Language has a critical role as a social determinant of health and a source of healthcare disparities. Rhetorical devices are ubiquitous in medicine and are often used to persuade or inform care team members. Rhetorical devices help a healthcare team acknowledge and interpret narratives. For example, metaphors are frequently used as rhetorical devices by patients to describe cancer, including winning or losing a battle, surviving a fight, war, potentially implying that the patient feels helpless like a pawn fighting in a struggle directed by the physician, thus reducing patient autonomy and agency. However, this occidental approach is flawed because it excessively focuses on the individual's agency and marginalizes external factors, such as cultural beliefs and social support (Sontag, 1989). Although there is a large body of research about how the rhetoric of medicine affects patients in the United States, there is a lack of such research about how patient experiences' rhetoric can help increase the understanding of Latino populations' unique social determinants. This creative project aims to analyze the rhetorical differences in the description of disease amongst Latino and American communities, translating to creating an educational module for a Spanish for biomedical sciences class. The objective is to increase future healthcare professionals' ability to understand how the composition of descriptions and medical rhetoric in different mediums of humanities can serve as critical tools to analyze social determinants in Latino healthcare delivery.
Problem: The prospect that urban heat island (UHI) effects and climate change may increase urban temperatures is a problem for cities that actively promote urban redevelopment and higher densities. One possible UHI mitigation strategy is to plant more trees and other irrigated vegetation to prevent daytime heat storage and facilitate nighttime cooling, but this requires water resources that are limited in a desert city like Phoenix.
Purpose: We investigated the tradeoffs between water use and nighttime cooling inherent in urban form and land use choices.
Methods: We used a Local-Scale Urban Meteorological Parameterization Scheme (LUMPS) model to examine the variation in temperature and evaporation in 10 census tracts in Phoenix's urban core. After validating results with estimates of outdoor water use based on tract-level city water records and satellite imagery, we used the model to simulate the temperature and water use consequences of implementing three different scenarios.
Results and conclusions: We found that increasing irrigated landscaping lowers nighttime temperatures, but this relationship is not linear; the greatest reductions occur in the least vegetated neighborhoods. A ratio of the change in water use to temperature impact reached a threshold beyond which increased outdoor water use did little to ameliorate UHI effects.
Takeaway for practice: There is no one design and landscape plan capable of addressing increasing UHI and climate effects everywhere. Any one strategy will have inconsistent results if applied across all urban landscape features and may lead to an inefficient allocation of scarce water resources.
Research Support: This work was supported by the National Science Foundation (NSF) under Grant SES-0345945 (Decision Center for a Desert City) and by the City of Phoenix Water Services Department. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of NSF.