Woman: Why don't we deserve the right to be healthy?

Why is it so easy to be able to afford the things that are harming us?

Woman 2: Your Zip code determines more on your life expectancy than your DNA code now.

Woman 3: Over 2,000 homes have contaminated yards.

Nobody should be living in those situations.

Woman 4: I was not the person who I used to be before the pandemic.

I was feeling that I was dying, basically.

Man: "If you would have showed up an hour or two later, you would have been so severe that there would have been nothing we could have done for you."

Man 2: Our kids were exposed to things that they never needed to get exposed to.

Those kids will be scarred for life.

Man 3: Where you live really determines your health.

And in the United States, the truth is that the poor pay the price.

[Camera focus adjusting] [Camera shutter clicks] [Camera focus adjusting] [Camera shutter clicks] Announcer: "Earth Focus" is made possible in part by a grant from Anne Ray Foundation, a Margaret A. Cargill Philanthropy, and the Orange County Community Foundation.

Announcer 2: Hasa is a proud sponsor of "Earth Focus."

[Indistinct chatter] Man: I know right now you're having a difficult time financially, right?

It sounds like it's not easy.

Patient: Yes.

Doctor: Yeah.

Patient: Um... yes, yes, it has been very difficult.

I mean with the pandemic.

We've gone where we had multiple notices that "We're going to cut off the gas," or, "We're going to cut off the light."

And it was terrifying because just outside our door, we have a lot of homeless people.

And that's a big impact when you have to walk past them to your own apartment and then thinking you might end up having to join them.

What's going to happen?

Doctor: Yeah, it's definitely...

In voice-over: 20% of someone's health is determined based on clinical care.

The rest of it has to do with the environment.

Do they have clean, fresh air?

Do they have access to parks?

Do they have stable housing?

Do they feel safe in their community, right?

So all these factors play a huge role.

[Knock on door] [Conversation in Spanish] Doctor: As a doctor, when I came in, you know, I wanted to save the world and, you know, help those patients.

I quickly realized that what's happening outside the clinic--where you live, work, worship, play-- is really what's going to affect your health.

You know, some people really try to push the genetic thing.

Yeah, you know, it has a little bit to do with.

Not, not a lot, as much as our environment.

You walk outside, you're going to see it.

We look at how many people live in a household.

What is the household income?

Who has insurance or not?

Who has access to clinics?

How many crimes are in the area?

Quality of air?

You have the freeway with all the trucks, the oil industry, and then you have all the factories.

Then you can look at certain areas will have a liquor store and not have actually a supermarket or a grocery store.

Michael Granados: I mean, you can look it up on your phone.

There's an app where you put in your physical address, and they will tell you your life expectancy.

That's crazy, right?

Ana Karina Melgar: Our clinic's located in South Gate, which is the southeast Los Angeles area.

Granados: It's in a very interesting community.

We're eight miles southeast of downtown Los Angeles.

75% of our patients are Latino, and 20% of our patients are under the federal poverty line.

What's a meal typically look like?

Patient: Um, whatever I have available at my house.

Granados: OK.

Patient: I had a friend that was bringing leftovers from his house.

So it was like tacos, or he had made pizza or whatever that was high carb... Granados: Yeah.

Patient: was usually what... Granados: Mrs. Medina is a patient that I have known for over two years now.

And at first, I was always asking myself as a doctor, What am I doing wrong?

Is something getting into the way of me being able to manage her diabetes?

And it was after a couple of visits where I really realized that the medications were not really the issue, but it was really about her home and her having no source of income.

Medina: But now I'm getting to know the schedule of when they bring in healthier options at the market near me.

Granados: And you feel like you have options there, healthy options?

Medina: Yes, yes.

There are other markets where we used to go to where they were very limited in what they had health-wise.

And when I approached one of the managers there, I asked him, you know, "You're in a predominately Hispanic neighborhood, where everyone either has hypertension or diabetes or other chronic illnesses.

Do you have any options?"

And the man literally looked at me, laughed at me, and walked in his office and closed the door, and... Granados, voice-over: When we do screening in our clinic for social determinants of health, 30% of the patients tell us they have food insecurities, meaning sometimes they don't know where their next meal is going to come from.

And it's sad to say, sometimes the best treatment that I would want to give is money.

Medina: I was a substitute teacher and a theater technician.

