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Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud

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  • Ryan I. Logan

    (Department of Anthropology, Geography & Ethnic Studies, California State University Stanislaus, Turlock, CA 95382, USA)

  • Heide Castañeda

    (Department of Anthropology, University of South Florida, Tampa, FL 33620, USA)

Abstract

Rural populations in the United States are faced with a variety of health disparities that complicate access to care. Community health workers (CHWs) and their Spanish-speaking counterparts, promotores de salud , are well-equipped to address rural health access issues, provide education, and ultimately assuage these disparities. In this article, we compare community health workers in the states of Indiana and Texas, based on the results of two separate research studies, in order to (1) investigate the unique role of CHWs in rural communities and (2) understand how their advocacy efforts represent a central form of caregiving. Drawing on ethnographic, qualitative data—including interviews, photovoice, and participant observation—we analyze how CHWs connect structurally vulnerable clients in rural areas to resources, health education, and health and social services. Our primary contribution to existing scholarship on CHWs is the elaboration of advocacy as a form of caregiving to improve individual health outcomes as well as provoke structural change in the form of policy development. Finally, we describe how CHWs became especially critical in addressing disparities among rural populations in the wake of COVID-19, using their advocacy-as-caregiving role that was developed and well-established before the pandemic. These frontline workers are more vital than ever to address disparities and are a critical force in overcoming structural vulnerability and inequities in health in the United States.

Suggested Citation

  • Ryan I. Logan & Heide Castañeda, 2020. "Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud," IJERPH, MDPI, vol. 17(24), pages 1-16, December.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:24:p:9223-:d:459578
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    References listed on IDEAS

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    1. Maes, K. & Closser, S. & Kalofonos, I., 2014. "Listening to community health workers: How ethnographic research can inform positive relationships among community health workers, health institutions, communities," American Journal of Public Health, American Public Health Association, vol. 104(5), pages 5-9.
    2. Sabo, S. & Ingram, M. & Reinschmidt, K.M. & Schachter, K. & Jacobs, L. & De Zapien, J.G. & Robinson, L. & Carvajal, S., 2013. "Predictors and a framework for fostering community advocacy as a community health worker core function to eliminate health disparities," American Journal of Public Health, American Public Health Association, vol. 103(7), pages 67-73.
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    Cited by:

    1. Thomas H. Lee & Bobby Do & Levi Dantzinger & Joshua Holmes & Monique Chyba & Steven Hankins & Edward Mersereau & Kenneth Hara & Victoria Y. Fan, 2022. "Mitigation Planning and Policies Informed by COVID-19 Modeling: A Framework and Case Study of the State of Hawaii," IJERPH, MDPI, vol. 19(10), pages 1-14, May.
    2. Thomas A. Arcury & Sydney A. Smith & Jennifer W. Talton & Sara A. Quandt, 2022. "The Abysmal Organization of Work and Work Safety Culture Experienced by North Carolina Latinx Women in Farmworker Families," IJERPH, MDPI, vol. 19(8), pages 1-19, April.
    3. Michelle S. Wong & Taona P. Haderlein & Anita H. Yuan & Ernest Moy & Kenneth T. Jones & Donna L. Washington, 2021. "Time Trends in Racial/Ethnic Differences in COVID-19 Infection and Mortality," IJERPH, MDPI, vol. 18(9), pages 1-14, May.
    4. Keng Yang & Hanying Qi, 2022. "Research on Health Disparities Related to the COVID-19 Pandemic: A Bibliometric Analysis," IJERPH, MDPI, vol. 19(3), pages 1-25, January.

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