Excerpt... Hilda mostly works in neighborhoods with higher Latino concentrations, such as Cicero, Pilsen and Berwyn. Half of the work is driving around the city to talk to people about what they have, where to go and to help people make the appointments. The other half is learning. "O sea, tengo muchas actividades." ("In other words, I have a lot of activities.") Add to all that — caring for her family. Hilda is the mother of four. She is among the 86,000 community health workers in the U.S. and part of the 1,200 in Chicago. Nearly a quarter of these frontline workers in Chicago are Latina. Many of them between 40 and 60. Health navigators like her build trust across all areas related to health, she says. 100LatinaBirthdays.com
Excerpt...
Hilda mostly works in neighborhoods with higher Latino concentrations, such as Cicero, Pilsen and Berwyn.Half of the work is driving around the city to talk to people about what they have, where to go and to help people make the appointments. The other half is learning. "O sea, tengo muchas actividades." ("In other words, I have a lot of activities.") Add to all that — caring for her family. Hilda is the mother of four. She is among the 86,000 community health workers in the U.S. and part of the 1,200 in Chicago. Nearly a quarter of these frontline workers in Chicago are Latina. Many of them between 40 and 60. Health navigators like her build trust across all areas related to health, she says.
100LatinaBirthdays.com
100 Latina Birthdays is an original production of LWC Studios. It is made possible by grants from Healthy Communities Foundation, Kellogg Foundation, and the Chicago Foundation for Women, the Community Memorial Foundation, and Visiting Nurses Association. Mujeres Latinas en Acción is the series’ fiscal sponsor.
Vicky: I’m visiting Hilda Rodriguez in Burbank, a suburb west of Chicago.
RODRIGUEZ: Te digo que aquí se disfruta mucho. Está hermosísimo. Da una paz y una tranquilidad.
She says this neighborhood is beautiful and enjoyable. It gives her a sense of peace and tranquility.
She lives in a light blue house with a willow tree out front. She likes that her street is mostly quiet, except for birds chirping.
[AMBI: si escuchas? – followed by birds chirping, fade out]
Here, she meditates and tends to her small garden.
RODRIGUEZ: Salen hasta cardenales, vienen a visitarme los cardenales y en esos árboles hay unas unos aguiluchos. Y la nada más se oye como están. Y no debo salir a mi gato si no se lo llevan.
VO #1: Even cardinals come out, the cardinals come to visit me and it’s in those trees you see hawks. And you can hear them. I shouldn’t let my cat out if not they’ll take her away.
She takes a deep inhale.
RODRIGUEZ: Aquí se respira aire puro. Y estamos cerca de 10 minutos está puro bosque. Solamente de bosque.
VO #2: Here you can breathe clean air. We’re around 10 minutes away from the woods. All woods.
The surrounding nature preserve and woods smell like wet earth and flower petals. It’s spring.
She gently touches a bud on her small apple tree.
RODRIGUEZ: Este es el de manzana. Pero no, mira, apenas va a salir sus por el invierno, ¿verdad? Están apenas en Mira.
VO #3: This is the apple tree. But no, look, it is about to sprout because of the winter, right? They are barely growing, look.
When I visit in April, the air is brisk, teetering on 40 degrees.
When it’s warmer out, Hilda goes outside to spend time in her garden. Here she can listen to flocks of birds fly by – her favorite – and the tree leaves swish as she sips a cup of coffee – no sugar.
She sits outside surrounded by grape vines, cilantro shoots and pumpkins …
[Fade ambi under/overlap: Y aquí no bueno pongo mi se puede decir que en mi jardincito, mis mesas, mis sillas y me salgo en las tardes … cuando hay tiempo
VO #4: Well here I put my, we can say, my little garden, my tables, my chairs and I go out at night, when there’s time.]
Looking around at the natural beauty of her beloved garden, I can tell that Hilda is a born caretaker. And from talking to her, I see that her gift for helping sustain life goes well beyond her home garden.
Hilda started on this path with a diagnosis four years ago. Stage two breast cancer.
What followed was a whirlwind of doctor’s appointments. She began with chemotherapy, then got a lumpectomy, followed by 31 rounds of radiation.
She began to feel depressed. Withdrawn. Her hair began to fall out after the first few rounds of chemo.
Her energy - gone. Physically, she couldn’t go back to her job at the hotel.
RORIGUEZ: no quería salir, no quería hablar con nadie. Y dije Hilda no es asi, tengo que hacer algo
VO: I didn’t want to leave the house or talk to anyone. And I said, Hilda’s not like this. I’ve got to do something.