So when the pandemic hit, both of my jobs are gone.

And it's extremely difficult to make any type of ends meet when you don't qualify for unemployment, stimulus checks, grants.

I didn't qualify for a lot of things because I guess I'm known as a gig worker.

I remember a time where I was tutoring a friend so she could get her college degree, and her parents had a doughnut shop, and she didn't have any money, but she paid me in three dozen donuts.

So my daughter thought it was funny.

She goes, "Good!

Now we have breakfast doughnuts, lunch doughnuts, and dinner doughnuts."

And we laughed about it, but it was true.

That's what we had to eat for a while was just those doughnuts, and that isn't what people should go through.

They shouldn't have to deny themselves and their families their health.

Why don't we deserve the right to be healthy?

Why don't we have the right to have accessibility to things that are good for us?

Why is it so easy to be able to afford the things that are harming us?

Woman: Here in L.A. County, it's a tale of many different cities.

This is a huge county, 10 million people.

And what we see over and over again is communities that do not have health-affirming resources and opportunities and then communities that have an abundance of those resources.

When we look at what we see, for example, in South Gate, we can see a mortality rate that's actually 10 years lower than a mortality rate of a community like Manhattan Beach that's really a very short distance away.

But Manhattan Beach is a community with lots of very wealthy people and lots of community resources that affirm positive health outcomes.

It's very hard to tell people to eat healthy if they A--don't have a lot of money and B-- there's no place in their neighborhood that, actually, they can go and purchase healthy food.

It's pretty hard to tell people that they need to exercise every day for 45 minutes if, first of all, they're working two jobs and taking care of a family and, second of all, they live in a community with very little green space.

The less expensive housing is often close to freeways here.

So I think we have to be very mindful that it's the conditions in which they live that actually make the biggest difference.

Medina: I know that before we moved to the building that we're in now, my children and I, we didn't have as many health issues.

I have asthma.

And we only live feet away from the freeway, where there's constant traffic and the pollution from the cars, and it's going straight up into the apartment.

Every time I clean my windowsills in my kitchen, there's black soot.

And in the bathroom, the black soot.

And that's every day.

And I can only imagine what the inside of my lung looks like.

Medina: If we had universal health care, it would be amazing.

I know so many people that wouldn't have died because it was either a roof over our heads or it was getting a medical treatment they desperately needed.

It wouldn't be this or that.

It would be this and that.

And people would contribute more to society because they knew their health was intact, but the way things are going now without universal health care, it's just living minute to minute, and that's not the way we should be.

[Conversation in Spanish] Granados: Community health clinics are vital to our economy.

They're really the backbone in terms of being able to provide access to our most vulnerable patients.

And the important thing to realize here is that they're reducing barriers by seeing patients where it doesn't matter how much you make.

We're still able to see you.

[Conversation in Spanish] Granados: Mrs. Lopez is a patient who is uninsured.

And even before stepping on our clinic, she had a fear of the potential cost of her medical care.

Granados: OK. Lopez: Sí.

Lopez: Yeah.

Sí.

[Lopez speaking in voice-over] Granados, voice-over: Psoriasis is a condition that is treatable.

But because of the extensive distribution on Mrs. Lopez, the treatment for her would probably be a medication that costs close to $100 every week.

[Blood pressure measuring device hisses] [Irma Lopez speaking Spanish] [Man speaking Spanish] [Irma Lopez speaking Spanish in voice-over] Melgar: Our communities are getting Covid a lot more, and some people ask, Why?

And again, you go back to, you know, they have people to take care of.

They're going to continue working.

They don't have the luxury to say, "OK.

I'm going to work at home."

They have jobs that you can't say that.

You're going to say you're going to work at home?

Then you don't have a job.

And when you get Covid and you have a lot of people living in the house, because that's the way you live, how are you going to stop living in it, you know?

So definitely, we got hit harder here.

So then you see the struggles a little bit more.

Woman: Oh, his stubbornness.

He didn't want to go.

He thought it was just like something that would bypass himself, like, "Oh, it's just a cold.

I'll get some time off.

I'll feel a little better."

I go, "No, I'm not going to take a chance.

So let's just go."

Man: It was real.

It was no joke.

I was in the hospital about 3 months.

I was so severe that I would break down and yell.

I couldn't breathe.

