|
 THE
COMMUNITY WE SERVE AND THEIR NEED
Health People's services are largely targeted to the
South Bronx, the core of one of the poorest Congressional districts
in the country. The median household income in our area, encompassing
the neighborhoods of High Bridge, Morrisania, Hunts Point, and Mott
Haven, is $13,776, compared to the County median income of $24,014,
and the New York City median income of $33,475. More than 40% of
the population in these neighborhoods receives some form of public
assistance, far more than in Bronx County (29.2%) and in New York
City as a whole (19.3%).
The incidence of serious chronic disease in the South
Bronx is the highest in New York City. Morrisania and High Bridge
have the highest HIV/AIDS mortality rates. In Hunts Point and Mott
Haven, two South Bronx neighborhoods central to Health People’s
service area, diabetes incidence has doubled in the past decade
and its mortality rate is two times higher than the city’s,
while the rate of stroke is 55% higher. The Bronx also has the highest
childhood asthma hospitalization rate.
With proper prevention and care, the effects of these
deadly diseases can be minimized. But in the South Bronx, routine
and/or preventative health care is far from the norm. The community’s
high death and chronic disease rates have engendered a pervasive
feeling of hopelessness about even the prospects of obtaining good
health and proper health care. Health People believes that the people
of the South Bronx must be empowered to understand that good health
is possible. Sensitive, targeted outreach, intensive education,
human support and peer strategies are crucial to improving self-care
and clinical care.
THE
HEALTH PEOPLE MODEL
 Health
People helps people from low-income communities become leaders to
effectively fight chronic ill health. When the organization began
in 1990, it was one of only a few agencies using the peer-education
strategy for HIV/AIDS prevention and care. Peer education for disease
self-management is now a tested and successful approach, and Health
People has the largest program in New York City. We not only believe—we
know because we’ve seen it repeatedly—that the people
most affected by chronic disease make outstanding and certainly
the most dedicated educators to help others.
Our emphasis on peer-to-peer health education was
developed from experience with what really works, but our practices
are thoroughly grounded in the clinical Health Belief Model (HBM)
that seeks to explain the health behavior of individuals. HBM makes
clear that in order for people to take positive health action, they
must (1) perceive that they are ill and that the illness has negative
effects; (2) be aware of the treatment options; and (3) believe
that those treatment options can be accomplished without insurmountable
barriers and will have positive effects on their disease. Health
beliefs are essential "tools" for health promotion because
patients will rarely follow advice that doesn’t consider their
existing beliefs. Our programs work because our peer educators,
who come from the neighborhoods they serve, understand the local
culture and needs. Health People’s health educators are peers
of their "clients" and possess an intimate understanding
of their beliefs, fears and needs.
PEER
EDUCATION TRAINING
Health People's peer education model begins with three
months of peer training. During that period, new peer educators
attend classes and workshops four days a week. In addition, peers
participate in a weekly support group to discuss what they are learning
and the personal challenges they face. This three-month training
is followed by a six-month internship, during which, in addition
to their ongoing support group, peers help deliver at least two
peer-education activities a week. These activities may include teaching
courses in AIDS, diabetes, and asthma self-care, and conducting
groups in smoking cessation; health outreach at fairs and community
events; and workshops on health topic at schools and community centers.
Peers also get involved in advocacy efforts, taking trips to Albany
or Washington, D.C., to speak out for their community and their
health.
Our Peer educators are directly representative of
their community. Many are on public assistance or on parole or in
drug recovery programs. And although Health People began as a peer
program by and for women, neighborhood men saw the program's benefit,
and volunteered to be part of it. Today the program is 60% women
and 40% men. In addition, Health People has an award-winning Junior
Peer Educator and Children’s Mentoring program.
Health People graduates 4 to 5 classes of peer educators
each year; at any time, we have 45 to 50 active peers in the field.
For many participants, peer education training is transformative.
Many peers did not complete their high school education and for
them, acceptance into and graduating from the peer-training program
is their first adult experience of educational success. At a recent
graduation ceremony, one graduate proudly explained what the program
meant to her: "Before I got into the program I was nothing.
Now I'm a peer educator." After the six-month internship, many
peer educators secure full-time jobs. Some are hired by Health People—three-quarters
of Health People's program staff began as peer educators. Others
stay in the community health field as staff for other organizations.
|