She connected with ALAS - Wings, a group for breast cancer survivors. They connected her with a therapist who she credits with helping get her out of a deep depression.
Inspired by the women she met, she signed up at Arturo Velasquez Institute. Nine months of studies later, she started working as a promotora.
RODRIGUEZ: Ya no quería estar sentada solamente viendo novelas, sino quería estar haciendo algo productivo por por la comunidad o por porque ya hay veces que uno sabe cómo ayudarles
VO: I didn’t want to stay on the couch watching novelas, rather I wanted to be doing something productive for the community, and because there are times when one knows how to help.
[Sounds of Hilda’s youngest grandson squealing at me and Hilda offering me coffee, introducing us to her pet birds los “chismosos”]
MUSIC
Inside Hilda’s warm and colorful home, her four-year-old grandson gives me a hug, squeals and twirls around the living room.
He wakes up his grandma’s pet parakeets.
[AMBI CONT: “Son australianos, se les llama cotorritos australianos …”]
On her dining table are two vases filled with pink and yellow flowers.
Bright pink and purple flowers decorate the whole house – in paintings and in pictures. In her office, hot pink flowers with a handwritten card that says, “Bellisima.”
Her living room walls are filled with portraits of her wedding, her children and grandchildren.
Then she brings out a photo album.
[AMBI: Picture book flips, plastic crackles]
Flipping through, she shows me pictures of her family who she says are her anchor. She flips to the back of the book.
Selfies, printed and preserved in a plastic sleeve so she can look back on the five years since her cancer diagnosis.
[AMBI UNDER - HILDA POINTS AND SAYS, “ESTO SOY YO”]
[AMBI + HILDA: Y aquí ya es cuando ya estaba yo bien triste, deprimida, dije, "No." Y dije, "Las voy a desaparecer." dije, "No." Para recordarme dónde estuve y que supere
VO #5: Here is when I was sad, depressed. I said, ‘No.’ And I said, “I am going to erase these.’ Then I said, ‘No.” So I can remember where I was and how I overcame.’ ]
Today, she is in classes to help others manage not just physical health but also …
RODRIGUEZ: el que identificar que es un estrés, cómo es que nosotros se eleva la el cortisol por el estrés y eso causa enfermedades también.
VO #6: How to identify stressors, since Latinos have elevated cortisol levels because of stress and that causes illnesses too.
Hilda is also studying substance use counseling for fentanyl, and palliative care. After that she plans to take a course on HIV.
She studies everything she can.
This on top of weekly 30-minute drives to the city to do outreach. She mostly works in neighborhoods with higher Latino concentrations, such as Cicero, Pilsen and Berwyn.
Half of the work is driving around the city to talk to people about what they have, where to go and to help people make the appointments. The other half is learning.
RODRIGUEZ: O sea, tengo muchas actividades.
VO #7: In other words, I have a lot of activities.
Add to all that — caring for her family.
Hilda is the mother of four. She is among the 86,000 community health workers in the U.S. and part of the 1,200 in Chicago. Nearly a quarter of these frontline workers in Chicago are Latina. Many of them between 40 and 60.
Health navigators like her build trust across all areas related to health, she says.
RODRIGUEZ: O sea, que todo lo que es la de la medicina, nosotros vamos aprendiendo y eso se lo vamos llevando a la a la comunidad. //
VO #8: We learn everything that pertains to health and take all of that into the community.
She has been doing this work for nearly 11 years – nine of them in Mexico and two in Chicago.
The top health concerns she sees …
HILDA: somos el número uno en en problemas con la diabetes, con la hipertensión y con el cáncer.
VO #9: We are number one in suffering from diabetes, hypertension and cancer.
Promotoras play a key role in expanding preventive health services, helping to cut costs in healthcare, and lowering the likelihood of disease among the communities they serve.
DR. DARCIE MOELLER: community health workers and promoters, they can do all kinds of work and really anything that's serving …as that interface between the community and healthcare, whether that's the public health system, whether that's the healthcare system, whether that's social services. A lot of those things are not super accessible to anyone
That’s Dr. Darcie Moeller, a public health physician and the COVID-19 Health Equity Medical Director at the Cook County Department of Health.
Promotoras also help support medical professionals like physicians and nurses, says Kim Jay, a worker herself and trainer at the Sinai Urban Health Institute.
