August 5, 2014
Salud y Bienestar: Helping Latino Seniors and Families Prevent and Manage Diabetes
By: Dr. Yanira Cruz

Obesity is a foothold for chronic diseases, such as diabetes, posing a particularly serious health challenge for all diverse communities, including Hispanic older adults. Sadly, the number of Latino diabetics increases with age: one out of three Hispanic older adults suffer from the disease, which is often accompanied by related complications such as kidney disease, amputations, heart disease, high blood pressure, and nerve damage. While factors such as obesity predispose Latinos to diabetes, there are also myriad cultural, educational, linguistic, financial, and institutional barriers that keep Hispanics from being diagnosed in the first place. In fact, two of out every seven diabetics in the United States are undiagnosed. This is poses a significant health threat and challenge not only among families, but also in the realm of public health.

woman demonstrating

One of the evidence-based strategies NHCOA has developed to help combat the onset of obesity and diabetes within the Latino community is Salud y Bienestar (Health and Wellbeing). This program is a community-based intervention conducted by promotores de salud (lay health workers) to inform Hispanic older adults and families about diabetes, and how to prevent and manage the disease. What differentiates Salud y Bienestar is that it specifically tackles the barriers Hispanics face when it comes to preventing and managing diabetes or getting diagnosed in easy-to-understand terms, with visually pleasing graphics, and through age-appropriate games and activities. Through group charlas (community discussions) and activities, one-on-one meetings, and assistance in attending healthcare visits, promotores de salud play a vital role in helping seniors stay healthy.

What sets this intervention apart from other diabetes education programs is its culturally and linguistically appropriate approach that goes beyond education to provide a support system for participants. One of the reasons many Hispanic older adults don’t receive health care at all is due to isolation and even shame — seniors we have talked to have expressed they are afraid to ask their doctors questions or say they don’t understand. The presence of a promotora de salud can ensure their inquiries are answered, and they feel comfortable communicating with their healthcare provider:

“For me, the impact is that [seniors] know they aren’t alone, and that being an older adult doesn’t signal the end, rather another stage of life in which they need to take care of themselves to live as fully and in the best health possible.” – Promotora de Salud (California)

Another key aspect of Salud y Bienestar is supporting healthcare professionals to help close the yawning healthcare provider-patient gap that is keeping Hispanic older adults from adequate healthcare across the country. That is why as part of the program, NHCOA offers a free Cultural Competence Course for healthcare providers who serve Latino populations. The promotores de salud are also fundamental in helping close this gap by using their knowledge and skill set to bridge communications and interactions between healthcare providers and Hispanic older adult patients:

“We don’t speak in medical jargon, we are using simple, correct language. We give them the time a [health care provider] can’t, we have the time to listen to them… In short, I think our approach is simple to understand and targeted. Seniors completely understood everything they were told, and that is impact of the [Salud y Bienestar] program.” – Promotora de Salud (California)

However, I consider the best part of this program to be the word-of-mouth it generates within the community. Every time we visit different regions of the country where Salud y Bienestar has a presence, the response is overwhelming from Hispanic older adults, family members, and promotores de salud alike. In fact, many seniors are so empowered by the idea of promoting a healthier lifestyle, that they themselves become promotores de salud. And I have to say there is nothing more empowering than helping seniors become their own best advocates!

bingo“As an older adult and promotora de salud I can say that the materials were well received. They helped me because I have diabetes and my friends at the senior center as well because we like to play bingo.” – Promotora de Salud (DC)

The National Hispanic Council on Aging’s Salud y Bienestar Program is sponsored by the Walmart Foundation.

Dr. Yanira Cruz is the President and CEO of the National Hispanic Council on Aging. The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.