out to. Um, so again, a very complex, uh.
Dorothy: And you had one statistic in there, you’re gonna have to remember it for me, that had to do with women about, uh, this deplaning, this, uh. That we weren’t gaining any.
Camerino: No. And especially, I mean yes, among Texas females, um, what we’ve seen is, um, actually decrease in their life expectancy. Part of it, again, what we see in, in, or what I see in my research in terms of those drivers, like drug overdoses and, but really the mortality that that Texas women are experiencing is really the, the maternal mortality. Where we see some of the highest rates of mortality, uh, among Texas women, um. And especially in the [00:30:00] last, uh, several years, and I know Texas has recently become a little bit, uh, much more, um, restrictive in terms of the abortion bans and those other services, uh, which actually are, are really, um, a wrap of, of other preventive services for women, but really in these types of legislative, um, enactments, what you also do very similar is that you roll back prevention services, you roll back opportunities for access, you roll back, um, you know, uh, the, the confidence for, for women to go seek care in the first place. And so really again, what this type of legislation tends to do is it did, it, it’s really intended to hamper, to limit, to deter.
And so unfortunately, what then happens is there’s these other repercussions where, you know, um, women which generally enjoy higher life expectancy than males, uh, on average, um, you begin to see some of their own health [00:31:00] decline. Especially in the maternal mortality side, which the state has, has issued several reports on.
Dorothy: Right.
Camerino: Yeah.
Dorothy: And everyone has a different reason for the cause, which is.
Camerino: Right.
Dorothy: I mean, it gets down to access at the end of the day. It always gets down to that.
Camerino: Right, right.
Dorothy: Is it your opinion that if you’re poor, your health is gonna be bad?
Camerino: If you’re poor, the circumstances are, uh, are generally worse because this number one is you have your, the means are not there. Um, and so, um, there’s a Matthew Desmond, he’s actually, he’s written a book on poverty by America, and, and his argument is to be poor is to have no choice. And I think that is very, that’s very telling because, and those that are, those that are in poverty, um, you know, then they have to look for those resources or try to rely on resources that they can hopefully be, [00:32:00] that the through public good can be made available.
But when government begins to curtail those various services that the poor are, um, are in need of, um, I’ll give the example like Medicaid, then people don’t seek care. Um, people delay care, uh, the cost of care. Um, and so those things again began to further undermine, um, these types, these communities, for sure.
Dorothy: So do you think the recent passage of the Big Beautiful Bill is going to make that even worse?
Camerino: I, um, I haven’t read an experts of, of the Big Beautiful Bill, but what I have read in, you know, in terms of some of the legislators, especially from Texas, that actually, um, have looked at it, that it is, it does place into communities at risk again because it does focus on cutting some programs to fund others and whether it’s snap, uh, the, you know, which [00:33:00] looks at food ins addressing food insecurity. Um, to Medicaid, uh, which looks at prevention and, and affording access. Those communities that are the most vulnerable and the most fragile already will probably end up suffering the most, um, because it’s these types of services that have been cut.
Dorothy: Well, and you know, there’s a bit of a myth going around, well, Texas didn’t expand Medicaid, so it’s not gonna get hurt as much, but that doesn’t, that it, that really doesn’t make sense to me.
Camerino: That doesn’t make sense. Yeah, that doesn’t make sense. And, and like I mentioned too, you already have, um, well over about a million Texans uninsured. Um, and if you look at certain communities, certain, the working communities especially, you have um, you have wages where people are not even able to afford daily living with the wages they’re making.
Dorothy: Right.
Camerino: And so again, it’s this, this under undercutting of, of social support systems that then at the end, undercut health.
Dorothy: Right. I don’t think we [00:34:00] have such a small percentage of our uninsured who apply for help here at The Rose. They’re all working, you know, it’s not like they’re not working.
Camerino: Right.
Dorothy: And I, I keep thinking, how, how do we have these myths going around? Well, that’s just people not wanting to work. No. We see, we see 8,000 of these primarily women, some men.
Camerino: Yes.
Dorothy: That, that are asking for help simply, they can’t afford insurance.
Camerino: You know, when I was at University Health, I, I had the opportunity to support a program called CareLink. CareLink is a financial assistance program for really the, the ones cannot afford any type of insurance. And so they seek care at the hospital. And then, and so then what CareLink does is they, it, it affords them some financial assistance. Um, and when I was, you know, asked to analyze some of their information, I always looked at, they have like occupation. Vast majority working. And working multiple jobs.
Dorothy: Right.
Camerino: [00:35:00] Working, you know, and to, to try to make a, to try to make a living. And so I think this, again, this, um, this idea or this concept that it’s, uh, people that only want to, um, you know, live off the system or take and drain the system. That’s, that’s not the reality.
Dorothy: No. And especially in Texas.
Camerino: Especially in Texas.
Dorothy: Uh, you know, the, the mothers recently, you know, had children are the very, very poor. Something like less than 4,000 a year are some disabled. You know, that’s, that’s the only ones that really get Medicaid. And it’s, it’s, it’s so, it’s such a, um, misfortune that we have that concept, right? That these people just don’t wanna work. You know, they’re lazy. That’s, that’s wrong.
Camerino: Right. I totally, I totally agree. And I think part of it too is I think in, in some of these states, their, their Medicaid eligibility is so [00:36:00] restrictive too. Um. And like you mentioned, the ones that are, uh, disabled and not able or impaired for, for other, you know, reasons. Um, but again, again, the concepts exist that this, there’s a population that’s draining taking. And so we need to do something about it.
Dorothy: Right.
