Villarosas’ Kinder Approach to Structural Competency

When reading Metzl and Hansen’s scientific article on structural competency, it seems clear to me why this article would not be of interest to others outside of the field of medical anthropology. The way that the article is structured with fine print and two columns per page, the article itself is very daunting looking, and if one were to read said article, those with a lesser education or low income might have a challenging time reading this. Comparing this article to Villarosas’, there is a stark difference between the two articles, and while Villarosas never states the actual term: “structural competency” and does state statistics and facts such as “Black infants in America are now more than twice as likely to die as white infants — 11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies,readers will have a much easier time understanding that term than if they were to read Metzl and Hansen’s less approachable article. Villarosa explains structural competency through personal experience and guides readers through the experiences of losing a baby and another childbirth process. 

“Landrum noticed that her hands, her feet and even her face were swollen, and she had to quit her job because she felt so ill. But her doctor[…]brushed aside her complaints. He recommended Tylenol for the headaches[…] Landrum says. “When I told him my head still hurt, he said to take more”’ (Villarosa).

“When Landrum complained about how she was feeling more forcefully at the appointment, she recalls, her doctor told her to lie down — and calm down. She says that he also warned her that he was planning to go out of town and told her that he could deliver the baby by C-section that day if she wished, six weeks before her early-January due date. Landrum says it seemed like an ultimatum, centered on his schedule and convenience” (Villarosa).

The above quotes are responses to her experience in pregnancy only to have a stillborn birth. By combining her personal experiences and relating them to the facts of mortality rates such as, “For black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress, resulting in conditions — including hypertension and pre-eclampsia — that lead directly to higher rates of infant and maternal death” (Villarosa).

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