Healthcare a community responsibility

Dr. Eva Galvez, Ford Scholar Class of 1994, received Oregon State University’s 2020 Alumni Fellows Award in October. 

Eva Galvez, M.D.

Eva Galvez was a senior at Hood River Valley High School in 1994 when Kenneth Ford selected her to be a member of the inaugural class of Ford Scholars. The daughter of Mexican immigrants who worked as seasonal farm workers, Galvez and her twin sister, Olivia (who was also selected to be a Ford Scholar) attended Oregon State University, graduating from the College of Science’s biology program in 1999. Both went on to earn medical degrees. Galvez graduated from the University of Washington School of Medicine in 2004. 

Galvez has worked for Virginia Garcia Memorial Health Center in Hillsboro since 2010, where many of her patients are Spanish-speaking migrant and seasonal farm workers. She regularly speaks on panels to educate the public around health disparities. 

During the COVID-19 pandemic, she became a vocal advocate for mitigating health risks for Oregon’s seasonal farm workers, and she has addressed the Select Subcommittee on the Coronavirus Crisis in the U.S. House of Representatives.

In a video talk she delivered after being named an Alumni Fellow of Oregon State University, Galvez examines the social determinants of health, their role in shaping health, and how to better address these factors to achieve health equity for all Oregonians:

“Much of society believes that health is something that we have control over — eat the right food, exercise and take the right medications to be healthy” she tells her audience. But that is not the reality. Health is the sum of many factors. “Only about 20% of our health is determined by healthcare and our individual choice. And the rest is shaped by social factors, otherwise known as social determinants of health, and those include cultural beliefs and your values.”

While the pandemic has touched every community in the United States, it has hit the Latino community hard. 

“In Oregon, Latinos make up about 13% of Oregon’s total population, but are about 40% of the total cases. If you’re Latino, you’re almost three times more likely to die from COVID,” Galvez says.

A story behind the data

 The statistics come alive through the story of one of Galvez’s patients: Luis, a 68-year-old farm worker. When she met Luis, he was healthy and in his mid-50s. Five years later she diagnosed him with Type 2 diabetes and expected him to come in more regularly to manage his chronic condition. But he came in sporadically — only when work was slow. 

Last spring, Luis called her to say he had fevers and body aches, symptoms of COVID. She encouraged him to come to her clinic to be tested, but he declined. The following day he called saying he was feeling worse. “At that point, I told him he needed to go to the emergency room. But again, he declined because of his concern over the cost,” she recalls. Instead, he insisted he wanted to be seen at her clinic the next day. But Luis never showed up. He had been taken to the hospital in respiratory distress and intubated; he died two weeks later, alone, without his family.

“So what did Luis die from?” she asks. “We could agree that Luis died from the complications of COVID-19. But what were the factors that led to his death? You see, Luis was a seasonal farm worker, so he did not have the luxury to work from home. Complicating matters, Luis was paid low wages. To afford rent, he lived in an apartment with six other people, conditions known to contribute to the spread of the virus.”

Galvez argues that education, access to food, economic stability, neighborhoods, physical environments, and support systems play the biggest roles in a person’s health.  

“As a society we still tend to perceive health as an individual responsibility based on a series of good or poor choices,” she says. “Sometimes, we might blame the individuals for their poor health.” She encourages society is to think of health not only as an individual responsibility, but also “as the responsibility of an entire community.”

“As a woman, as a daughter of a Mexican immigrant, as a daughter of seasonal farm workers and now as a physician, I’m aware of the unique and privileged position that I have,” she says. “But my success is more than just a product of my hard work and my individual actions. I had the conditions that set me up for success, starting simply by being born and raised in a safe community, that my parents had steady work so that I could establish roots, and that I had teachers who were invested in my learning. 

“These are the conditions that are at the core of healthy individuals and communities. So, I believe that health equity is not giving people things, but rather it’s removing obstacles and ensuring the right conditions so that then with our hard work and our talents, we can achieve our goals, whatever that might be.” 

View the full video of Dr. Galvez’s talk at Oregon State University