JAY (7:11): Many times the doctors don't have the time to spend to get into the weeds and details and get into the whys of some of the patients they encounter, but the community health worker does …
For patients, talking with a community health worker can reduce the stigma of having a health condition or asking for help.
Their presence may help reduce “white coat syndrome” - a phenomenon where people’s blood pressure soars in healthcare settings. This is common among women and people older than 50. Wandy Hernandez, a Chicago-based promotora and the co-executive director of the Illinois Community Health Worker Association, is a big believer in the impact of promotoras.
Hernandez: I always say the promotoras, the community health workers, are the pulse within the community. They know what's going on and so it's really important to actually, you know, really truly understand what they're about and how they … are experts in this profession.
{MUSIC}
In 2020, COVID-19 changed the way public health responded to community health needs.
[combo of news clip collage]
Research on hospitalization and death rates revealed the virus hit Latino and Black patients the hardest.
Racial disparities in healthcare existed way before then – but this global crisis illuminated the widening problems.
Early on in the pandemic, Illinois became the first state in the nation to provide state-funded, Medicaid-like health insurance to undocumented seniors. Later expansions covered additional adult age groups.
At the same time, a movement to recruit and train promotoras de salud – Latina community health workers – has been building for decades. In recent years, Chicago has become a notable hub, through SUHI, Enlace’s PAES network, new training programs, and statewide CHW certification.
In March 2022, Dr. Allison Arwady, Chicago’s Health Commissioner, explained:
ARWADY: I mean this has been a terrible pandemic. It has also been a probably once in a generation opportunity for public health to build up some of the infrastructure, and for cities to help think about how we address some of the inequities that have always been there, but really came to light I think, for a lot of people for the first time in serious ways during COVID …
The city funded 31 community-based organizations to recruit and train CHW-style workers through earn-as-you-learn programs. The trainees came from areas with the highest rates of chronic disease, .
ARWADY: We’ve hired more than 800 folks through that, and they have been the lifeblood of everything that has been best. And they are all folks who had never been in public health, but are very much from the hardest hit communities and we want them here long term.
She emphasized the need to hire more workers who could connect residents with resources.
The case to hire more community health workers took off nationwide, says Sandra Wilkness.
Wilkness: They're embedded, trusted, understood the language, and I don't mean just the language formally, but the language, the heartbeat of the community and the state people needed that connection.
Wilkniss is a senior program director at the National Academy for State Health Policy where she supports state policymakers on community health worker policy and sustainable financing, including Medicaid and Medicare reimbursement, certification, and cross-sector funding strategies.
The best agents for change came from the communities experiencing higher hospitalization rates and complications from infection. Here’s Wandy.
Hernandez: We all actually come from different walks of life. And there's something that brings us together. And it's all of the injustices that we've been actually dealing with for a very long time.
The Illinois Community Health Worker Association, which Hernandez leads, is a unified front of all community health workers state-wide, that advocates for policies that support the workforce and reduce health disparities.
Data show that half of Latinos in the U.S. are inadequately insured. And more than half could not afford their doctor’s appointments, delaying visits or treatment.
Transportation is another barrier. One study ranked the West and South sides of Chicago among the lowest for “health care accessibility” by transit.
Problems in health literacy and access were pervasive. So, at the start of the pandemic the National Institutes of Health pooled resources with city and state public health partners to fund research, teams and outreach. For instance, some funding went to expand pop-up vaccine clinics.
The CDC funded 67 organizations nationwide.
Two in Chicago.
In total, the city’s public health department and Cook County received $12 Million.
ARWADY: This is the opportunity to create jobs, public health related jobs in the communities that we have long needed community health workers in
Even though community health workers have been part of public health since the 1960s, the pandemic highlighted how crucial they are for underserved communities.
MOELLER: Community health workers really are like what I see as a health literacy intervention, they are a link, right, between health care and social needs and the community
Dr. Moeller has seen the evolution and benefits of having promotoras join the frontlines.
Moeller: I'm not somebody who wants CHWs to be embedded in our workforce simply because it makes sense financially. This makes sense for health equity.
An Illinois Department of Human Services task force study recommended expanding community health workers across several initiatives. It also highlighted their role in helping to close care gaps in behavioral health, maternal care and more.
Kim sees the impact on the field:
JAY: because somebody looks like you understands the language and shares it in that way, you're like, okay, I can receive that from you. And again, it does not take away from our medical professionals at all. It just allows people to receive information in a way that they can relate to and wrap their heads around and get them back into care or get them into care altogether.
