How Las Promotoras de Salud Are Keeping Their Neighbors Healthy

On a drizzly January morning, Rundberg residents file into the clinic. Some come by themselves, others with family members. Teresa Rivera greets each of them with a welcoming smile, guiding them through the necessary paperwork.

“We laugh because they’ll say, ‘thank you doctor,’” says Rivera. “And we’re like, no, we’re not doctors!”

She is a promotora de salud, or community health worker, in the Rundberg community. And this clinic is a Medical Access Program clinic. These clinics are hosted at area schools and are meant to help residents sign up for Central Health’s Medical Access Program, or MAP. Promotoras can also connect residents with a host of other programs. But their main mission is to use their influence as well-known community members to reach out to residents and bridge cultural gaps that might be preventing their neighbors from seeking medical care.

“They see that like, oh I know you, you’re from the community,” Rivera says. “So it’s like, we are an equal. They can talk more to us.”

A promotora de salud helps an applicant with MAP paperwork. For adults who don’t qualify for Medicaid, MAP may be their most affordable healthcare option.

The community health worker program Rivera works with is run by Austin Voices for Youth and Education. AVEY Family Resource Center Coordinator Julie Weeks says the organization has long noted the importance of healthcare access in connection with student achievement. But the program really took shape at the height of the COVID-19 pandemic when the organization received a grant to train community members on vaccine outreach.

“When our community health workers no longer needed to promote Covid vaccines, we looked for other things that they could do because they had become so effective at doing outreach in the community,” Weeks says. AVEY partnered with El Buen Samaritano to organize a health worker program. Promotoras are trained to connect people with not only MAP, but also other programs like SNAP and Medicaid.

“There's a lot of things that are referred to as social determinants of health,” Weeks says. “Social determinants of health can be nutrition, housing, access to basic needs, keeping the lights on in your house. Those are things that are family needs that our family resource centers can help families with.”

While resources are available to families, knowing about them and how to sign up can be a major hurdle, according to Amy Einhorn, program director at the St. David’s Foundation.

“One of the biggest issues that we've identified through that is trust in the system,” Einhorn says. “Having a community health worker who is of the community, who really understands the people that they're supporting … is just an incredible resource.

An attendee rests her forehead in her hands. “It can be difficult for them,” Rivera says.

Research has shown that community health workers can both increase marginalized communities' access to healthcare and also help reduce cost. While they’ve been a part of the medical system for decades, they received more interest and funding through Covid-era relief plans in an effort to curtail the disease in high-risk communities. But their contribution extends past the pandemic, according to Weeks.

“Me being a middle aged white woman, Spanish is not my first language, I am not going to be as effective reaching into this community,” Weeks says. “They have the trust. They have the relationships.”

For Rivera, it’s the one relationship she lost that drives her to do this work. Her husband battled diabetes for years, and eventually his kidneys started to fail. He eventually started dialysis treatments, and seemed to be doing well. Per his routine, he left for appointment in good spirits. That was the last time they spoke.

“[The clinic] called me and said he’s had a heart attack,” Rivera says. “We were not prepared for that.”

Rivera says that’s why she wants to encourage her neighbors to sign up for the medical coverage they qualify for, and not wait.

“I feel like we are working all the time. We don't prioritize the time to go having all these check ups,” Rivera says. “I feel like that's what happened to my husband.”

Teresa Rivera (left) looks at attendees of the Medical Access Program, or MAP clinic. She helps run events like this one across Rundberg.

Now Rivera works to ensure that her neighbors can access the healthcare they need, along with any other programs they might qualify for. And while they might not be doctors, these promotoras are changing their communities.

“One man … he later on came back and say, ‘thank you so much, because y'all saved my life,’” Rivera says. “That's why it's important to me. I'm doing something good for the community.”

*You can find more information about the MAP program here*. *Find times and locations for future MAP clinics here*.