title: Eyes wide open: an essay on developing an engaged awareness in global medicine and public health.
abstract: BACKGROUND
  There is a growing understanding of the role social determinants such as poverty, gender discrimination, racial prejudice, and economic inequality play on health and illness. While these determinants and effects may be challenging to identify in parts of high-income countries, they are patently obvious in many other areas of the world. How we react to these determinants and effects depends on what historical, cultural, ideological, and psychological characteristics we bring to our encounters with inequity, as well as how our feelings and thoughts inform our values and actions.
  
  
  CONCLUSIONS
  To address these issues, we share a series of questions we have asked ourselves-United States' citizens with experience living and working in Central America-in relation to our encounters with inequity. We offer a conceptual framework for contemplating responses in hopes of promoting among educators and practitioners in medicine and public health an engaged awareness of how our every day work either perpetuates or breaks down barriers of social difference. We review key moments in our own experiences as global health practitioners to provide context for these questions. Introspective reflection can help professionals in global medicine and public health recognize the dynamic roles that they play in the world. Such reflection can bring us closer to appreciating the forces that have worked both for and in opposition to global health, human rights, and well-being. It can help us recognize how place, time, environment, and context form the social determination of health. It is from this holistic perspective of social relations that we can work to effect fair, equitable, and protective environments as they relate to global medicine and public health.
authors.affiliation: Institute for Studies in History, Anthropology, and Archeology, University of El Salvador, Urbanización Buenos Aires III, Block H, Calle Los Maquilishuat N° 3-A, San Salvador, El Salvador. wventres@gmail.com.|Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA. wventres@gmail.com.
authors.forename: William B
authors.initials: WB
authors.lastname: Ventres
authors.affiliation: Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala. meredith.fort@ucdenver.edu.
authors.forename: Meredith P
authors.initials: MP
authors.lastname: Fort
mesh_terms: D001364:Awareness; D002489:Central America; D004501:Education, Medical; D058006:General Practice; D014943:Global Health; D006262:Health; D006801:Humans; D007391:International Cooperation; D011634:Public Health; D064890:Social Determinants of Health; D012941:Social Responsibility; D012959:Socioeconomic Factors; D014481:United States