{MUX}
One promotora in Chicago, Juanita Arroyo, calls the work “el chisme de la salud.”
[AMBI - Juanita rings the bell during a cancer survivor group meeting, beginning announcements]
We’re at a breast cancer support group where some 20 women sit shoulder-to-shoulder around a large table. The room is packed because this particular meeting is popular.
The women talk about everything. About their diagnosis, what supplies they need or why they feel depressed even after completing treatment.
But the tone is … cheerful. Like a family reunion.
One attendee brought out a wig, and a couple of the women tried it on.
Mid-way through the meeting, one of the attendees lit the candles on her birthday cake as the group broke out in song. The classic - Las Mañanitas …
[AMBI — ladies cheer and start singing in unison]
It is in these settings where people can share – where to get a haircut, where women bought their new shoes, and where to get a mammogram.
ARROYO: I always tell them, "Vamos a seguir el chisme de la salud." What I share with you, you go share with the comadre. And the comadre is going to go share with the other comadre. So, let's get up there and gossip about health.
She too is a breast cancer survivor, and admitted – she took care of everyone – her family, her neighbors – before herself.
Then she found the group called ELLAS, which stands for “en la lucha a sobrevivir.” Today she is a community health worker for the Resurrection Project. ELLAS gave her more than just health resources. She found a community. And she wanted to pay it forward.
Nationwide, community health workers or health navigators are mostly women, with Latinas comprising the second largest group. Many get into the work part-time, and some go on to build careers.
They spend hours to weeks in training, often multiple times per year, such as the CHW trainings Kim Jay leads at Sinai Urban Health Institute …
[AMBI: Footsteps walking up to the hospital. Chatter during a training happening in a Chicago hospital.
In-field:
Vicky- ”Can you describe what’s happening right now?”
Kim: “Right now…” shares about the training activity, case studies and who the case is based on – one of her own patients]
This training was a week long, hosted at Holy Cross Hospital in the Southside.
There were 28 attendees.
Instructors covered everything from how to talk to a patient about basic needs, such as food or transportation, and the five pillars of what is called “patient self-management support.”
[AMBI: Facilitator explains the five pillars and what each mean. Underneath VO]
One, Assess. Two, Advise. Three, Agree. Four, Assist. And Five, Arrange.
Kim Jay (02:03.318) We want people to be prepared for the people part of community health work. Meaning that those that you may meet … (02:09.934)
or support through their conditions or just an education come with complexities. And we don't want you to be caught off guard about what those may look like. But a lot of that comes with really addressing the complexities of the community health workers themselves.
Kim - like many others - got into this work because a promotora knocked on her door and worked with her to address her own health condition.
That encounter changed the trajectory of her life.
In the fourteen years since, she has risen in the ranks of the public health workforce.
And now she wants to see more people do the same. But there’s an intractable barrier.
KIM (20:00): funding is definitely the issue that prevents programs from continuing on.
Everyone//Most people we spoke to said funding is a top priority, especially right now as federal grants are rescinded and Medicaid cuts are looming.
For instance, this past Spring, the Cook County Department of Public Health lost funding and had to pivot.
MOELLER: A lot of these organizations have CHWs on their staff who were 100% funded by this grant. And we felt so comfortable to be connected with the in this public-private partnership because we knew that no matter what, that learning collaborative was going to continue because we've already identified a shared funding model for that learning collaborative and we'd already been talking about ways to sustain that work.
Community Memorial Foundation, which is among our series’ funders, is one of the key members of the private-public partnership, which is headed by Nan Silva, program director. During the pandemic, Community Memorial Foundation forged partnerships with Cook County’s public health department.
The initiative blossomed.
Silva: The fact that we were able to partner private health foundations with a public health department was unique because it's such different entities, right? Such different cultures and we found this middle ground to be able to find alignment.
Dr. Moeller explained it supports sustainability for staffing and training over time.
Here is Sandy Wilkniss on what she advises for state policies:
SANDY: The other thing I would really encourage is an opportunity to think in a cross sector way and a a braided funding kind of way. Medicaid, yes, but also departments of aging, departments of public health, maternal and child health programs. … behavioral health programs are plugged in to the recognition of community health worker value and want to figure out how to be part of that. So the more you can bring those efforts together, the more you have a sustainable funding web, if you will, or network of funds to support CHW. So that's something I would encourage also.
From a policy perspective she says that requires buy-in and an understanding of the day-in-the-life of a community health worker.
