Latino Health Access, Santa Ana
Latino Health Access website
Lyndee Knox, University of Southern California
Orange County, one of the state’s most affluent regions, is not a place that many people associate with the health disparities of the urban poor.
Yet if you live in one of the low-income, largely Latino immigrant neighborhoods of Santa Ana, located in the heart of the county, you are far more likely to suffer from diabetes, obesity, heart disease, and a host of other illnesses.
Many people here have no health insurance and no regular source of health care. Other factors — a lack of parks, the prevalence of liquor stores, and the loss of physical education classes at local schools – contribute to poor health outcomes. Some might accept these systemic problems as too entrenched to fix — but not America Bracho.
"Change comes from an understanding that, as an individual in a community, you have a lot of power," Bracho says. "As an individual, you can mobilize an entire city."
A native of Venezuela and a physician, Bracho founded Latino Health Access (LHA) in 1993 to help new Latino immigrants meet their health needs and to advance policies that improve their well-being. Bracho modeled her program on the Latin American practice of using community health workers, or promotores — local residents recruited to help educate neighbors about important health issues.
Bracho explains, "The promotores are great community leaders. We don't make them, we recruit them. Then we help them build their skills."
Over the past 15 years, these promotores have reached out to thousands of community members, including low-income elders, women with cancer, and children with chronic diseases. LHA programs have helped residents combat rising rates of obesity and fight domestic violence. A diabetes self-management program, taught by promotores to thousands of residents in garages, laundromats, and living rooms, is now a model for health care organizations around the state.
And with Bracho acting as the catalyst, a partnership was created among LHA, Kaiser Permanente, and the University of California, Irvine, to provide health care services directly to uninsured residents for the first time, while also training medical students in community health practices.
In an area where immigrants sometimes face hostility, most residents would rather remain anonymous. Yet thanks to Bracho’s leadership, many have found the courage to testify before city councils and local school boards and to meet with elected officials — all in the interest of addressing local health concerns and improving their communities.
Through this collective action, LHA has blocked new liquor licenses in a neighborhood already saturated with liquor stores. It helped create the first park in the county's poorest area. And when local schools dropped their physical education classes because of a lack of teachers, LHA trained parents and worked out an agreement with the local schools so that the parents could teach classes.
For her creative and collaborative approach to empowering the low-income, immigrant residents of Orange County and improving their health, America Bracho is a recipient of a 2008 James Irvine Foundation Leadership Award.