The places where we live, work, play and learn, affect our health

Because we know that where we live, work, play and learn affects our health, our programs are designed to confront disease and problems at the same time that we pay attention to the multiple root causes of these problems. When one works within this philosophy, the struggle for better salaries is the struggle for better health. Helping youth graduate or women learn how to read are considered health strategy.

We strongly believe that health is determined by social conditions and that the place where one lives is a major factor in limiting, determining, enhancing, or inhibiting health. We have been working within a place-based approach since our inception. We see this principle grounded in the larger international, national, and regional bodies of work that continue to build evidence for the soundness and relevance of this approach such as the WHO Commission on Social Determinants of Health, (World Health Organization, 2008) and the entities that set national and regional agendas such as the CDC’s Healthy People 2020:

“The Social Determinants of Health topic area within Healthy People 2020 is designed to identify ways to create social and physical environments that promote good health for all. All Americans deserve an equal opportunity to make the choices that lead to good health. But to ensure that all Americans have that opportunity, advances are needed not only in health care but also in fields such as education, childcare, housing, business, law, media, community planning, transportation, and agriculture”.

We analyze problems in their historical, social, and political context

Because we believe that the problems in a community are the consequence of multiple factors, we work hard to understand the historical, social, political, and psychological context and trajectory of our realities. Social problems and individual responses to them did not appear overnight. We try to learn and understand the current circumstances of individuals in these vulnerable communities connected to histories of oppression, colonization, racism, forced or volunteer immigration, discrimination, chronic disinvestment, individual and collective trauma, poverty among families for multiple generations, and contexts of violence, political corruption, and drug and sex trafficking economies in Latin America, the US, and the world, among others. We are conscious of the cumulative effect of historic injustice and the lack of restorative practices in our society. It is extremely important for our team to understand these socio-historical contexts, to analyze why things happen and the elements that influence people’s points of view, behaviors, and decision-making. We are always encouraged to deepen this analysis and not always settle by saying, "If they wanted to change they would have done it," or “They should stay in their countries,” "That’s how Latinos are," or "People are like that," or "They deserve those living conditions.” It is our duty to challenge these myopic and simple explanations and engage in deeper and multiple analyses.

Participation Makes the Difference

Because we believe that without participation we are passive witnesses to the decisions of others and suffer the consequences of others' actions and our own inaction, we work to continuously activate mechanisms of participation.

Of all the behaviors that people can practice to improve their lives and communities, participation is the most important. When we decide to take part in something, our voices and our hands are added, and the chances of achieving what we want increase. It is easy to take advantage of communities that do not participate because they do not use their power and instead endure in silence. Participation or the lack of participation creates a power dynamic between the parties. Whether it be talking to a doctor or teacher or advocating for a park or street improvements when we take part in something we are stronger, we have more power and we achieve more.

We question the idea of ​​unity for unity’s sake

Because we believe that unity makes a community more powerful, we strive to create a common purpose with common terminology, educating ourselves on commitment and creating mechanisms for participation for all. We assume that we have two things in common: that every individual wants the best for themselves and their families and that everyone has something to contribute. From there we can move to think about how to improve our community and how to act in unity. So we worked for unity, for the common unity, for the community.

Unity of a community does not occur naturally, whether between Latinos, whites, blacks and indigenous people, the LGBT community, or other groups. Unity has a purpose. It requires effort and an intentional process to achieve and maintain unity. Even geographical unity, religious, cultural, or family unity requires common goals, sacrifice, and a level of selflessness to focus on the most important things for the group. To expect Latinos to be united because we are called Latinos is not realistic and only leads to frustration.

We need to be united to achieve healthier communities and stronger families. The identification of a common purpose and common interests is vital for the creation of plans and strategies to improve our communities.

