Find Your Inner Yoshimi: A look at the social determinants of health and stress

by Steffie Duginske – Western Regional Coordinator

Every time I hear the Flaming Lips song, Yoshimi battles part 1, from their album, Yoshimi Battles the Pink Robots, I can’t help but think that it could be the theme song for the NC Preconception Health Campaign when it comes to our multivitamin/folic acid message. Listening will make reading the rest of this article more enjoyable and understandable, but not totally necessary. Check it out here:

Yoshimi battles her “evil robots” by “taking lots of vitamins”. I interpret this as: Yoshimi must have a very good understanding of the importance of taking a daily multivitamin with 400mcg of folic acid, because if she becomes pregnant, it reduces her chance of having a baby with neural tube defects by up to 70%. Ok, so it’s a little far-fetched to think that anyone else other than a health educator who’s known as the “Multivitamin Pusher” for the Western Region of North Carolina would make that connection, but now that you’ve heard it, you may also forever make that connection – and maybe, just maybe, remember to take YOUR daily multivitamin as well as remind others?

Dig into the song and Yoshimi with me a bit more if you will. I can’t help but also think about her health through a social determinants of health lens. According to the Center for Disease Control (CDC), the social determinants of health – the challenging factors that contribute to a person’s health status are:

  • Biology and genetics. Examples: sex and age
  • Individual behavior. Examples: alcohol use, drug use, unprotected sex, and smoking
  • Social environment. Examples: discrimination, income, and gender
  • Physical environment. Examples: where a person lives and crowding conditions
  • Health services. Examples: Access to quality health care and having or not having health insurance

To me, Yoshimi sounds like a strong and empowered women who has someone (the listener or singer maybe) supporting her. She works hard at her job, she handles the stressful evil robots in her life in a positive way that enables her to take care of herself, and she seems to be encouraging others in her life to defeat their evil robots too. Thinking from a practical preconception health point of view: what obstacles are the women you know up against in their lives? Consider their social environment: are their stress levels and/or mental and physical health being affected by their social environment? Could they be experiencing racism, sexism, homophobia, or classism that is so engrained in their daily lives that they have become “used to it”? Now, add an unplanned or even planned pregnancy in the mix with any combination of those stressors. According to March of Dimes, high levels of stress that continue for a long time may cause health problems like high blood pressure and heart disease. When you’re pregnant, this type of stress can increase the chances of having a premature baby (born before 37 weeks of pregnancy) or a low-birthweight baby (weighing less than 5½ pounds). Babies born too soon or too small are at an increased risk for health problems. 

Let’s further explore the women who are not as resistant to the stressors of life as Yoshimi. Why aren’t they as strong? What’s going on in their lives that keep them from being as resilient? Think about the female clients and patients who come into your office. What are they dealing with as they go through their daily lives? What resources do you need or does your community already have to help your patients/clients battle their evil robots? What steps is your practice taking to ensure all women of childbearing age are screened for the social determinants of health that may be affecting their health BEFORE they become pregnant? Now take this one step further and think about your health. How do you handle stressors in your life? How does it positively or negatively reflect on your patients, family, friends, and community?

A brand new webinar is coming up this month that will educate us about Adverse Childhood Experiences or ACEs. The Campaign will be discussing women’s preconception health and the importance of a Reproductive Life Plan while connecting it to any possible “evil-natured robots” (aka ACEs) a woman might have experienced. ACEs determination can help providers understand that the trauma she may have experienced age zero to 18 may be influencing her health as an adult and could affect the health of her future children. Addressing a woman’s health with a preconception health lens is key to tackling any health behaviors like substance use or even managing a healthy weight head on BEFORE she becomes pregnant.

To sum it up, find your inner Yoshimi while helping others find their strength too.  You may not be able to get rid of all the evil pink robots, but one at a time, you may be able to reduce them to a manageable amount to move through life with happiness, ease, and the resiliency needed to improve overall health. I encourage you to give the album a listen for further inspiration. If the Flaming Lips are not your cup of tea, find your inspiration elsewhere…just make sure find it – your mental health will thank you for it.


Revised: November 10, 2015

This web site is designed for informational use only; it is not designed to give advice, diagnose, cure or treat any medical condition you may have. If you have any questions about your health, please contact your health care provider.