It hurt me when I was in the hospital, having myself in that bed and then having my son Samuel in another hospital.

Jeanette: At that time for me.

Ruben: At the same time.

Both of my sons, they were just doing their last-minute shopping for Christmas on the 24th of December.

They were returning back.

They were followed.

I guess they wanted to rob them, wanted to rob them... And, uh, sorry.

Jeanette: And all we heard was gunshots.

Ruben: And, yeah, we heard gunshots, went up there.

I see both of my sons on the ground.

Sammy was on the floor.

Jeanette: And he shot my son for trying to save his brother.

And they're just yelling for each other: "Samuel?"

"Daniel, are you OK?"

"Call 911, somebody."

We're out there, and my son passed away.

Ruben: Passed away in my arms, in my arms.

I go, "Hang in there.

Hang in there."

Jeanette: Part of me is gone, my heart.

Ruben: After our son passed away, about a week after I woke up in the morning, I told my wife, "I don't feel too good today.

I feel weird."

She goes, you know, "I'm going to take you to the emergency right away."

At first, I told her, "Nah.

Let's wait till tomorrow."

She goes, "No.

We're going now, right now, so, get ready."

Thank you...

I was in the emergency room.

The doctor came up to me, told me, "You have Covid."

She goes, "You should be blessed that your wife brought you because if you would've showed up about an hour or two or later on during the day, you would have been so severe that there would have been nothing we could have done for you."

Melgar: Ruben I met when I was working at the hospital with the residents.

I saw him at the end of the recovery, but I connected with him.

There's also a lot of other emotional things he was going through that we talked about before.

He was discharged from the hospital.

But again, you talk about problems with insurance.

He needed a nebulizer.

It took us almost two or three weeks to get it approved.

I went through different pharmacies.

Oxygen, too, was hard.

Apparently, they gave him the oxygen.

Then they saw that the insurance changed.

They didn't want to give more oxygen.

You know, we have done a lot as a team to make sure he got what he had, or else, he would have been without oxygen already.

Cinthya: My name is Cinthya, and I'm calling from AltaMed in the city of South Gate.

I was just calling to follow up.

Did Dr. Melgar talk to you about the IHSS part?

Yeah.

The forms, your mom can get all those...

I basically help the patients schedule their appointments.

I deal with their referrals, any supportive care they need at home.

Try to schedule everything for the patient.

Yeah, it was denied.

They said that it wasn't covered under the Medicare...

If we have a chronically ill patient that can't come out of home and the wife needs help, depending on their insurance, sometimes they can't get that help at home.

So, you know, it's really hard.

Like, we're trying to do the best we can, but sometimes you just can't, we can't do anything.

Health care worker: Open that one?

Melgar: Yeah, I'm gonna give her some numbers here for, like, urgent care.

Health care worker: OK. Melgar: So in the United States, we don't have universal health care, which is actually pretty sad and disappointing because that means if you don't have a job that offers insurance, you can't afford what's out there.

And if you're not poor enough, you won't have insurance.

We have Medicaid, Medi-Cal for low-income patients.

Then we have private insurance for anyone else.

And then we have insurance from, that we get from jobs.

Granados: Have you talked to the neurologist since your last seizure?

Patient: Um, no, but I plan on making an appointment.

Granados: OK, so I really encourage you to make the appointment because now something's changed, right... Granados, voice-over: So when we talk about health insurance, I think it's really important to know that there are varying degrees of coverage.

So a lot of patients in our clinics, sometimes I'm not able to refer them to the right specialist because that specialist might not accept their insurance.

And the reason is because they do not get good reimbursement.

Good.

Don't break my finger, man... Granados, voice-over: A lot of specialists really try to take either cash patients or patients with really good insurance, so that causes our patients to kind of be left behind.

So what ends up happening is that their care gets further delayed, and so they have the risk of now having complications due to that chronic disease because they can't see that specialist.

So if they say, "Hey, we'll have you come back in three months," you're like, "No.

My primary care doctor wants me to be seen soon," OK... Granados, voice-over: And a lot of families have to decide, "Do I save that money for rent or for food, or am I going to use that money to pay for a visit with a doctor?"

All right, Joseph.

Take care, OK?

Say hi to your family for me.

Joseph: OK. [Vehicle horns honking, siren] [Indistinct conversation] Woman: This is our baby.

