2023 Grants Challenge

Promotores Meeting Community Health Needs

Esperanza Community Housing's pioneering Promotores de Salud (Community Health Promoters) Leadership Training Program was developed in 1995 to build and sustain a comprehensive approach to health systems change that taps the underutilized skills of bi-lingual local residents while developing a cadre of professional multilingual community health leaders to provide culturally and linguistically accessible health education, primary prevention, and advocacy to children and families living in underresourced regions of Los Angeles.


What is the primary issue area that your application will impact?

Health Care Access

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

South LA

County of Los Angeles

City of Los Angeles

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

Applying a proven model or solution to a new issue or sector (e.g., using a job recruiting software or strategy to match clients to supportive housing sites, applying demonstrated strategies from advocating for college affordability to advocating for housing affordability and homelessness, etc.)

What is your understanding of the issue that you are seeking to address?

Low-income communities of color face widespread health disparities caused by multiple factors, including the interlocking problems of poverty, chronic disease, limited access to quality education, discrimination, lack of good-paying jobs, lack of affordable housing, slum housing, and environmental damage. Economically disenfranchised individuals and families are concentrated in South LA where residents are also plagued by the harmful effects of racist land-use and planning policies resulting in poor air quality due to urban oil drilling, gas excavation, freeway congestion, and toxic industries. Many South LA residents live in one of the top 10% most polluted communities in the state of California. These are the same communities that suffer disproportionately from asthma, cancer, and other health concerns that result from an over concentration of environmental hazards which will only get worse from the impacts of the global climate crisis.

Describe the project, program, or initiative this grant will support to address the issue.

Esperanza Community Housing's (Esperanza) nationally recognized Promotores de Salud (Community Health Promoters) Leadership Training Program is the framework for our programs at the intersection of health and housing, developing local residents into health ambassadors for their own neighborhoods by focusing on primary prevention and participating fully in shaping health services and systems. The Promotora Model has proven to be a successful strategy in targeting health disparities and increasing access to health services for community members. Promotora graduates are often women who come from low-wage service industries and pursue Esperanza's training in order to secure better economic and long-term employment opportunities. The Training Program is also a resource for recent immigrants with the majority of graduates able to earn 50-100% more after program completion. Promotores gain employment from various hospitals, CBO's, government offices, and educational institutions, and they do not have to be deployed to "hard to reach" areas because they already live, work, and are engaged in those areas. They have a unique ability to reach vulnerable, low-income, and underserved members of the Latinx and Black communities. With culturally relevant expertise, our Promotores are successful in increasing health insurance enrollment, decreasing the cost of emergency care, improving health outcomes, and advancing structural interventions and policies for all of Los Angeles.

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

Promotores de Salud are simply an antidote to a trauma-creating health system. Through community, clinical, and government partnerships, Esperanza aims to build a cadre of Promotores who provide comprehensive, preventive care and support as well as addressing growing issues such as utilization of Doula expertise for a healthier postpartum, environmental justice and climate resilience, and healing the healer. Beyond individual health, Promotores are leaders in informing, empowering, and mobilizing community residents with exposing and proactively addressing the harmful health effects of slum housing and toxic pollution such as urban oil drilling. The Training is a replicable model to truly be a catalyst for change within other communities in Los Angeles whose goal is to build a community-led preventive health system with embedded trauma-informed care and in which achieving health includes the process of liberation, restoration, and transformation from both the patient and provider.

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

The Training has 4 primary goals: 1) educate and empower community leaders to participate fully in shaping health services and systems to meet the needs of medically underserved communities; 2) increase access to health services; 3) improve community health through primary prevention measures; 4) support career wage employment in the health field for previously low-income residents. With pre- and post-survey information provided by our training participants, it allows us to develop a better understanding of the program's impact, specifically knowledge gained from topics covered, skills acquired, and improved communication skills. Participants will also receive follow up at three, six, and twelve months following their graduation in order to track their progress with job placement, earning power, and reach in the community. With our Promotora staffed programs, we conduct in-home health surveys and follow-up assessments to measure progress or changes in behavior and health outcomes.

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

Direct Impact: 25

Indirect Impact: 3,000