This story is written in collaboration with the Southern New Mexico Journalism Collaborative.
At the height of the COVID-19 pandemic, Loretta Gonzalez was outdoors at a network center in southern New Mexico waiting for elderly people arriving for their daily in-car food distribution.
With a pen and notepad in hand, he looked at cars and trucks, smiling at the masked faces of the elderly who may no longer gather or socialize at the center.
“I would ask them if they had anything to say to the group,” said Gonzalez, a network fitness employee at Radium Springs, a small network of about 1500 people along the Rio Grande in southern New Mexico.
He wrote down his answers and, in his spare time during the day, translated them into English and Spanish, typing them in giant letters on a sheet of bachelor paper. Then he would make photocopies and, at the next self-service, wait for the old circle of friends to return, now with a stack of their messages to each other.
“I would give it back to them so they could see what other people were doing. It’s a bit like, ‘Oh, look, Maria Elena’s fine’ or ‘Oh, so-and-so had a new great-grandson logo. ‘You know, things like that,” Gonzalez said. Many other seniors don’t have the ability to text or do technical things. So I think it’s a smart way to stay in touch.
This was one of many tactics that Gonzalez and other network fitness staff helped cushion the adverse effects of the pandemic on the vulnerable population in remote spaces of southern New Mexico. Gonzalez is one of the network’s 730 fitness staff members statewide, or “promotoras” as they are known in those rural Hispanic neighborhoods. They are part of a network that includes more than 160 network centers and network gyms for meetings and network care that have been put to new purposes, which can grow well beyond the pandemic. .
All thirteen counties in southern New Mexico had a higher pandemic death rate than northern counties. According to research by the SNMJC, the southern component of the state had 515 COVID deaths according to 100,000 residents, compared to 461 COVID deaths in the northern component of the state. Nationally, the communities hardest hit by the pandemic have been disadvantaged, poor and uninsured communities, and for New Mexico, with the third-worst poverty rate in the United States, COVID-19 has been no exception.
Similar bilingual organizers deeply rooted in rural New Mexico neighborhoods, promotoras have been “an important community bond” that the government has used to disseminate data and provide medical and fitness facilities during the pandemic, said Claudia Mares, community coordinator for the Doña Ana County Department of Health and Human Services.
“We partner with a lot of agencies to let other people know about our network centers,” he said, adding that promotoras in Doña Ana County have “between 50,000 and 60,000 meetings” with the network each year. Doña Ana County has about 15 network centers and about 20 promotoras on staff at seven of those centers throughout the county.
As of September 2022, New Mexico’s social facilities had just over one million, 1,070,231, encounters statewide, according to data from the firm. , which had 300,579.
In states with giant rural communities like New Mexico, where 60% of their citizens live in rural areas, the first waves of the pandemic have made it difficult to succeed in rural communities where service is asymmetrical or nonexistent, undocumented citizenship status, and language barriers. have hindered the flow of critical information.
Jodi McGinnis-Porter, a spokeswoman for the New Mexico Department of Health, agreed that promotoras have been a must-have resource for the government during the pandemic, helping with everything from number one care, dental services, school fitness and behavioral conditioning assistance. Said.
Promotoras at the network centers “were very vital in the pandemic because that’s where network members leaned to get data on various topics,” she said in an email. Critical issues such as “vaccine registration, COVID testing, housing assistance, pantries” have been established. above “in rural and border lands in New Mexico. “
The New Mexico Department of Human Services, which is also guilty of a wide diversity of fitness systems for disadvantaged New Mexicans, has reached out to Southern New Mexico promotoras to help “community members complete applications, collect data and submit it,” Marina said. . Piña, Director of Communications for the New Mexico Department of Social Services.
“As the pandemic went on and as it progressed, we stayed open and continued to serve the community,” Piña said. “Often in the massive parking lots of our offices across the state. “
Gonzalez said an effort to supply testing to rural southern New Mexico has been successful. Several groups of promotoras from network centers in the domain banded together to distribute COVID testing in Salem, a small network between Hatch and Caballo Lake.
“In Salem alone, we distributed 12 boxes of check kits. And in two hours, more than a thousand kits,” he said.
A University of New Mexico study conducted a COVID-19 surge in 2020 and found the price of those promotoras in improving the quality of fitness facilities for “underserved and hard-to-reach populations in Bernalillo County and elsewhere in New Mexico. “
In this UNM “Community Health Worker Model” study, it was decided that new Mexicans visiting the network’s fitness clinics would identify those with social desires (poverty, language, or other signs of marginalization) and then referred to an internal promotora for further culturally applicable counseling. . .
When promoters were used, the study found that the number of unplanned emergency room visits was reduced by 12%. This potentially stored New Mexico health care payers about $2,500 “customer-based per year” for other people enrolled in Medicare Advantage or managed Medicaid. , according to the examiner.
