live / 2020

Esperanza’s Promotores de Salud (Community Health Promoters)

Idea submitted in the My LA2050 Grants Challenge by Esperanza Community Housing Corporation

Esperanza’s Promotores de Salud (Community Health Promotors) provide life-saving culturally accessible in-home health education, primary prevention and advocacy to families in South LA. Our nationally recognized Promotora-led model increases access to health services and decreases preventable ER use for asthma patients in low-income communities of color. Through our Promotoras Leadership program, we have trained over 500 community health workers, and are providing opportunities for meaningful careers in health for low-income women of color.


In which areas of Los Angeles will you be directly working?

  • South LA

In what stage of innovation is this project?

Expand existing program

What is the need you’re responding to?

South LA is one of the most economically disenfranchised areas in LA County, with the majority of households earning below the federal poverty level of $25,100 for a family of four. The Covid-19 crisis reinforces the ways in which our communities are the most “at-risk”, as poverty is the leading health risk for our primarily Latino (67%) and Black (31%) community. Many of our residents have chronic conditions and live in sub-standard “slum” housing, which can cause serious health issues including acute asthma, lead poisoning and sinusitis. Living under the stress of poverty, overcrowding and with the constant fear of eviction causes anxiety and other mental health issues. Due to historic disinvestment, South LA is under-resourced in basic care, preventative and mental health services to remedy these issues. This global pandemic worsens conditions, as families must choose between foregoing work and face homelessness or continuing to work and putting their lives and loved ones at risk.

Why is this project important to the work of your organization?

In 1998, we pioneered the Promotores de Salud (Community Health Promoters) model, a strategy for reducing health disparities and increasing access to health services for low-income communities of color, while building a powerful cadre of community health leaders. Esperanza’s Promotoras conduct free life-saving home health assessments that provide education and resources to low-income households, and connect families to important services. Our nationally-recognized model is built on the training and expertise of our health leaders, who come from the very communities they serve. Over the past 25 years, our Promotoras have assessed and helped remediate over 2,000 units for home health hazards, leading to an 85% reduction in ER visits for asthma patients and a 57% reduction in missed school and work days. Through our success, Esperanza has been able to advance city-wide and national policies on housing, habitability, code enforcement, workforce development, and asthma home visitation.

Approximately how many people will be impacted by this proposal?

375
Direct impact
2,250
Indirect impact

Please describe the broader impact of your proposal.

Through this work, we hope to expand our evidence base for our Promotora home health model, ensuring more holistic, quality care for South LA residents in the near term, and increasing respect, job opportunities, and pay for Promotoras in the long term. Esperanza’s goal for this project and all of our work is to ensure that community health promoters are more fully integrated into healthcare teams, and institutionally recognized and funded by the state. Esperanza is working with partners at the local and state level to secure a State Plan Amendment (SPA) to allow qualified non-licensed professionals such as community health workers (CHWs) and promotores to provide reimbursable primary prevention and education services through home visits.

Please explain how you will define and measure success for your project.

In 25 years, our nationally recognized Promotores de Salud Leadership Training Program has trained and cultivated 533 Promotoras, with 4 primary goals: 1) improve community health through primary prevention measures; 2) increase access to health services; 3) empower community leaders to shape health systems and services to fit the needs of medically underserved communities; and 4) support career wage employment in health for previously low-income residents. This year, 25 community participants will undergo a comprehensive training of over 250 hours on over 50 health and well-being topics, followed by an additional 250 hours of on-the-job learning through internships and/or employment at local health and social service agencies.

Our Promotora-staffed health programs will serve 350 families and over the next year we will: 1) reduce the number of patients returning to the ER for acute asthma care by 65%; 2) decrease number of missed school and work days by 50%; 3) establish prescription adherence and asthma self-management practices to better control and prevent asthma episodes; 4) establish medical home use for primary and continuous healthcare services for our patients at local health centers; 5) refer our clients to other vital services, including mental health and tenant rights clinics. We measure the success of our Promotores work by analyzing the data derived from our in-home health surveys and follow up assessments as well as through periodic community health surveys.

Which of the live metrics will your submission impact?​

  • Healthcare access

Are there any other LA2050 goal categories that your proposal will impact?

  • LA is the best place to CREATE

Which of LA2050’s resources will be of the most value to you?

  • Access to the LA2050 community
  • Communications support