Health Equity Challenge Finalist, Angela Rose David

The scent of antiseptic and tapioca pudding wafted through the air. Placing the empty food tray on my borrowed cot, I glanced around my grandparents’ shared room. Clunky metal beds, a suitcase full of clothes, and a bulletin board on the wall filled with doctor notes and medication lists. Feeling a nudge, I turn to my right and see my grandpa’s toothless smile, his favorite card deck in hand. This was my childhood for many years. Although it was isolating at times, bouncing between nursing homes, I will always be grateful to my grandparents for being my caregivers, even when they themselves often needed more care than I.

To be Filipino is to be immersed in a caring culture. The act of caregiving is so deeply ingrained in our identity as a Filipino people that we have created words to describe these feelings of filial piety and respect towards older generations: pakakisama (family unity and closeness) and utang na loob (mutual reciprocity, or the organic “give and take” that exists within relationships).

Reflecting on my childhood, my grandparents and I were lucky: we would have been in worse shape, uninformed and powerless in our situation, without the support of each other and other compassionate Filipino caregivers. Recognizing our luck, I wanted to invest my time and efforts in giving back to my community who helped raise me. My personal experiences in this caregiving culture have become a driving force in my life, prompting me to seek out opportunities that positively impact the elderly and similarly vulnerable populations.

My first job out of high school was as a caregiver In-Home Supportive Services (IHSS), a federal program that offers in-home health and social services to aged, blind, and disabled individuals. At first, I merely wanted to save money for college. Little did I know that becoming an IHSS provider would expose me to a world of medicine beyond geriatric palliative care and allow me to uplift others also suffering from health care insecurity.

During home visits, I was often assigned to elderly Filipinos. Because many were jobless with all their family overseas, my visits were often the only form of social interaction for these patients. We often connected with each other through stories of our homeland and shared experiences with caregiving. It was humanizing to see just how quickly life can leave you vulnerable, reliant solely on the kindness of strangers. Although I was not able to perform complex medical treatment as a caregiver, I realized that simply addressing people with compassion and mindful listening can be just as impactful as tending to their physical needs. Working as a caregiver for my own people spurred within me a desire to explore medicine further — to pursue a career as a public health professional and better advocate for Filipino patients who often felt overlooked or unheard.

To better understand the conditions that my grandparents and other older Filipino individuals faced daily, I began working part-time at the health clinics that my caregiving patients visited. I saw how they struggled at doctor’s appointments because of language barriers and a lack of cultural competence. Their struggles showed me that any small changes or tools that allowed independence became incredibly significant.

Caregiving will never be one-size-fits-all. But my life has taught me that to be Filipino, to be human, is to care — to grow and challenge ourselves daily, so that we can care for and love each other in ways that we did not know were possible.”

Using my caregiving experience and bilingual skills, I created multilingual pamphlets and resources to help Filipino patients better understand their health plans. The joy I felt was immeasurable when, at a follow-up visit, an older man showed me a video of him and his one-year-old grandson exercising together, thanks to my Tagalog instructional video. Patient interactions like these not only affirmed that my scientific knowledge expanded daily as a caregiver, but that my creativity could positively impact and empower others. My contributions, however small, felt meaningful and strengthened my desire to become a public health professional, delivering personalized informed care to Filipinos regardless of physical limitation or socioeconomic status.

However, it was during the COVID pandemic that my identity as a Filipino and as a caregiver was truly tested. In 2021, Filipinos comprised only 20% of Asian, but 32% of all deaths among U.S. registered nurses and 42% of COVID-related deaths in California alone. More egregious during this time was the scarcity of culturally tailored mental health information, especially as it relates to advanced care planning and bereavement. Caring for my grandparents during this trying time taught me how intergenerational support networks become more crucial as people age. In the context of illness, it is especially important as a caregiver to understand a person’s cultural perspectives on death and dying.

My goal moving forward is to teach others how to treat life and death in equal measure. I want to prepare households so they know how to respond to death, as well as natural and human-caused disasters of a post-pandemic era. Inspired by my identity and collective experiences as a Filipino caregiver, I am in graduate school to develop the tools needed so that I might, one day, develop a culturally tailored bereavement curriculum emphasizing mental health care and advanced care planning. I see the Health Equity Challenge as a foundational first step towards this dream of equipping my community with the social support and knowledge needed to protect and support themselves and each other in the face of future traumas.

Caregiving will never be one-size-fits-all. But my life has taught me that to be Filipino, to be human, is to care — to grow and challenge ourselves daily, so that we can care for and love each other in ways that we did not know were possible.

    Photo of Angela Rose David


    By
    Angela Rose David
    2024 Health Equity Challenge Finalist
    Angela Rose David is a student in the Master of Public Health for Health Professionals program at the UCLA Fielding School of Public Health. She also works at UCLA full-time as the project manager for a lab that explores health disparities affecting the Filipino immigrant population.

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