Those numbers are significant, given that Medicare and Medicaid lately cover more than a portion of the state, or about 1. 3 million new Mexicans, and New Mexico’s Medicaid is “the state’s biggest payer” for fitness services, according to the state Medicaid director. Nicole Comeaux.
Other studies show that promotoras have played a huge role in identifying negative attitudes that have undermined vaccination rates among minority populations during the pandemic. A study to be published in December via SSM Qualitative Research in Health, a peer-reviewed journal of global fitness studies, says many immigrants in Los Angeles County, whose demographics mirror that of New Mexico, mistakenly believed COVID-19 vaccines were a government seeking to monitor them.
Mercedes, a 38-year-old promotora who reached out to immigrants, told the study authors that many immigrants believe the government needs to “dominate” immigrants by tracking them with vaccines.
The CDC said vaccine knowledge can be used for any immigration enforcement, however, many immigrants are still hesitant to get vaccinated.
“Growing anti-immigrant sentiment, even in the midst of a global pandemic, has led minorities to understand that the social and political formula is manipulated, intentionally them and COVID-19 vaccines,” the report says.
In New Mexico, the share of immigrants in the southern part of the state is nearly twice as high as that of northern New Mexico — 12. 7 percent compared to 7. 8 percent, respectively, according to county-to-county research of U. S. Census data. Conducted through the Southern New Mexico Journalism Collaborative.
Ramona Urbina, a promoter of the nonprofit Empowerment Congress, recalls the time when, at the beginning of the pandemic, they went door-to-door to citizens in the poorest neighborhoods of the state.
“The other people we were visiting were scared and we were afraid,” Urbina said. “We had masks and face shields all over our protective gear, it was a scary time. But it is vital for us to inform others where assistance is available. “. Almost everyone we visited was looking to get vaccinated. “
Claudia Mares, network outreach coordinator for the Doña Ana County Department of Health and Human Services, said promotoras were on the front lines of the fight against the pandemic, even as network sectors closed.
“Regardless of the closure of network centers, network fitness workers, promotoras, have become active,” Mares said. all mobilized to evaluate neighborhoods in rural county spaces for a variety of government COVID emergency initiatives.
“Different agencies needed other types of investigations and other types of disclosure. So we had to use outdated published material,” Mares said. “Most of our communities don’t necessarily have access to the web because there isn’t a website. a lot of our curtains and we distribute them,” he said.
Mares said the collective wisdom of promotoras and acceptance as truth with what they have built in rural New Mexico risk being underutilized if public policy planners don’t draw on their experiences.
“When CEOs, presidents, managers, when they get together, if there’s not a member of the network who brings that network attitude, then all those officials can know that there’s a human component to this,” he said.
“At the level of making plans, unless we bring in someone from the network who brings that perspective, something is missing,” he said. Otherwise, “the human component is not there. “
The effects of the Qualitative Health Research of the SSM verify their belief, especially in the fatal wake of a pandemic.
“Promotoras’ perspectives are integral to developing methods and approaches to combat COVID-19 vaccine hesitancy, adoption, and deployment in underserved communities,” the article states. the acceptance of the COVID-19 vaccine in the domain they serve. Their wisdom and skills are effective in encouraging others in the network to adopt or adopt positive health-related practices.
Promotoras organizers and network proficiency studies have indicated that the diversity of other agencies and jurisdictions (state, county, nonprofit, and sometimes personal) involved in promotoras’ activities has resulted in confusing orders given to communities.
A 2020 through the Society for Public Health Education asked five experienced promotores what the biggest barriers to good fortune were, and they found a variety of problems: discriminatory and misogynistic attitudes on the part of network members and fitness providers, the emotional burden of hearing about people’s problems, Limited English skills of the promoters and logistical problems such as shipping and limited knowledge gathering skills of the promoters.
NMDOH addressed some of those issues by creating the state’s Office of Community Health Workers, one of the few in the country, and “developed a standardized statewide curriculum and certification procedure for network fitness workers,” according to an NMDOH statement.
Commonwealth Fund released a study after the pandemic began that highlighted a central challenge with the promotora model: proving the cost of promotora programs.
“Convincing state and local agencies outside the fitness sector of CHW facilities could require more concrete evidence of return on investment,” the case study said.
New Mexico has made progress on those investments and in highlighting the price of developers’ expertise. For example, the University of New Mexico Family Circle Medical Residency has placed citizens of the Family Medicine Circle in a New Mexico network clinic that serves low-income people. Hispanic and is run by promotoras.
“Residents have acquired skills (from network fitness workers) in interprofessional teamwork, cultural competency in patient care, effective communication, cost-conscious care provision, and individual and network fitness advocacy,” one study of the experience found.
The project, according to the study, “a hard justification for greater recognition” of the experience of the promoters.
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Reyes Mata III is a journalist with the Southern New Mexico Journalism Collaborative.