Granados: Oh, she is our baby.

Woman: She's my baby.

She's my baby.

I used to carry her.

I used to play with her, dance with her.

Woman 2: OK, well, one more bite... Woman 1: Is yummy?

Granados: ...So she tells you when she's hungry.

She opened her mouth.

You see that?

She opened it really wide.

And she'll definitely tell you when she's not hungry.

Woman: OK. Granados: OK. Huh...

In voice-over: My sister Adriana was actually born at 26 weeks of gestation.

So, she came at a really, really young age, and she came out weighing 1 pound, 6 ounces.

[Kids speaking indistinctly] Granados: So she's 30 years of age now.

She was born in 1991.

So she graduated high school.

And here's a picture of her when she went to prom.

[Dog barking] When she was born, I mean, she looked well, everything was looking fine except for her vision, but during her incubator stay, she had developed an infection in her eye, which later got complicated and eventually required surgery.

During that surgery, she actually went a couple of minutes without oxygen, which ended up, what they said was cerebral palsy.

Come and hang out with us...

In voice-over: So we think it was that short period without oxygen after birth that really played a huge role in how she is today.

It was very difficult at first, my mom being an immigrant and not knowing English.

You know, she went through a hard time.

I think a lot of the information that was getting processed to her through the physicians or doctors at that time, it wasn't really cementing.

She didn't really understand what cerebral palsy was.

I think my mom went through a period where, you know, she probably thought there was going to be a cure for my sister.

My parents tell me this story all the time.

I don't remember it, but they always tell me that when I was a young kid that I would try to comfort my mom and say, "Mom, I'm going to grow up to be a doctor so I can cure Adriana," you know.

And, you know, we haven't been able to cure her, right?

But I think I've learned a lot about healing, and that's something that I really try to practice in my clinic, that it's not always about cure, right, but there's always space for healing.

If it wasn't for her, you know, I probably wouldn't be here today.

So, yeah, I still get sentimental thinking about it.

She's really impacted a lot of people, you know, something that she probably has never heard.

[Voice cracks] You know.

Sorry.

Woman: It's OK.

It's OK.

It's OK. You got this.

You got this... Granados: I know.

Woman: The first thing when I met him, he told me about his sister.

He never shied away from her, he never hide her.

And that was beautiful to me, that that family foundation, it plays a full circle of why he wants to do fam--why he did family medicine, why he works in the underserved community, why he's always looking out for the well-being of his patients, because he first-hand experienced it with his mom and his sister.

[Kids speaking indistinctly] Granados: I would say our community is very resilient.

I like to use the example of a cactus.

A cactus does not need a lot of water, but yet it's gonna thrive and survive.

And I feel that's the same thing with our patients.

Health care worker: Eduardo Duarte?

Granados: They have a lot of obstacles, food insecurity, financial struggles, but yet they continue.

[Conversation in Spanish] Granados: So Mr. Duarte is a lovely 72-year-old gentleman, who I was blessed to meet.

And one thing that really concerned me was that he did not have the ability to buy food every day.

Sí...

In voice-over: And so when I brought up a program where they can provide warmed cooked meals to your home, I mean, you can just imagine his facial expression.

Granados, voice-over: It seems that everything kind of spiraled downhill about two years ago, when he lost housing.

His van was stolen from him.

And after that, he was not able to continue with his job.

And he, sadly, told us stories of how he was getting robbed, mostly every day, living on the streets.

Granados: Luckily for Mr. Duarte, being the kind gentleman that he is, he had a lot of friends in the community, and that is where his friend recommended him to talk to a local family that was going to the nearby church.

And they were able to offer him housing, which is where he currently resides.

[Indistinct conversation] [Conversation in Spanish] Doctor: We are starting this beautiful morning at AltaMed here in Boyle Heights.

The first thing that we usually do is we take our temperatures here.

[Thermometer beeps] Then we are set.

And we have here our amazing Miguel of part of our team helping us here.

And this is actually my favorite part of the clinic.

This is actually our pediatric office.

Right now, of course, everything is dark and we are starting the day, but here is our beautiful clinic.

♪ Ta-da!

♪ Which one is your favorite one?

Of course, of course.

T. rex.

Of course...

