December 6, 2017
One day at a middle school in Chicago’s Little Village neighborhood, Marcela Espinoza was telling students about the health care resources available to them and their families. Afterward, a student approached her. “He said,‘My dad’s sick, and I don’t think my mom knows what to do,’” says Ms. Espinoza, Health Promoter, Enlace Chicago. Ms. Espinoza called the student’s mother and helped her find a doctor for her husband.
Many Little Village residents do not receive the health care they need. Too often, the problem is that they simply do not know about the available resources. Enlace Chicago, a community based organization, has been successfully working to correct that.
In recent years, hospitals that serve Little Village, a mostly working-class, Mexican-American neighborhood,conducted assessments of the community’s health needs. They found that not only did residents lack knowledge about resources, but high costs and a lack of insurance also presented barriers to their health care. In addition, about 70 percent of residents who needed mental health services did not receive them. For a predominantly Latino neighborhood where almost half of residents are immigrants and about a quarter are undocumented, getting health care can be particularly daunting.
“Health is not an easy topic for our community,” Ms. Espinoza says. “Our clients face barriers like language and money, so when they go to clinics or hospitals, they feel overwhelmed.”
In 2016, Enlace put together a plan of action: It recruited and trained about 50 community health workers to connect clients with health care resources, including financial assistance.These workers are not formally trained clinicians. They are individuals who come from the community they serve— so they intimately know their clients’ concerns and needs. “Our community health workers are deeply embedded in the community and trusted by the community,” says Amanda Benitez, Community and Economic Development Manager, Enlace Chicago.
Community health workers’ three days of training begin with a classroom session where they learn about their roles and duties, such as when to refer clients to primary care, urgent care, or emergency care. After that, the trainees visit local health care institutions and become familiar with their processes. “They then can share that information with community members to help them navigate the health care system,” Ms. Benitez says. These visits also allow the community health workers to inform the providers about their community’s experiences.
Once trained, the health workers go out into their community to reach residents in need. For instance, the health workers spend a few hours each week in neighborhood schools, educating students and parents on how to get and pay for health care.
Enlace partners with the local mental health collaborative, Roots to Wellness, to provide additional training to local community health workers and other leaders in the community that targets mental health. For 12 hours over six weeks,trainees learn how to assess community members’ mental health needs and refer them to providers. Health Promoter Sahida Martinez recalls learning how to identify and properly address signs of suicidal tendencies. “I would not have known that if I had not gone through the training,” Ms. Martinez says.
However, Enlace realized that referring residents to mental health providers was not enough. Often, those individuals then faced months-long waiting lists. So in the fall of 2017, Enlace began training its community health workers to conduct support groups for individuals placed on waiting lists. “They need a space where people listen to them and support them,” Ms. Martinez says. As Ms. Benitez notes, “The need for support groups came up a lot more after the 2016 presidential election and the changes in immigration enforcement policy.”
Each year, Enlace’s community health workers reach about 700 residents and connect at least 150 of them to health care or mental health providers. They also help about 100 residents enroll in health insurance. Enlace ensures success by not going it alone. A small agency, Enlace leads partnerships with large health care and mental health organizations. For example, Enlace assembled the training for its community health workers by collaborating with partners such as Sinai Urban Health Institute and the UIC School of Public Health. “We know we can’t do this work alone, and we know there are great organizations out there that have the expertise, so we work with them as much as we can,” Ms. Benitez says. The benefits of these partnerships extend in both directions: By listening to Enlace’s community health workers, hospitals and clinics gain a stronger understanding of this patient population.
Enlace’s community health workers effectively serve as liaisons between residents and resources. As Ms. Martinez puts it, “We know the people in our community, and we know their needs.”