The Affordable Care Act (ACA) or health reform gives the Department of Health and Human Services (HHS) a strong base upon which to implement programs that will promote health equity among racial and ethnic groups.
And of one the actions HHS is taking is to develop the HHS Action Plan to Reduce Racial and Ethnic Health Disparities. In this strategy and action plan, HHS recognizes the strong role promotoras de salud play in communities across the country to promote health and wellness. HHS specifically recognizes the contributions promotoras make in Latino communities, who have less access to health care services and insurance.
Promotoras de salud are community health workers who live in, engage with and understand their communities and connect members of the community to health care services and health information in culturally and linguistically competent ways.
The HHS Action Plan calls for the increased “use of promotoras to promote participation in health education, behavioral health education, prevention and health insurance programs” and creates the HHS Promotora de Salud Initiative. A Promotoras Initiative Steering Committee has been created to develop a national training curriculum and enhance national recognition for promotoras. The initiative also calls for the creation of a national database to facilitate recruitment, track training and certification, and to link promotoras across the country. The initiative envisions a role for promotoras as “navigators” helping families understand and utilize the Affordable Insurance “Exchanges” that will be set-up in 2014 to enroll families in health insurance plans.
Why will increased support for the “promotora de salud” model of health enhance Latina reproductive health and justice?
As outlined in the NLIRH Publication, Advancing Reproductive Justice in Immigrant Communities: Promotoras/es de Salud as a Model, promotoras share the values and goals of the reproductive justice movement, as they connect Latinas and immigrant women to health information in a way that accounts for the intersectionality of Latinas’ lived experiences and the multiple challenges they face in accessing private and public health care services. Veronica Bayetti-Flores, NLIRH Policy Research Specialist and co-author of the publication, notes that the reproductive justice framework is one which “allows for a variety of opinions and that connects women’s lives realities to the way they access health care” and this strikes “a chord with the promotoras in a way that reproductive choice analysis could never have done.”
Promotoras, as leaders in their communities, link struggles in their communities to reproductive oppression. For example, in colonias along the Texas-Mexico border, promotoras have been able to connect the need for transportation funding to reproductive health.
While the HHS Promotora de Salud Initiative is still in its development stages, HHS is engaging promotora leaders throughout the country, through its Steering Committee, to promote the expansion of this unique model of health while retaining the programs’ roots in communities.
And with increased support, more promotoras can engage immigrant communities, especially undocumented immigrants, for whom access to private and public health services remains largely out of reach. More promotoras can assist immigrant and underserved communities find community health centers in their neighborhoods. More promotoras can help determine a family’s’ eligibility for Medicaid under the new eligibility rules or help them navigate the new health insurance exchanges. And more promotoras can engage Latinas on sexual and reproductive health topics.
NLIRH knows that promotoras are poderosas who promote salud, dignidad y justicia in their communities. With increased support from HHS, we hope to see more poderosa promotoras serving Latin@ communities across the country!