In voice-over: As a community pediatrician, I see, you know, the first days of life, so amazing little kiddos to actually kids that are growing--9, 10 years of age--and a lot of young adults are going to college.

Do you want me to check the dinosaur first?

Yeah?

[Woman laughs] Which one?

That one?

Grab this.

Check his ear.

How's the ear?

Good?

In voice-over: I knew always that if you give the correct tools and the correct encouragement and the correct pathway, kids will flourish, and when kids flourish, the entire communities are flourishing back.

Creating healthy starts for everybody, it's the way that we can actually grow and grow healthy.

And that's one of the best things that we have.

[Indistinct conversation] Ilan Shapiro: The things that I'm seeing specifically with obesity is that it's a compounding effect especially right now with Covid-19.

I'm seeing problems with cholesterol in 8- or 9-year-old kids-- things that you usually see in a 35 year old, 40 year old.

In reality, most of the industrial countries, you have access to food, but the quality of food, it's very calorie-rich.

Woman: Ooh.

So it's going to go right here, OK?

[Smaller child crying] Shapiro: Come over here, my friend.

Woman: Sean, you can do that.

Shapiro: Can I?

Woman: He's gonna check your heart, OK?

Oh, wow.

Shapiro: Does it tickle?

Woman: No.

Ha ha!

OK, your turn.

Wow... Shapiro: First of all, any questions or concerns that you have?

Woman: No, they're fine.

Shapiro: That's awesome.

Woman: Getting big.

He's stretching.

[Shapiro and woman chuckle] Shapiro: James is actually doing great with his weight right now.

You see that right now it's trending down.

That's what we want to see.

Woman: OK, OK. With Covid, he's actually gained a lot of weight, so, and then I spoke to a nutritionist already from here, AltaMed, because we were stuck indoors because of Covid, so he didn't really get all the exercise he would have got if he was, like, in daycare or if he started school.

Kid: ...you get hot.

Woman: Yeah.

It gets hot.

Ha ha.

Shapiro: One of the things that we have around here, it's lead?

Woman: Yeah.

Shapiro: Have you heard about the battery industry that we had around here?

It made a lot of waste.

OK.

Right now...

In voice-over: One of the things that we check always is for lead at one and two years of age.

Lead, it's toxic in high levels, and it gets to a point that actually can go to your brain and your brain can stop working.

Then you have problems with learning disabilities, talking, development, and other issues.

And usually the lead can be in paint in old houses.

Also, you know, if someone is working construction, but here specifically in east L.A., we have it because we had a battery plant that actually polluted the area with lead.

Woman: Yeah, our neighbors just did their house.

They took out all the dirt, and they replaced it with, like, rocks.

The paper on the front, it said that there was lead in their dirt.

Shapiro: You probably do as well... Woman: Probably have it, too... Shapiro, voice-over: It's very common that we have one or two kids a week with higher than normal lead levels.

And the thing is, it's not that lead will go away.

We actually need to physically remove it from that place in order to safeguard the kids.

When a number is very, very high--but it's not right now-- we need actually to do, like, a cleanup, a special cleanup inside of the blood.

That's not the case right now, but something that we need to be watching for that.

Woman: OK. Shapiro: We have medications for that, but part of it is actually what's happening at home, the public health part of it because we can actually give all the medications that we want, but if they're exposing themselves and exposing themselves, the lead level will not go down.

Ferrer: So here's a really good example where people don't have resources or they're living in communities that have been disinvested in.

There's a lead smelting plant that was allowed to basically operate without appropriate permits from the state for dozens and dozens of years.

They completely contaminated the surrounding community.

Over 2,000 homes have contaminated yards.

So we still have hundreds and hundreds of families who have to keep their children inside and be fearful of the exposures that they may be having just by walking in and out.

There's almost no other place where this would have been tolerated except in a community that was really made up of Latino and Latina families, who were, in fact, without a lot of resources.

And again, this is what I call an environmental injustice.

You need to clean up.

Nobody should be living in those situations.

Melgar: So today I have the pleasure of going to Ruben's house.

I took care of him when he was in the hospital post-Covid.

And I actually haven't seen him since then, because he's unable to visit the doctor's, and he's doing better but still needing oxygen, and he's still not at all at baseline.

Knock, knock.

Ruben: Come in.

Hi, Doctor.

Melgar: Hi, Ruben.

Ruben: How are you?

