Rossana Barrera with a client at the Women's Health Center

Wedged into a small office carved by paper stack canyons, Rossana Barrera expresses surprise at the events in her life since she received her MPH at UIC. Now the coordinator of the Womenís Health Center at Norwegian American Hospital, Barreraís life took several unexpected turns before she got there.

When she came to the United States ten years ago, she expected to attend a residency program and specialize in order to become "one of the best cardiologists in Guatemala," her home. It turned into a trying experience for her, however, with obstacles such as the language barrier and an unexpected barrage of tests thrown in her path.

Back in Guatemala on vacation, Barrera returned to the local hospital where she completed her internship. "It was like a light going on," she says. "I thought [the hospital] was so far behind when I went back. I felt cardiology wasnít the direction I should go in when people had much more basic needs."

On her return to the United States, Barrera was accepted into the graduate program at the UIC School of Public Health and volunteered at Cook County Hospital. Soon after, she was offered a job as a clinician in a Cook County Hospital breast-feeding program. After three years, she moved to Norwegian American Hospital in the Humboldt Park neighborhood, an area housing many first-generation Latinos for whom language presents the same barrier Barrera had faced herself. In addition, they face potential socioeconomic isolation in terms of health care and education.

At Norwegian, Barrera worked with a study based at the University of Missouri on low- birthweight babies delivered by women of Mexican heritage, and she received a scholarship from the hospital to support her studies at the School of Public Health. Barrera was eventually offered a position at Norwegian as an educator in a program serving new mothers. "I worked as a patient educator, continued the research, and became involved in the community through the local agencies," Barrera said. "We began doing collaborative work." The Midwest Latino Health Research, Training, and Policy Center at UICís Jane Addams College of Social Work has distributed some of her findings.

As she learned more about the Humboldt Park Latino community, Barrera realized there was a need for expanded public education services that could be coupled with a way for Latina women to obtain the basic preventive care essential to their health. Barrera wanted to provide those services in a nurturing environment in which the patients would not feel intimidated. The Womenís Health Center, tucked into a corner of a new multistory professional building at the hospital, opened last December. Its emphasis on Latina women in mid-life stems from one of the things Barrera learned from her research. "Here in Chicago and elsewhere in the United States, all the attention is on women in their reproductive years. After they reach a certain age, they are basically ignored," Barrera says. "And these mid-life women have many chronic conditions that nobody teaches them how to manage." The center also addresses language and socioeconomic barriers affecting Latina women.

There is a high prevalence of diabetes and heart disease in the local population, Barrera says, largely attributable to diets high in processed foods and a lack of exercise. "In the interviews I did for research, when I was talking with low-income women, I found they all remembered starving at some point in their childhood," Barrera says. "They come here and they can afford a little bit, and eating becomes a way for them to compensate. But theyíre not ready for this kind of diet, and the incidence of diabetes and heart disease is incredible. Menopause also puts women at risk for other problems."

Therefore, she says, there is a great need for education, a major focus of the Womenís Health Center. "The tough part," Barrera says, "is that the insurance companies donít reimburse even mainstream education. Thatís hard because we want to treat the whole human, not just the body. We want to take a holistic approach. Weíre all individuals full of beliefs and feelings that affect our health. These are areas we also need to consider in public health."

The center offers an array of tests important for the women who use it, at a price most can afford. Tests include mammography, cholesterol screening, and pap smears. If clients canít pay right away, the center works out a payment plan with them. Barrera notes that all the centerís clients want to pay something for the services.

"I told myself that if I made a difference in one womanís life, Iíd feel like I accomplished my goal, and thatís happened," Barrera says. "In one case, a woman who was very depressed came in. She was overweight and very concerned about how she could get any health care. We did some tests she needed, and she kept coming back for follow up. The last time I saw her, it was amazing. She had lost weight and was showing confidence in herself. She just needed to know someone cared."

Barrera says her MPH provided "a lot of information" she uses in managing the center. "I never expected to be a manager, and Iím still learning," Barrera says. "The MPH opened my eyes to the fact that public health is not just counting people with a disease. Instead, itís a field that offers a whole spectrum of things you can do. Marketing, for example. Ten years ago, I would never have thought Iíd be a marketer of health care. But thatís just another way of being creative, trying to reach a population.

"The satisfaction and enjoyment of this job is amazing. I enjoy it so much I donít feel like Iím coming to work," Barrera says. "Coming from the background Iíve had, I really believe that public health has not been given the importance or the credit it deserves."

Contributed by Rick Asa

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