The National AHEC Organization (NAO) has awarded SEAHEC with the Center of Excellence for Community Programs for our work with the Winchester Heights community in northern Cochise County. NAO recognized SEAHEC for our unique model of community development that incorporates training for health professions students into a community health worker driven model for improving rural health and safety in marginalized communities. The Healthy Farms program hosts students and helps them conduct health related community service projects which provide much needed expertise to community health workers and their neighbors who are trying to solve persistent public health issues, often with no funding or infrastructure.
Linda Cifuentes, SEAHEC’s Capacity Building Coordinator at Winchester Heights, accepted the award in July during a virtual awards ceremony.
“On behalf of SEAHEC and Winchester Heights, thank you for this award,” Ms. Cifuentes told meeting participants.
Earlier this year, SEAHEC helped the community launch its own nonprofit, the Winchester Heights Health Organization, Inc. The organization will be responsible for managing the Winchester Community Center, founded in 2018. SEAHEC helped residents build the community center in 2018 with funding from the Legacy Foundation of Southeast Arizona, and other community partners. The Legacy Foundation of Southeast Arizona provided generous financial support for construction of the Winchester Heights Community Center, as well as support for recruitment and training of community members to form the governing board. The Legacy Foundation of Southeast Arizona is an Arizona charitable organization whose philanthropic mission is to promote population health and community wellness throughout Southeast Arizona.
“As many of you may know,” Ms. Cifuentes said during the NAO meeting,” farmworkers are one of the most marginalized groups in this country, and our hope through this project is to inspire other organizations to support and uplift these communities to improve their quality of life.”
A Model for Overcoming Longstanding Health Disparities
For many years, Winchester Heights, whose residents are mostly farmworkers, was one of hundreds of communities along the US Mexico border region that lack basic infrastructure most Americans take for granted. Now, with a community center and a sustainable organization to run it, they finally have the leverage they need to make substantial improvements to local health and safety, and to build a local economy.
Nearly one million Americans live in communities designated by the federal government as colonias. These communities are located within 150 miles of the US Mexico border and often lack potable water, decent housing, paved streets, and access to health and safety services, the internet and other infrastructure that supports public health. These communities also often lack organizational infrastructure, such as a local government or non-profit corporation, which would provide eligibility for federal funding targeted at small, rural communities. Without expertise and an accessible location for residents to meet, these communities don’t have the leverage to take advantage of development funding that would improve public health and jumpstart a local economy. They often languish for years without any substantial improvement unless they can acquire the basic infrastructure needed to build resources.
For over a decade, SEAHEC has hosted health professions students from the University of Arizona, the Icahn School of Medicine at Mt. Sinai, and other universities, to provide “boots on the ground” health and development expertise to local communities under SEAHEC’s Healthy Farms program. The goal is to improve public health and develop local infrastructure that will sustain those improvements.
How Healthcare Workforce Development Supports Sustainable Community Development
The first step in the Healthy Farms model is to recruit, train and launch a local community health worker team from among community residents. Students then provide on-going community health worker (CHW) training, guide the CHWs in partnering with distant service providers to develop a health and safety referral system. Meanwhile, CHWs canvas the community to share their knowledge and collect data on local health issues and factors that prevent residents from addressing them. They also use these visits to recruit more residents to help tackle local health issues. This sharing of skills and expertise enables future health care professionals to increase their cultural competence and gain knowledge about rural health care delivery, while the community builds leadership and increases local skills and knowledge that increase their efficacy to create positive change.
For example, in Winchester Heights, students worked with Healthy Farms CHWs in 2017 to conduct an environmental health assessment, which helped the community learn to collect and use their own data to support development plans they had long been unable to implement. These efforts resulted in improvements in drinking water quality. The project also provided opportunities to raise local awareness of lead exposure issues, and provide ongoing recruitment and training of additional community health workers. A constant supply of residents trained in advocacy and public health promotion has increased the community’s access to health information and has enabled the community to conduct local health fairs and numerous community-based health information workshops on topics such as prevention of mosquito borne diseases, asthma, sun and workplace safety, and community advocacy training.
Each project has built on the next until the community gained the expertise and leverage needed to build the community center and launch their incorporated health organization. Before we built the community center, “getting the entire community together was nearly impossible,” said SEAHEC Executive Director, Gail Emrick. After the community center opened, local civic activity exploded.
“The community’s transformation has been remarkable,” Ms. Emrick said. “A fenced playground, a soccer field, a sturdy, bright blue building in the center of the neighborhood, have become a magnet and generator of civic unity and social activity,” she added. Once known for its lack of infrastructure and services, Winchester Heights now hosts a wide variety of activities at the new community center, which also houses the Winchester Community Action Board (CAB), founded in 2017 to implement the findings of the environmental health assessment. The CAB became the precursor of the WHHO, Inc.
SEAHEC polled community members in the summer of 2019 to find out what the impact of having their own community center had on residents’ lives. From our survey, SEAHEC found that the community center has made a significant improvement in the quality of life for Winchester Heights residents. “The level of engagement has surpassed our bravest hopes,” Ms. Emrick said, adding that community residents have come together to continue the property’s development, adding a soccer field that is constantly in use, planting trees, a garden and raising funds to pay the bills.
In addition, having access to the center for service delivery has made community outreach more efficient, convenient and cost-effective for local service agencies across the county. A representative of the county’s only federally qualified health center (FQHC) called access to a central location for community gatherings a “game changer” for both residents and service providers. Formerly, service providers would have to wait out in the wind, on a dirt road, hoping to catch the attention of passers-by to provide information about available services. With the community center, which is located within walking distance for virtually every resident, service providers can post notices and hold health events indoors. It has made things like distributing vaccines, and providing clinical services much easier. Even the US Census Bureau has benefitted. This year, Census Bureau representatives were able to recruit and train census workers for the 2020 census at the community center, enabling the census to reach elusive rural residents much more efficiently.
“The community center is both critical infrastructure and an indelible symbol of hope for this community and others like it,” said Ms. Emrick.