‘Promotoras’ help bridge gap between Latinos and health care providers

Emma Torres was only a teenager when she began working as a farm worker. She worked in the fields of California and Arizona, along with many of her family members. As a farm worker, Torres learned about the injuries and illnesses associated with farm working.

She also saw how many farm workers face barriers — like working long hours, lacking health insurance and not speaking English — that make it difficult for them to access the medical care they need. Seeking to ensure farm workers receive the medical care they need, she became a promotora, also known as a community health worker, in the late 1980s.

As a promotora, she was tasked with helping ensure that pregnant women who worked as farm workers received the medical care they needed. Soon after that, she joined a small team of promotoras who worked with farm workers to educate them about staying healthy and the medical services available to them.

SEE ALSO: Poor health literacy greatly hurting Hispanics in the U.S.

Now, Torres heads Campesinos Sin Fronteras, an organization she co-founded in 1996 that consists of promotoras working to improve the quality of life of farm workers and their families. The grassroots organization is based in southwest Arizona, which has a large community of farm workers.

“At the beginning when we started, we were not welcomed,” Torres told VOXXI. “It wasn’t a known model so there was a lot of skepticism about it, especially from the medical community who thought that we were a bunch of gossiper women.”

Nonetheless, the health care community has taken notice of the promotora model as it has proven to draw out Latinos who might not otherwise reach out for medical help. The promotora model has also been effective in bridging the gap between medical providers and Latinos who lack access to adequate health care.

Who are promotoras and what do they do

The vast majority of promotors are women. Many of them speak the same language and live in the same communities as those whom they serve. This allows them to gain the trust of community members and to understand the barriers they face to access medical care.

Floribella Redondo, board president of the Arizona Community Health Outreach Workers Network, said one of the main roles of promotoras is to identify health care services and to refer people to those services. She said that often involves promotoras going to the homes of the “hard-to-reach” people facing barriers — like not being able to walk or lacking transportation — that prevent them from accessing care.

“I think their work is really valuable,” said Redondo, who has been a promotora for nearly 20 years and is also the programs director for Campesinos Sin Fronteras. “Nobody else is doing that type of work in our communities.”

SEE ALSO: Hispanics continue to face rising rates of chronic disease

Most promotoras do not receive formal education the same way that doctors or nurses do. However, they do undergo rigorous trainings that provide them with fundamental health knowledge.

Torres said the estimated 45 promotores who work for Campesinos Sin Fronteras are trained in various areas of health care, including behavioral health and chronic disease prevention.

“They know that they are not to provide or give any recommendations for medications,” she said. “On the contrary, our role is to facilitate that people get to see the doctor and that they understand the importance of following up with prescriptions.”

Promotoras gaining momentum in the U.S.

The promotora model first spread across Mexico and other Latin American countries in the 1960s. It wasn’t until the 1970s that the United States began using the model. Now, promotoras have quickly become popular in various parts of the country, especially in communities with large populations of marginalized and hard-to-reach individuals who are facing health disparities.

Most recently, promotoras played a major role in helping Latinos benefit from the Affordable Care Act. An estimated 10.3 million uninsured Latinos gained health care coverage following the first open enrollment period in the health insurance marketplace.

SEE ALSO: AARP: ‘Promotores’ are key to educating Hispanics on new health law

Elena Rios, president and CEO of the National Hispanic Medical Association, told VOXXI that one of the main reasons why so many Latinos were able to sign up for health insurance was due to the work of promotoras. She explained that the federal government provided states that had a marketplace with money to deputize promotoras as patient navigators. They then went out to their communities and educated Latinos about the health coverage options available to them under the health care law.

Some states have also taken steps to increase the role of promotoras. This includes providing more funding to pay promotoras for their work, as many of them do their work as volunteers.

In Arizona, the state’s Department of Health Services recently hired Yanitza Soto to work as the community health worker program manager. Soto told VOXXI that in her new role, she will be providing technical assistance services to groups that are interested or are already working toward the advancement of community health workers. This includes educational, consultative and technical work collaborations.

When asked if she believes there’s enough emphasis among the health care community to expand the role of promotoras, Soto said:

“I think the emphasis is there. Hopefully in the next couple months or years it’ll be emphasized even more, and when someone mentions a community health worker hopefully the question of ‘what is that’ or ‘what do they do’ won’t have to come up.”

SEE ALSO: Mexican-Americans have highest diabetes risk among Hispanics