SANDY: I'll just try to go back to 30,000 feet again where I live and that is I would like people who think about community health worker policies, think about community, think about lived experience. … I would love for those people to sit for a moment, reflect on what it means to have experience in your own community. What does it mean to have community, like sit and be with it for a minute and then translate it to what you're trying to solve.
More sustained funding models – or the funding web as Sandy called it — promotes a liveable wage.
Currently, Bureau of Labor Statistics data shows that a Community Health Worker’s mean annual wage in 2024 was around $51,000. Hourly, they can make between $17 to $36 an hour, depending on the state and employer.
Sometimes, that is not enough.
Hilda earns $25 per hour, but the organization caps work to a maximum of two hours per month. Another organization pays her $400 every two weeks. Neither offers benefits.
RODRIGUEZ: Pero es muy difícil. Más ahorita con el gobierno que está pasando ahorita es un poco complicado.
VO #10: It’s hard especially now with what’s happening in the government. It’s a bit complicated.
But she loves being a promotora. Doing this work is a chance to educate and pass on health information. It is a way to give back to her own community, especially after going through chemotherapy and radiation.
Her cancer diagnosis catapulted her into a career she never even considered. It was through the cancer support group that she found where she belonged.
Those friendships have continued today. Her promotora friends and support group friends threw her a birthday bash in April. The only requirement?
RODRIGUEZ: “Pues que vayan todo floreadas.”
VO #11: That they all dress up in flowers.
And she is enjoying every minute.
[AMBI: Sounds of her birthday party surrounded by her family and promotora friends singing. “Happy birthday” … ending with chachacha”]
RODRIGUEZ: Y lo que te puedo decir es que me siento bendecida porque digo todos los días le doy gracias a Dios por un día más de vida y vivo al día, yo digo, un día a la vez porque mañana no lo sé y trato de disfrutar cada momento de mi vida.
VO #12: What can I tell you? I feel blessed because I say every day that I thank God for another day. I live day by day, because I don’t know about tomorrow, so I try to enjoy every moment of my life.
Becoming a promotora guided her to what she wants to be: a counselor.
Mental health is part of health, she says, and she wants to be the person to support her community through that.
RODRIGUEZ: veo la necesidad también tanto en la en la comunidad como en mi familia. Decir, ¿sabes qué? Es que nos tenemos que educar, tenemos que aprender a a cómo estar saludables y que la salud mental también es importante. Y el 95% de la gente tenemos problemas de salud mental y no a veces no sabemos dónde recurrir, y hay áreas y hay recursos, pero que a veces la gente no sabe.
VO #13: I see the need in the community, like I see it in my own family. I say, you know what? We need to educate ourselves, learn how to stay healthy and that our mental health is also important. I mean, 95% of people have mental health problems and sometimes we don’t know when it’ll happen again. And there are resources, but sometimes people just don’t know.
Hilda is in this for the long run.
RODRIGUEZ: La satisfacción de trabajar como promotora es cuando cuando ves los resultados con la gente. … cuando les enseñas cómo cómo comer, cómo este cómo educarse y cuando tu los ves y dices ay, ‘ah si tu has cambiado’ o sea es un satisfacción muy bonita
VO #14: The satisfaction to work as a promotora is when you see results in the people. When you show them how to eat, how to educate themselves and when you finally see them and say, “wow you have changed.” That is such a beautiful feeling.
A note to update the story.
A Bureau of Health Workforce analysis projected an increased demand of 12% for CHWs in the next four years.
But in March 2025, the Department of Health and Human Services announced the cancellation of $125 million in COVID-era grants.
Programs must now look for other funding sources to make community health staffing sustainable long term.
CREDITS
100 Latina Birthdays is an original production of LWC Studios. It is made possible by grants from Healthy Communities Foundation, Kellogg Foundation, Woods Fund Chicago, The Field Foundation of Illinois, Pritzker Foundation, and The Chicago Foundation for Women, Chicago Community Trust, and Visiting Nurses Association. Mujeres Latinas en Acción is the series’ fiscal sponsor.
Juleyka Lantigua is the series creator, executive producer, and editor. This episode was reported by me, Vicky Diaz-Camacho. Mixing and sound design by Florence Barrau-Adams. Fendell Fulton fact checked it. Kori Doran is our marketing associate. Cover Art by Reyna Noriega.
For more information, resources, episode transcripts, and Spanish translations, visit 100latinabirthdays.com. That's one, zero, zero Latina birthdays dot com. Follow us on Instagram, X, and Facebook at 100 Latina Birthdays.
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