Camerino: And so again, I think it goes back to the, the whole, um, you know, what we talked earlier about was this, this segment of the population that believes that, again, limited government. Um, intrusion. Those, those don’t, those shouldn’t be part of, you know, where we live, part of, but in the end, it’s those types of services that enable help.
Dorothy: And everyone suffers.
Camerino: Right. And, and like you mentioned, it’s, unless we, we try to confront it or we try to, to have a more of a conversation than, um. These things are always kind of like, again, they’re loose, they’re um.
Dorothy: Vague.
Camerino: They’re vague. We, we are. And so then it [00:37:00] become, and it never becomes really grounded. And so at the end it is like, like we talk about, it’s a very complex picture. It’s it’s history. It’s ideology, it’s, it’s, it’s economic.
Dorothy: It’s tradition.
Camerino: It’s tradition.
Dorothy: If you came from a family that believes that you.
Camerino: Right.
Dorothy: Well, how else are you gonna believe?
Camerino: Yeah. And, and there are cultural norms and, and I think, and I think that’s very normal. We all come from communities where we have certain cultural norms that we support and it’s very natural to us. But when somebody from the outsider looking in. They may not see it as normal, but we see it as normal. You know, and this goes back to we talked about, um, there’s some studies on vaccinations, you know, where we notice that certain communities have lower vaccination than others. And part of it they find is that in those communities, well, that’s kind of the cultural norms.
And so when people move to those communities, they may not necessarily believe, well, I need to vac, i, I need to vaccinate or vaccine my, you know, vaccinate my [00:38:00] child. But what they find is over time, as those, as those families live longer in those communities, they begin to take on those norms. And so then it becomes normal to say, well, I’m not gonna vaccinate this year. No, I think they’re good. They don’t only, I, I, you know, I’ve read more. I’ve heard more. So there’s a, there’s a var, there’s an influence. You know, and now more than ever with social media.
Dorothy: Right.
Camerino: There’s so many perspectives coming at you. And oftentimes we like to latch onto the perspective that we feel most comfortable with. Mm. That we feel we’ve like, ties into our value or cultural system. So again. It is, I think it is very natural. I think like Metzl finds, it’s, it’s very interesting. But at the same time it’s like, these are communities that have normalized this type of thinking.
Dorothy: But it, but it’s deadly.
Camerino: But at the end it is. Yes, it is very deadly.
Dorothy: Deadly.
Camerino: It is very deadly.
Dorothy: All right, one last question.
Camerino: Yes.
Dorothy: What can average person, you know, Joe Blow citizen do, if anything?
Camerino: If [00:39:00] any, you know, I, you know that, and that’s a question that’s been asked and, and I think part of it too is. I always encourage people to, to think beyond what you feel comfortable with, right? To like, uh, to create a, an opportunity where like, like these forums or these types of uh, of opportunities where people can listen, can hear, uh, maybe a different perspective. They may not agree on it, but I think for, for that is that to further the conversation, that hopefully begins to build some type of consensus.
You know, yesterday my, my wife and I were, um, you know, we were in Cyprus. ’cause again, my daughter’s water polo tournament was there. And we, we had, uh, dinner and there’s this little boardwalk, I guess they have by this little lake. And it was on a Sunday, of course, Sunday evening. And I see all these children.
Uh, from different race, ethnic, just playing in this little green space. And I’m looking and I’m observing, thinking, you know, about today’s conversation and I thought, you know, this is like a, an open forum or space where everybody’s just having a good time. [00:40:00] Families from different economic backgrounds, different political ideologies.
I’m sure just having a good time, enjoying a common ground, a common area. And I just feel that. And today where we’ve kind of really taken signs and moved to one end or one end of the post or the other, that I feel there’s a need more than ever for some type of common ground that encourages compromise.
And that really encourages conversation, healthy conversation really that thinks, not that we want to change your mind, but that we want you to see our perspective or our side, you know, from what for whatever. And to hopefully, um, encourage that discussion that really begins to hopefully then rethink how we form policy and how we reshape it.
Because in Texas, you know, in the LA in the last census, Texas grew by almost 4 million people. 95% of that population growth was driven by racial and ethnic minorities. Almost half of that were by Hispanics [00:41:00] and in Texas, um, out of the 5 million students we have in public schools. 75% of those 75% of the population in Texas are Hispanic.
And so when you think of those numbers, you think of the diversity and how Texas is changing. And I think more than ever there is need to really embrace that diversity, embrace those types of di whether it’s in conversation or in other pockets, because again, I think it makes us a better state. It makes us a stronger state, uh, when we really not try to. Not confront, um, change, but more encourage it in a healthy way.
Dorothy: Good advice. Good advice. Hard.
Camerino: It’s hard. Yeah. Hard.
Dorothy: Good advice. Well, thank you so much for being with us today. This was fascinating and you, and thank you for helping us to understand this very complex, very convoluted in some ways systems that you’re talking about [00:42:00] and how. We as just general public can help.
Camerino: We appreciate it. Well, I, I wanna say thank you so much for your time today and for inviting me.
Dorothy: Oh, of course.
Camerino: And to be a part of this. I really enjoyed it. Thank you.
Dorothy: Uhhuh.
Post-Credits: Thank you for joining us today on Let’s Talk About Your Breasts. This podcast is produced by Speke Podcasting and brought to you by The Rose. Visit therose.org to learn more about our organization. Subscribe to our podcast, share episodes with friends, and join the conversation on social media using #LetsTalkAboutYourBreasts. We welcome your feedback and suggestions. Consider supporting The Rose. Your gift can make the difference to a person in need. And remember, self care is not selfish. It’s essential.
