Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud
2. Materials and Methods
2.1. Data Collection
3.1. Rural Health Disparities
3.2. Role of CHWs and Promotores
3.3. Characteristics of Data Collection Sites
4.1. CHWs and Social Determinants of Health in Rural Indiana
A lot of the clients don’t have regular access to technology. If they don’t have a phone, how are they going to have a computer, or the internet? ... People rely too much on everybody having the same access to everything and that’s not always the case. They need to ask what is the best way to communicate with you? … If there was a way to make all that a little more accessible or more financially affordable for everyone, make some low-cost internet or low-cost computers or something.
4.2. Immigrant Communities in Indiana
I help the parents mostly, really just try to understand the children’s diagnosis or how they need to be treated or what medications they need to be taking. And if people are rude to them, I always stand up for them, too. Because it’s crazy, but a lot of people…they just don’t treat them the same, and I see that on a daily basis.
4.3. The COVID-19 Pandemic in Indiana
4.4. Promotores and Social Determinants of Health in the Rio Grande Valley
Back in ‘98, we started a pilot program for six months, just to see how it worked, the promotora concept. Ever since then there is no project that we do without a promotora, because it’s that effective and we’re able to take that out to the community. Peer-to-peer is less intrusive and also a little bit more, “I’m willing to listen, because it’s not this person from the outside coming in and pretending that they know better than I do how to raise my children”. It’s their neighbor saying, “Hey look, this is what I learned, let me show you what I learned” kind of thing.
4.5. Immigrant Communities in the RGV
A lot of times we ask them about their immigration status in other ways or just make it clear we understand their situation. For instance, I might say to someone, “Since you don’t have Medicaid, you can go to [local charity clinic] for this diabetes screening, or whatever”. So, we can ask questions about their insurance coverage or driver’s license or where they work and that can often tell you they are still fixing their papers (arreglando las papeles; i.e., they are undocumented).
4.6. The COVID-19 Pandemic in South Texas
I think it’s like anything else. An educator is born with that innate want and desire to teach, such that a doctor is born with that innate need to heal. A promotora would say in Spanish, “Una promotora nace, no se hace” [a community health worker is born, not made]….that’s just the skills that they bring with them, and all you do is polish some things and how to do reports, how to work within systems and organizations, but we don’t teach anybody how to be a promotora, they already come with that.
5.1. CHWs, Promotores, and Social Determinants of Health in Rural Areas
5.2. Immigrant Communities
5.3. CHWs, Promotores, and the COVID-19 Pandemic
Conflicts of Interest
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Logan, R.I.; Castañeda, H. Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud. Int. J. Environ. Res. Public Health 2020, 17, 9223. https://doi.org/10.3390/ijerph17249223
Logan RI, Castañeda H. Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud. International Journal of Environmental Research and Public Health. 2020; 17(24):9223. https://doi.org/10.3390/ijerph17249223Chicago/Turabian Style
Logan, Ryan I., and Heide Castañeda. 2020. "Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud" International Journal of Environmental Research and Public Health 17, no. 24: 9223. https://doi.org/10.3390/ijerph17249223