Nuestro Futuro Migrant Health Promotion National Folic Acid Promotion Program Presenter: Nicole Oppenheim, M.Ed. noppenheim@migranthealth.org 734.944.0244
Presentation Overview Migrant Health Promotion mission and history Target population and geographic area The Promotora Model Promotoras and Folic Acid
Philosophy & Mission Philosophy Based on social justice, community empowerment, systems change and Popular Education. Mission Migrant and seasonal farmworkers provide affordable food to the nation, often at the expense of their own health. Migrant Health Promotion is committed to strengthening the capacity of farmworker families and their communities to improve their health through collaborative peer education and advocacy.
The Population We Serve Migrant and Seasonal Farmworkers The Colonia residents on the Texas-Mexico Border
Migrant and Seasonal Farmworkers 3-5 million (generally cited, data n/a) Families, single men and single mothers Migrate in streams Agriculture, dairy, meat, packing plants, etc. "Never disrespect those people [farmworkers] because they are honorable people who are suffering to bring you the food on the table. If it's a lettuce, someone uneducated cut it, and if that uneducated person hadn't cut it, you wouldn't have it there in front of you." -Olga Ramirez, Promotora
Health Risks and MSFWs Occupational risks Poverty Living & Working conditions Migratory status Hispanic / Latino Diabetes Hypertension Cancer Birth defects Many more
Barriers to Health Care Barriers to Health Care Language Culture Mistrust / Misinformation Lack of information Logistics Poverty
What are colonias? Colonias are unincorporated neighborhoods along the United States- Mexico border. Some lack water and basic utilities, but provide housing options and a sense of ownership to residents.
Colonias "Dilapidated homes, a lack of potable water or sewer and drainage systems and floodplain locations make many colonias an ideal place for the proliferation of disease. Texas Department of Health data show that hepatitis A, Salmonellosis, dysentery, cholera and other diseases occur at much higher rates in colonias than in Texas as a whole. A lack of medical services compounds health problems in the colonias." -Texas Secretary of State
Cameron & Hidalgo County Stats 2000 Census: approx. 205,000 women ages 15-44 in both Counties combined. All of Hidalgo County and parts of Cameron County are designated Health Professional Shortage Areas and Medically Underserved Areas High poverty rates ~30% High uninsured rates ~30% In 1999 through 2002, (most recent avail.), there were 49 babies born with spina bifida and 37 born with anencephaly in both counties combined Rate of NTD births = 9.2 per 10,000 (vs. 3.0 for US)
Promotora Model Overview Promotora Programs train Community Members to: Build Leadership Skills and Community Empowerment Promote Social Justice and Systems Change Improve Health Improve access to Health Care Provide Health Education Work in partnership with Health / Human Svc Agencies
Who are promotores(as)? People who are Promotores(as) have a gift for service and a noble and kind heart. We think about things and take care of people. We identify with the people and the needs of the community. Mirian Perez, Promotora
What do promotores(as) do? Peer health education Clinic & social service liaison Needs assessment & quality improvement First aid Translation Advocacy Maximize use of limited resources
Benefits to the community Increased trust of health providers Referrals to appropriate health care providers and other resources Follow-up care Reduced stigmas or other barriers that prevent them from initiating or continuing care Provided culturally and linguistically competent information and education
Benefits to the promotores(as) Training Leadership skills Increased feelings of individual empowerment and self worth Opportunity for advancement or additional employment
Benefits to Health Care Providers Improved access to and communication with hard-to-reach communities Enhanced crosscultural understanding More widespread knowledge of and use of services Increased use of preventive care Better tracking of clients for follow-up care Decreased inappropriate use of emergency services
Program Abstract The Nuestro Futuro Program will contribute to a decreased incidence of Neural Tube Defects in Cameron and Hidalgo Counties in Texas through the planning, implementation and evaluation of a multi-sector, evidence-based Promotora de Salud Program
Abstract (Cont d) The Nuestro Futuro Program will increase the number of health and social service providers nationally that promote folic acid awareness and consumption.
Strategies: Individual Encounters Pláticas Community Events Campaigns
Strategies (cont d) Engage and collaborate with local, regional and national partners in promoting folic acid Attend conferences to reach health care providers
Collaboration CDC March of Dimes Spina Bifida Assoc. University of Texas Healthy Mothers, Healthy Babies Children s Health Coalition Texas Dept. of State Health Svcs. Migrant Clinicians Network Nat l Center for Farmworker Health Local clinics and providers (HOPE, Nuestra Clínica del Valle, Brownsville Center, etc.)
Dissemination & the CBA Team Migrant Health Promotion s National Capacity Building Team provides technical assistance and training to migrant health care providers and promotora programs across the country.
Questions? Comments?
Thank you for your time and this opportunity!