Melgar: Good.

And you?

Long time, no see, right?

Ruben: Likewise.

I knew it was going to take a while for me to recover, but I guess it's just gonna take longer than that, I guess.

Melgar: It can.

Yeah, it can.

And you have recovered, right?

I mean, I remember.

Ruben: Yeah.

Melgar: I know it can be frustrating, but... Ruben: Yeah.

Melgar: But it's OK.

I mean, you're here, you're at home, you're not in the hospital.

I think that's... Ruben: Yeah.

I was lucky, and I just, I thank God for her for bringing me home and taking my son, too, you know, what I spoke to you about my son who passed... Melgar: Yeah, I remember.

Ruben: You know, and it took a toll on my wife, her thinking that "We just lost a loved member.

Now what if I lose my husband, you know?"

We've been together, like, for 25 years but not actually married.

So that's why I told my wife in the hospital over the phone, "I don't know what the chances are going to be.

I don't know the outcome, but, you know, I love you.

We've been together for so long.

I want to marry you."

So one of the pastors there married us on video.

We know it wasn't the right way to get married, but it was married through the eyes of God, and that's what counts.

So, now that I'm home, my wishes are to get married, you know, as soon as I get better.

I finally went out after so long.

I finally got out the house.

Melgar: Oh, did you?

Where did you go to?

Ruben: I went to a San Antonio winery, where my son used to work.

So we went there on Sunday for his birthday.

Melgar: Aw.

That's nice.

Ruben: You know.

It was nice.

So, that was the first time I've been out of the house in a long time.

He is no longer with us, but he's here with us in spirit.

So we did that for him.

It was beautiful, and it was delightful, and we had a good time.

[Device beeping] Health worker: OK, have you been exposed to anybody that you guys are aware of who tested positive for Covid, or... Shapiro: Big commercial.

We have here the vaccine for absolutely everybody... Woman: OK. Shapiro: for the Covid-19 vaccine.

Then if you need someone, you know where to reach us.

We're here for you.

Woman: OK.

Sounds good.

Thank you.

Shapiro: One of the things that we are actually doing here is we're helping the community.

You know, we try to serve as much as we can without a card.

Right now, you know, with the pandemic, a lot of issues, you know, on the family aspect of it.

You know, on the kids, we are seeing a wave of anxiety and depression, and we need to make sure that we put a strong mental health component in our lives.

[Camera focusing] [Irma speaking Spanish] Young woman: For some reason or another, not having enough human interaction, watching the news, being alone with my thoughts and feelings, all of these emotions that I didn't know how to recognize them or how to express them, I just kept them inside of me.

So there was a point where everything just accumulated, and it exploded.

I was not the person who I used to be before the pandemic.

I was constantly having panic attacks every single day, and I was feeling that I was dying, basically.

[Indistinct conversation] Camille: In Latin America with older generations, there's not this culture of mental health and that it is important.

So I think at the beginning, it was difficult for them to understand that I needed professional help.

But one time I finally convinced them to help me reach out for a psychologist.

So, right now, I'm having my consultations.

So it's a lot better than what it was at the beginning of everything.

So, yeah.

My therapist recommended me to have a emotional support animal.

So with her, I'm a little less stressed, more calm.

I don't have to talk to her.

I can just go and pet her, and that's it.

[Dog barking] She's one years old, and I have to train her because she's not trained.

I adopted her from a shelter.

[Objects pour into bowl] Irma: Haruki.

Camille: I think it's important for me to share this because people can feel identified and can reach out, too, for help.

Shapiro: We will be scarred for decades.

We will be scarred for decades unless we actually create more than resilient programs.

What do I mean with this?

That at this moment, young people have seen family members die at their own homes because there was no beds at hospital.

Then they already saw the fear of that and hearing Covid-19 all the time.

And for other side, you know, family violence went up.

You know, everybody was tense.

There was no food.

There was no nothing.

Addictions went up.

Our Kids were exposed to things that they never needed to actually get exposed to.

Then there will be depression, anxiety.

There will be more addictions in kids, but it's also, as a community, and probably not just here in the U.S., but as a community in the world, we need to make sure that we create some type of program, some type of conversation with the parents, because we need to take care of the family first, because those kids will be scarred for life.

[Camera focusing] [Melgar chuckles] Melgar: This picture I love because this is finally when we went to Disneyland.

