Healthcare Heroes: Investing in Primary Care for Underserved Communities

Healthcare has always been marked by heroism. World-renowned surgical teams perform life-saving procedures while, floors away, emergency providers face Level 1 trauma. But unseen primary care physicians (PCPs) serve as heroes in their own communities day in and day out.

Although preventive health is a hot topic, our system underinvests in supportive infrastructure for primary care teams. This has triggered a PCP shortage that’s bound to worsen, which will harm underserved populations like Latinos.

At Zócalo Health, we see primary care teams as the eyes, ears, and hands of health care. Here, we leverage a primary care model that integrates community health workers (CHWs). In recent decades, CHWs - or promotores de salud - have led public health initiatives across the world. Research shows they’re crucial to helping health systems achieve full potential, since they work to connect patients to local resources and care. Their approach is holistic: they may help families who live in food deserts access nutritious food, offer culturally appropriate health education, or make home visits.

At Zócalo, this promotor coordinates a full care team of physicians, nurses, and mental health therapists. We believe each of these primary care team members is the true hero of healthcare. Why is this especially important for Latinos?

Latinos experience disproportionately limited access to primary care: in majority Latino neighborhoods, there’s a ratio of one primary care physician for every five to six thousand residents. And many Latinos live in urban areas, where they wait on average 24 days to see a PCP. In our communities, we know that between coordinating time off from work, childcare, and figuring out transportation to a faraway office, a single appointment can be a huge hurdle.

Over time, these challenges in access cause a lack of established primary care relationships. Latino patients may avoid care or use informal networks for advice and treatment - meaning they may wait until their conditions deteriorate before seeking urgent care or traveling to the ER. We know that this is detrimental to their immediate health and impacts long-term health outcomes, in addition to being expensive for the patients.  

Growing up in predominantly Hispanic communities in Houston and rural New Mexico, challenges with the healthcare system didn’t stop once you were able to get to the physician’s office. Our loved ones told stories of doctors not taking the time to listen to their stories or judging them for trying home remedies. In the rare case where there was a Spanish speaking provider or the physicians had translated materials, the treatment our friends and families received remained far short of being truly culturally aware.  

The pandemic reminded us that downstream issues of limited access and insufficient care can have big upstream implications. Across the Latino population, we see significantly higher rates of chronic diseases, like heart disease, cancers, and HIV. One in two Latinos will develop diabetes during their lifetimes. These chronic health conditions can wreak havoc on individuals’ lives and place additional stress on our healthcare system.

But early intervention and targeted lifestyle changes have the power to transform health across an individual’s lifetime – a bit of prevention goes a long way. Strong primary care relationships with cultural competency as their foundation can lower costs, streamline care, and improve outcomes population-wide. Zócalo’s promotores lead teams that integrate health in a way that our current fragmented system doesn’t.

And most importantly, these promotores have deep roots in the communities they’re serving. They speak their languages and share common life experiences and values. We believe more health care professionals should look like the people they serve, and promotores are part of that solution.

Yes, innovation is crucial to transforming the way primary care operates and is invested in. But our Latino community also deserves care that respects and emphasizes heritage. Zócalo Health was founded on the belief that innovation and tradition can co-exist in primary care. To truly impact the health of Latino communities, we need to support our primary care heroes with a care model that offers a team of like-minded, relationship-focused providers to catalyze change.

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