We create healthier communities with each other’s strengths

Because we believe that people’s needs do not improve communities, we focus on what really does, people’s strengths and talents. Focusing only on needs does not generate the energy, vision, and passion to make one’s community better. We understand that people have needs, but only by strategically mobilizing strengths and capabilities can we make things better. By engaging people’s strengths, we can create possibilities. When we see possibilities we become hopeful. We celebrate that every person has knowledge, skills, strengths, and talents that can be mobilized to build healthier communities. In the same way, that unity does not occur in the absence of purpose, people don’t contribute skills unless they think it is worth it, their contributions are needed, and are welcomed. We approach our work with the assumption that we all value having a healthy, prosperous life for ourselves and our children. It is our responsibility to observe, identify, question, motivate and provide the mechanisms and opportunities for people to use their strengths, wisdom, and desires to make their dreams come true and contribute to a better community.

We all can reflect and take action

Because we believe everyone can reflect and take action, we invite all members of the community, young and old, with or without formal education to be included in the process of reflection and action. The ideas generated by one of us alone are less effective and often less successful than those that result from dialogue and joint actions with neighbors in our communities. Creating healthy communities by inviting everyone to reflect requires more time but the ultimate results are real and profound. When we better understand what is happening around us we can learn how to fix it. When we learn, we expand our thinking with new elements and possibilities. When we take action, we affect the environment. We then learn and have the opportunity to incorporate the lessons into our thinking to create even more effective actions. This ongoing reflection and action are vital to transforming our communities and sustaining changes. Strategic thinking and action should not be privileged to some as if there were a "thinking class." If our families are not included in the reflection process for individual, family, or community changes, we are imposing our findings on their lives and telling them what to do. Individuals have and generate realistic ideas that are the clear product of their daily cumulative experiences, and of their desire to improve.

We value different cultures and we incorporate them into our work

Because we believe that we are cultural beings, we know there is always a culture underlying every intervention, whether it is evident or not. Culture may be invisible but is everywhere; it is just like oxygen for land-living creatures and water for aquatic creatures; you only notice it when you are away from it. However, it determines to a large extent many of our most trivial routines and our most important life decisions. What do we have for breakfast, hot or cold?; what we wear to go to work; how and when we form a family; how we talk about disease and with whom; how we discuss death and dying; and how we grieve, etc. At work, how do we answer equivalent questions: How do we run meetings? How do we structure an organization? Whom do we hire? How do we supervise? How do we create mechanisms for community inclusion? Answers to these and many other questions will reveal the dominant culture that is guiding the implementation of the activities in a particular institution or organization. The underlying culture tends to go unexamined when groups design activities that reflect what they were taught by their families, schools, corporations, or agencies.

Culture has a central role in our work. Our organization creates spaces where we can share each other’s cultures in an inter-generational format. Cultural practices, celebrations, values, music, art, and history are woven, within institutional constraints and resources, into everything we do within the organization and community. The activities are designed by people who are grounded in their cultural traditions. Activities with children, fundraising events, holidays, deaths, and births, all events and celebrations are informed and guided by the cultural practices of our participants and people who work in our organization.

We do not generalize. We honor the self-expression of a person’s identity

Because everyone has different identities, histories, and aspirations, we believe that people have the right to define themselves. Even though we share similar problems, we believe that every person, no matter how young, is an expert in her own life and can see her own potential solutions.

The Latino experience in the United States is diverse. We come from many places and we have different histories, ways of using language, educational levels, beliefs, religions, spiritual practices, values, sexual orientations, and economic resources. We respect the words people use to define who they are when they share their identity. For example, someone may prefer to be identified as Mexican while others prefer to be identified as Latinos or Chicanos. We don’t impose labels nor do we assume people’s identities. We understand well that the Latino community and for that matter, all communities are neither monolithic nor static. They are always renovating and innovating themselves. Our youth may self-identify differently from their parents. Our elders may identify differently from their adult children; however, our approach is to allow for everyone to be themselves. We find common problems and we analyze particular situations affecting a sector of the population or a particular geographic area, but we do not generalize. We let people speak for themselves.

