2021 Grants Challenge

Esperanza’s Promotores de Salud (Community Health Promoters)

Esperanza’s Promotores de Salud (Community Health Promotors) provide life-saving culturally accessible in-home health education, primary prevention and advocacy to families in South LA. Our nationally recognized Promotora-led model increases access to health services and decreases preventable ER use for patients in low-income communities of color. Through our Promotoras Leadership program, we have trained over 500 community health workers, and are providing opportunities for meaningful careers in health for low-income women of color.


In which areas of Los Angeles will you be directly working?

South LA

What is the problem that you are seeking to address?

The Covid-19 pandemic has reinforced the ways that South Central Los Angeles communities are marginalized. Due to historic disinvestment, South LA is under-resourced in basic care, preventative, and mental health services. Over the past year, South LA families have faced rates of infection that are 40% higher than the rest of the county, and we have had higher rates of job and business losses than wealthier communities. We have seen that many residents have had to choose between foregoing work and face homelessness or continuing to work and putting their lives and loved ones at risk. This project will support Esperanza’s Promotores De Salud. It is an effort to improve community health and reduce the collateral effects of the Covid-19 pandemic due to the global economic downturn, high rates of infection, social isolation, increased slum housing conditions, and movement restriction measures that are unequally affecting people in underserved communities like South Los Angeles.

Describe the project, program, or initiative that this grant will support to address the problem identified.

South Central Los Angeles has been hard hit by systemic racism and economic inequality, and the Covid-19 pandemic has put that in sharp relief. Our goal is to improve community health and reduce collateral damage caused by the Covid-19 crisis. A secondary goal is to expand the evidence base for our Promotora model, ensuring health and wellness for South LA residents in the near term, and increasing job opportunities and equitable pay for Promotores in the long term. Through our nationally-recognized model, Esperanza will provide support services to families in South LA. This approach is effective as it builds upon the expertise and knowledge of the very people impacted by a problem to know what is needed to create meaningful systemic change. Our Promotora training supports career wage employment in the health field and last year we connected more than 40 Promotoras to COVID-related outreach, education, and contact tracing jobs. The outreach program will serve 350 families in the project period. Over the next year we will: 1) increase access to health care services, conduct vaccine awareness and referrals, and reduce the number of patients returning to the ER for acute asthma care 2) improve community health through primary prevention measures 3) Increase access to other vital services, including mental health and tenant rights clinics We measure the project’s success by analyzing in-home health surveys, follow-up assessments, and periodic community health surveys.

In what stage of innovation is this project, program, or initiative?

Expand existing project, program, or initiative

Approximately how many people will be impacted by this project, program, or initiative?

Direct Impact: 350

Indirect Impact: 1,200

Describe how Los Angeles County will be different if your work is successful.

This project will support the healing and just recovery of South Central’s most vulnerable communities. The Promotora Model is a successful strategy in targeting disparities and increasing access to health services for community residents and building community trust through home visits and mentoring. Through this work, we will ensure more holistic, quality care for South LA residents as well as expand our evidence base for our Promotora home health model; and we will increasing respect, job opportunities, and pay for Promotoras in the long term. Esperanza’s goal for this project is to ensure that community health promoters are more fully integrated into healthcare teams, and institutionally recognized and funded by the state. Esperanza is working at the local and state level to secure a State Plan Amendment (SPA) to allow qualified non-licensed professionals such as community health workers (CHWs) and promotores to provide reimbursable primary prevention and education services.

What evidence do you have that this project, program, or initiative is or will be successful, and how will you define and measure success?

In 1996 we pioneered the Promotores de Salud model, a strategy for reducing health disparities and increasing access to health services for low-income communities of color, while building a powerful cadre of community health leaders. Promotores conduct free life-saving home health assessments that provide education and resources to low-income households, and connect families to important services. Through our program’s education and environmental assessments, ER visits by clients for asthma decreased by 77% last year. This significant reduction in ER visits results in health improvements for patients and invaluable cost savings for community hospitals and clinics who are already overloaded with COVID-19 patients. Promotores provide culturally accessible health education, primary prevention, and advocacy to families and children. Esperanza has advanced city-wide and national policies on housing, habitability, code enforcement, workforce development, and asthma home visitation.

Which of the LIVE metrics will you impact?​

Healthcare access

Resilient communities

Indicate any additional LA2050 goals your project will impact.

LA is the healthiest place to CONNECT