How ‘promotoras’ could help fill the health gap in underserved areas

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The pandemic has made it clear that access to health care is not universally guaranteed and that some communities face greater barriers to care.

In parts of Georgia, organizations serving Hispanic / Latino communities have deployed community health workers or promoters, to reduce some of these barriers.

Promotoras are usually members of the community, who serve as a bridge to provide accurate preventive health information and resources to populations who have limited access to health services due to language barriers or underinsurance.

An organization called Ser Familia, which provides behavioral health, family counseling and other services, has a promoter dedicated to connecting its clients to COVID-19 resources. This includes locating accessible testing and vaccination sites and connecting people with health resources, said Belisa Urbina, executive director of Ser Familia.

“They speak the language and understand the culture. Our COVID-19 health promoter has created vaccination opportunities where people without papers or with mixed status (documentation) know it is safe to go. She’s there to make those connections, ”she said.

The promotora model is not unique to Georgia or the pandemic. Long before COVID-19 wreaked havoc in health systems and communities, promotoras helped provide preventive health information on chronic disease to populations with limited access to health resources. But COVID-19, which has taken a heavy toll on the Hispanic / Latino population, has amplified the model’s success as a care conduit and increased the need for investment in this area, advocates say. Among cases that indicate race and ethnicity, Hispanics accounted for about 27% of new COVID-19 cases as of Oct.5, 2021, while they made up only 17% of the U.S. population, according to an analysis from the Kaiser Family Foundation.

The Hispanic Health Coalition of Georgia, Inc., recently received a $ 250,000 grant from Direct Relief’s Health Equity Fund, to develop educational materials to train advocates beyond the pandemic. Direct Relief is a non-profit humanitarian organization.

This effort will create a vital bridge for access to health care, said Shirley E. “Bella” Borghi, Executive Director of HHCGA.

“Right now the promotora model is very popular. A lot of agencies depend on volunteers, ”she said.

David D. Safstrom, Director of Operations and Shirley "Bella" Borghi, executive director of the Hispanic Health Coalition of Georgia at a health fair in Gwinett County, Georgia.

The funding supports the organization’s goal of creating an approved curriculum in English and Spanish on different topics to help train promoters when they are in the community. The program, which will be available statewide, includes information on screenings for chronic diseases such as diabetes and heart health as well as cancer screenings, Borghi said.

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The funding will also allow HHCGA to hire up to five additional promoters.

The goal would be to have them train others who want to do this work with other agencies and nonprofits across the state, Borghi said.

“I always say that promoters are on the front line, they serve as the voice of our community. They have a strong knowledge base about what’s going on in our community, ”she said.

The influx of funding will also help fill some gaps in health services in rural areas.

Since 2008, nine rural hospitals have closed in Georgia, including two in 2020, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. While some have reopened with reduced services, accessing medical care remains a constant challenge for many people living in rural parts of the state, health experts have said.

The uninsured rate for Hispanic / Latino children was 15.9% in 2019, almost twice the national rate for Hispanic / Latino children (9.2%), according to the Children’s Healthcare Report Card from Georgetown University Health Policy Institute. Georgia is also one of 12 states that have not authorized the expansion of Medicaid, according to the Kaiser Family Foundation.

“As far as Latinos are concerned, medical access in Georgia is even more complicated, many of our adults are first generation, they may be undocumented or permanent residents who fear that seeking care or assistance will affects their ability to obtain their citizenship eventually, ”Urbina said with Ser Familia. “There are so many real and perceived barriers.

Urbina said finding and obtaining healthcare in Georgia is complex and language barriers make it worse. Identifying culturally competent medical care in Spanish or behavioral health services in Spanish remains a challenge.

In Dr Jose Rodríguez’s clinic in Georgia, many of his patients are Spanish speaking and travel from town to Marietta for treatment.

Promoras, with their knowledge of resources, help bridge the gap between their communities and health information, said Rodríguez, pediatrician at Wellstar Health System.

“They are a trusted part of the community. They increase access, they know the resources, they know which doctors will see patients without insurance, who speak Spanish, ”he said.

Dr Jose Rodríguez, a pediatrician with Wellstar Health System

Information in Spanish about COVID-19 and how to stay safe was not readily available in Dalton, Georgia, said America Gruner, executive director of the Coalition of Latino Leaders, a community-based non-profit organization based in the north. from Georgia.

Gruner, who previously trained promoters for five years, said she knew her community must persevere in developing information material that is relevant to them and that can minimize the spread of disinformation.

“We were telling people you can’t fight COVID with tea, lemon juice, or garlic. We had to be persistent, go to houses, share information on Facebook Live, hold meetings. The promoters’ job is not to wait for people to come to you, but to wait for you to go to them, ”Gruner said, speaking in Spanish.

The organization recently received $ 50,000 in funding from the City of Dalton and the County of Whitfield to support COVID-19 awareness efforts from promoters in Spanish, Gruner said. Their work includes setting up testing and vaccination sites with flexible hours for people who cannot take time off work. In addition, CLILA also received funding from Latino Community Fund Georgia for community food aid, Gruner said.

The organization currently has four permanent promoters. The success of the model prompts Gruner to look beyond COVID-19 to identify ways in which promoters can aid awareness of chronic health issues such as screening for diabetes and cervical cancer.

“We want people to continue to get accurate information from someone they trust in a setting they feel comfortable in,” she said.

Maria Clark is a general assignment reporter for The American South. Ideas for stories, tips, questions? Email her at mclark@gannett.com or follow her on Twitter @ MariaPClark1. Sign up for the South American newsletter. Follow us on Instagram, Facebook and Twitter.



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