Concilio Latino de Salud, Inc. has spent the past three decades expanding health promotion and disease prevention within Hispanic/Latino communities in Phoenix, AZ, as a national pioneer in community health work. In recognition of Hispanic Heritage Month, the NPA Blog interviewed Dr. Elizabeth Ortiz de Valdez, President and CEO of Concilio Latino de Salud and a member of the Pacific & Southwest Regional Health Equity Council (RHEC), to discuss health equity issues in Hispanic/Latino communities as well as promising practices and recommendations for collaborating with these communities.
NPA Blog (NB): Please tell us more about your health equity work in Hispanic communities. How did you get started in this work?
Elizabeth Ortiz de Valdez (EOV): When I was a practicing psychiatrist in Guadalajara, Mexico, I was called upon to work with a man who had physically punished himself for being diagnosed with HIV as a result of stigma and discrimination. When I came to the U.S. soon after, I realized that prevention services for people from diverse racial and ethnic backgrounds were either limited or nonexistent. It was clear to me that these groups were at a higher risk of contracting HIV due to the lack of prevention information. We formed Concilio Latino de Salud in 1987 to address this issue, but then expanded to provide culturally and linguistically appropriate health promotion and disease prevention services with an emphasis on Hispanic/Latino communities.
We were one of the first community based organizations to train Promotores de Salud (i.e. community health workers) working within Hispanic/Latino communities, and we also conduct master trainings for community organizations focused on health promotion and disease prevention. In 1989, we formed Ethnic Communities United in Health and Wellness, one of the first collaborations in the nation aligned to prevent and eliminate HIV/AIDS and substance abuse. As an evolution of my work in this field, I was involved early on with the National Partnership for Action to End Health Disparities and the Pacific & Southwest RHEC, as well as the advancement of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards).
My work concentrates on prevention to alleviate the health issues that disproportionately affect the Hispanic/Latino community. In Concilio Latino de Salud’s community work, we try to address the social determinants of health while focusing on social justice issues such as health care access for the working poor.
NB: What are some considerations or recommendations that you have for other health equity-focused organizations that work with Hispanic/Latino populations?
EOV: Concilio Latino de Salud does outreach work in Maricopa County, which surrounds Phoenix, AZ. This is one of the largest metropolitan areas in the U.S., so we consult Census Bureau data to identify concentrated Latino/Hispanic communities. Our work is always in partnership with these communities, and we go to the people rather than asking them to come to us, such as churches, community centers, schools, laundromats, supermarkets and beauty parlors. For example, we have done HIV prevention outreach under a tree at 5 am to reach community members before they go off to work in agriculture jobs.
We deliver health messages in a way that syncs with our culture, using music, theatre, murals and other forms of expression. Our organization also identifies the correct literacy level of the community members that we work with, and we customize our outreach and printed materials accordingly.
One recommendation for all agencies providing health promotion, disease prevention or chronic disease self-management, including Community Health Workers/Promotores organizations, is to revisit and revise recommended “best practices” so that they are more culturally appropriate for Latino communities. This is one challenge that we have experienced with funders – a reliance on best practices that may not necessarily be the best for our particular target population. Additionally, more resources should be given to reimbursement and training for Promotores working in all areas of health promotion, disease prevention and self-management.
Additionally, we have recognized that when organizations translate materials from English to Spanish, these materials don’t always consider the cultural perspective of the Hispanic/Latino reader. Rather than translating a material from English to Spanish, I would recommend developing the material from the beginning in Spanish with cultural context in mind, as well as the literacy level of the end user.
NB: Please tell us more about the work of the Pacific & Southwest RHEC. What is one example of the work that your council has done so far to advance health equity, particularly in Hispanic communities?
EOV: One of the priority areas for the Pacific & Southwest RHEC is to “identify solutions that demonstrate the value and impact of Community Health Workers/Promotores to address health disparities and the social determinants of health,” and this work will directly affect Hispanic/Latino communities that are served by Promotores. As a first step, the RHEC’s Community Health Workers (CHW) Committee has decided to map the characteristics of the CHW workforce across the region, which encompasses Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands and Republic of Palau. We are developing a regional database which will be posted on our website in the coming months that highlights existing CHW programs, populations served, services offered, language capacity, CHW collaborators, funding sources and CHW websites. Our intended next step is to use this database to engage CHWs, CHW trainers/employers and other stakeholders in the development and implementation of a regional plan that will align their efforts. Another priority area for our RHEC is behavioral health. So far, we have conducted literature searches on current behavioral health data of our region to determine what the baseline disparities are and use this information to establish mitigating strategies.
NB: What can individuals and organizations in your region do to help advance health equity for Hispanic communities?
EOV: Individuals and organizations can work together to ensure that Latino/Hispanic communities have a representation of voices at the table. Health is an everyday opportunity, meaning that anyone can be trained to become a CHW – you don’t need to have a medical degree to promote health. Community members should try to reach others where they live, learn, work and worship with health messages, and get involved in the policy and decision-making processes. We all can be champions of health.
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Dr. Elizabeth Ortiz de Valdez co-founded and presently is the President and CEO of Concilio Latino de Salud, Inc., a non-profit, community-based organization, dedicated to improving the overall health of the Hispanic/Latino and other underserved minority communities in Maricopa County, Arizona through health promotion and disease prevention. She is also the co-founder of Cultural Communities United in Health and Wellness (CCUHW)), among other coalitions and organizations. Dr. Ortiz de Valdez is a member of the Pacific & Southwest Regional Health Equity Council, an adjunct faculty appointee at the College of Public Health, University of Arizona, and a member of the Advisory Council for the Southwest Interdisciplinary Research Center (SIRC) at ASU and Maricopa County Public Health REACH Initiative.