In the affluent Southern California communities of Lake Forest, San Clemente and San Juan Capistrano, there are neighborhoods of extreme economic disadvantage. In these areas, immigration is also a major concern, as there are a number of families with mixed legal status. Because of their proximity to the US-Mexico border, many of these families avoid health care services for fear of being reported to Immigration Services.
With chronic conditions and other ailments left untreated, the people in these communities are at an increased risk of health issues. This is a detriment to the individuals and families living in these neighborhoods, but it is also a burden on local emergency departments.
However, the Community Health Worker Program, which is offered through the Mission Hospital Family Resource Center, provides a much-needed connection to care services for this vulnerable population. By connecting families to free or low cost services – from physical and mental health to immigration assistance – this program reduces health disparities in these underserved areas.
Through outreach at schools, churches, ethnically specific grocery stores, and even going door-to-door, these Community Health Workers, or Promotores, as they are called in the Latino community, are able to bridge a large gap in access to care. Because they speak the same language and share the same cultural background as the residents in these communities, they are able to establish trust more easily. Occasionally, their ability to do so can be critical to an individual’s well-being.
For instance, Soledad Gomez, a lead community health worker, visited a family in Lake Forest several times before learning that it was a situation of severe domestic violence. Once the individual opened up to Soledad, a “Family Preparedness Plan” was developed. This plan included two binders – one containing legal papers, with contact information for lawyers and shelters; the other containing family information like children’s immunizations and school information. When the victim decided to leave, having these binders at her disposal was one less stressor in a very difficult situation.
The Promotoras, or “ladies in the blue shirts” as they are affectionately referred to in these neighborhoods, are trained ambassadors to the Latino community and provide linguistic and culturally appropriate community outreach and connections to health and social services, and community resources. To become a certified Community Health Worker, Promotoras complete a comprehensive 80 hour training.
This program addresses the social factors associated with health,” said Christy Cornwall, director of community health investment for the Orange County region. “It bridges language barriers, economic restrictions and other access issues, and offers health care to people who otherwise wouldn’t have it.”
In 2018, the Mission Hospital Promotora program visited 4263 households, reached 5925 individuals, and collected 532 referrals to healthcare and social services through Mission Hospital Family Resource Center. Through a total community benefit investment of $100,000, this program has been able to connect families to much-needed services, addressing a critical access issue in these communities.
“This is a family event. When they start piecing together their family health information, it includes memories and stories,” said Gomez. “Through this process, we laugh and cry together. We accompany and support each other in breaking down barriers, creating bridges, establishing trust and fostering a welcoming community many of them lack.”