So it's like, Oh, you know, it's part of the American dream, Disneyland.

I was actually born in El Salvador, and I came here when I was 11 months.

My mom was pregnant, and we came to United States, uh, undocumented.

Because we were undocumented, you know, we didn't have the best clinics available, at least at that time, or at least we didn't find them.

The experience that my family had through the health care system is exactly why I'm this kind of doctor.

This is me at the U.C.

Davis School of Medicine graduation.

They have you walk down with whoever you want.

And I took my mom and dad.

And my dad could barely walk, but he said, "I'm going with you."

Mm-hmm.

So that's really nice.

Yeah.

Man: OK. Come on.

Melgar: Come on.

Let's go.

My dad is a teacher, but when he came here, he took whichever job, and he was working in the garment industry.

But eventually we found out that he actually got pulmonary fibrosis, interstitial lung disease.

So scarring of the lungs from that because of all the microfibers, I guess.

And later on, he got really sick.

And then the ICU doctors wouldn't even talk to us.

They would go in and just start talking and saying like medications, and I already knew the meds.

So I knew he was declining.

And I still can't believe I did this, but I think I was so frustrated and sad at that point.

I went outside, and I talked to the attending, and I was like, "This is not right.

This is not appropriate.

And I know everything that's going on.

You need to go back and tell my mom."

At the end of the day, I had that end-of-life talk with my mom and my brother.

I mean... it's sad.

And I still, I still get sad because, I mean, at that point, I had to be like, "OK, just because I know how hard it is, if we keep going like this," but I have to do this because the doctors are not doing it.

These are doctors that are trained for end-of-life care, and they're not talking to us.

I don't know if it's because the way we look, you know.

He wasn't undocumented anymore.

He had good insurance.

So what was happening?

There's still another layer there.

Man: Then let's check the oxygen level without... because you were at 94 with it.

And so let's see how far you go down without it, OK?

Ruben: Yes.

When does it drop?

Medic: It's gonna drop... [Monitor beeps] Ruben: Look, I had a second chance at life, but it's going to take a long time for me to recover.

The main goal is for me to get better and get my life back.

Medic: What I'd like for you to do right now, if you don't mind, can you just take a few steps to the kitchen and come back?

Ruben: Yes.

Medic: You can keep this on... Ruben, voice-over: Something I would like to do is to get my family together and just surprise them and take them somewhere, you know, even to take a trip, rent a motor home, and just go to the Grand Canyon.

That's one of my bucket lists I want to do with the family.

Medic: So right now, you're still at 93.

You're doing really good.

The heart rate went up to 100.

Ruben: Oh, my God.

Medic: That's because it is compensating.

So that's a good thing... Ruben, voice-over: I wanted to do that before, when my son was here, but we didn't get the chance to do it.

So I want to continue doing that for him.

[Sound of camera focusing] [Guitar music] [Camille singing in Spanish] Camille: I'm a person that enjoys nature.

So having a little time to just see the grass or touch the grass, and also just being here with the breeze and the air, surrounded by all of these trees, makes my anxiety levels go down a lot.

[Singing continues] I think having a space of nature around us or close to us is really important, mostly for my generation, because we grew up in all of these urban cities.

So we don't really have that connection with nature anymore.

So I think that just coming to a park like this can make you feel a lot better.

[Cheering] Man: Bravo, bravo.

Granados: Where you live really determines your health.

And in the United States, the truth is that the poor pay the price.

And what I would say is we need to change the messaging around universal health care.

We have to say, "This is a human right.

Everybody deserves to have access to medical care."

Melgar: Everyone is getting care in the emergency room instead of preventative care.

We're waiting for people to be sick and they're dying, and we're throwing all this money and at the end of life instead of enriching our community and our public health system.

[Shapiro speaking indistinctly] Shapiro: Whenever I'm here, I get hope because every day, it's a new opportunity making sure that we continue having conversations.

If we actually make a social determinants of health effort, meaning that we unite all the things that we can control on the outside, plus the medical side, maybe it will be different.

Announcer: "Earth Focus" is made possible in part by a grant from Anne Ray Foundation, a Margaret A. Cargill Philanthropy, and the Orange County Community Foundation.

Announcer 2: Hasa is a proud sponsor of "Earth Focus."