Health care in Fresno can improve by supporting promotoras, or community liaisons | Opinion
On Thursday, Zócalo Public Square is hosting an event in Fresno to examine what makes a good health-care job in the county. Visión y Compromiso believes that to build healthy families and communities we must start with recognizing and supporting promotoras.
The promotor model has been around for years, especially in communities where mainly women share information and provide support. Promotoras are trusted, respected leaders who live in the community they serve and are known by many titles: patient liaison, peer educator, health advocate.
They work in roles that value personal connection and community expertise and are dedicated to making their community a place where people can thrive. Despite this, they are not recognized as members of the health-care workforce.
The network of promotoras across California is a community-based solution for the health-care industry to deliver vital services, support and care coordination. They provide prevention education and support healthy lifestyles in the community, often in the neighborhoods where people live.
When someone is diagnosed with diabetes, the patient may not have access to resources to be healthy after they leave the doctor’s office. Promotoras provide connections to community organizations with local resources people can turn to for help managing their health conditions.
They can learn to adapt culturally relevant recipes that are cost effective and tasty, or attend an exercise program that is free and led by promotoras they know from the neighborhood. For example, Visión y Compromiso trains promotoras to lead bailoterapia circles, free exercise, dance or movement classes and nutrition and wellness resources..
Promotoras can speak with people in their preferred language, empower them to manage their conditions, and help them access nutrition education and emotional support. By investing the health-care industry’s resources in these organizations and working as partners to expand this programming in communities, promotoras can be a critical part of the health-care system.
During the pandemic, promotoras worked tirelessly to ensure their communities had accurate, up-to-date information on the health crisis — dispelling myths, increasing access to vaccines, masks and test sites, and scheduling appointments. Promotoras offered company to isolated community members, shared resources, and connected government and health professionals to the community.
In Fresno County, community organizations like Cultiva La Salud work with promotoras to support healthy eating and active living. At the height of the pandemic, they provided over $150,000 in rental assistance for people who were economically struggling or isolated. They created #SavetheSenoras and went into the community to raise awareness about vaccines and protect the most vulnerable residents who had lost jobs, lacked food or were isolated. These programs are instrumental and enabled high-risk Fresno residents to survive the hardest moments of the pandemic. Many other community-based organizations and promotoras across California similarly rallied to support their community.
We have an opportunity to take the lessons from the pandemic and fully, meaningfully integrate both promotoras and community organizations into the health-care system as equal partners. We can build a future where promotoras’ work is recognized, valued, and equitably compensated.
Visión y Compromiso has built an alliance of community organizations doing amazing work. Integrating these organizations into our health system can open pathways for professional development and sustainable jobs. In a recent survey, Visión y Compromiso found that nearly half of promotoras experienced a decrease in their annual household income during the pandemic; 84% struggle to pay their rent or mortgage.
Promotoras deserve to earn a living wage that respects their training, expertise, lived experience, and community connections. We need health plans, hospitals and clinics to meet us at the table and formally recognize promotoras as a vital profession and partner in building a new system of care.
Together, we can create community partnerships that are culturally competent and cost-effective while moving resources to community organizations to ensure they have the equipment and facilities they deserve. The future of the health-care workforce lies not only in training more doctors and nurses in California, but also in building a relevant, responsive system of care that includes the hundreds of promotoras who lead care in the communities in which they live and work.