We work in partnership and solidarity with the community

Because we believe that the core of our mission is to engage the community in addressing the root causes of suffering, we work in partnership and solidarity with the community. We partner with communities so that they can take a protagonist role. We are not there to rescue anyone. In the work we do with our families and communities, we hope that they participate, take action and become key leaders of transformation for change and success. Whether we are talking about a behavior that requires change, families participating in support groups to reduce violence, increasing places where children can play, or increasing the Latino vote; our expectation is that the community becomes an active partner in this enterprise of change and hope. While meeting basic and immediate needs is not part of our core mission, during the course of this work, we occasionally assist our neighbors and participants with urgent needs as well. It is possible for us to help people, who urgently need food or shelter, connect people with other organizations, or have a small fundraiser because someone needs money for a funeral, but this type of help is an expression of unconditional solidarity and not a philosophical approach to community work based on charity.

We value Reciprocity: All give and all receive

Because we believe that everyone has something to offer; we believe in creating a space for a fair exchange. We as an organization have something to offer and the community also has something to offer, we work with a philosophy of mutual respect and mutual contribution.

Our community often wants to help and offer something in return for what it receives. We believe it is a mistake to reject what the community offers, be it a glass of juice, an hour of volunteer work, an apartment where we can meet, cookies for children in the program, or folkloric ballet classes. Accepting what the community offers is a key to maximizing resources and maintaining mutual respect and dignity.

All parties can benefit from the transaction. Traditionally, organizations and charities working with low-income communities offer goods and services without expecting anything in return. One way of looking at this is that a service provider might think that it is not fair to ask a person in need to contribute. Another way of looking at this is to think that people in need have nothing to offer. In our opinion, asking the community to contribute to solutions to problems makes sense financially because resources are finite, and makes sense in terms of building community. Offering services alone is not a way to build community. Community is built with the contribution of all members.

At Latino Health Access, every person we know can contribute and should be offered a chance to do so. We believe in asking people to somehow contribute and embracing their offerings so others can have the possibility of benefiting, too. Some people have negative experiences of receiving things and then being used. For example, governments sometimes give in order to gain votes or marketers give to gain business. This can create distrust in our call for reciprocity.

We relate to the community in a way in which people can make the distinction between being used and being part of the solution. We make sure there are opportunities for reciprocity and opportunities to build trust. In our community work, we bring information, services, and the invitation to participate, give, and contribute to the changes we want, as a way to move away from paternalistic models. During our activities with the community, we make reciprocity an expectation. Sometimes people think they have nothing to give because their talents and skills were not valued before. Once they start to contribute, they become convinced of how important their talents and skills are for catalyzing action and change.

We work in partnership with other sectors and encourage shared accountability

Because we believe that we are all in this together; we work in partnership with other sectors located inside and outside the community, physically, but whose decisions have a major impact on the residents of the communities in which work. At LHA, we recognize that everything we do is from the perspective of and in partnership with and for the benefit of local residents. In addition, for the community to prosper it needs relationships with other institutions while still preserving the connections between neighbors. We have to build relationships and work with all: The business sector, the faith community, the health sector, schools, political representatives, other organizations, and public or private groups. The community needs to be built and improved with the contributions of multiple sectors while ensuring representation and active participation of residents. We may work with a sector individually or we may work in multi-sectoral collaboratives to reach collective outcomes.

We develop comprehensive responses

Because we believe problems are inter-connected and so are the solutions, we work in designing comprehensive responses. When we include the community in the conceptualization of a strategy, it tends to become very comprehensive. Mothers in our community are not only concerned about their children's weight. They also worry about their education, their emotional wellbeing, and their relationships with others. In this paradigm, people who are concerned about housing, food, and education can work simultaneously.

In comparison with traditional institutions, communities think in a less fragmented way. A mom whose child is overweight will tell us that her son has no place to run and play. This offers us an opportunity to talk about why he doesn’t have a place to run and play. This conversation leads to the political question of why we don’t have parks. It creates a partnership between the mom and us where we can analyze the root causes of her son’s difficulties in managing his weight instead of just talking about his Body Mass Index (BMI). If we do not have parks for children to play in, they remain sedentary at home gaining weight. But if people do not understand this process, political change won’t occur. That's why we train the community to join the political effort.

After reaching a deeper collective understanding of the root causes of the problem and the potential solutions, we feel obligated to develop comprehensive, or more complete strategies from which solutions consistent with the analysis of the problems can emerge.

Additionally, comprehensive responses allow us to work simultaneously on short and long-term change. For example, in the short term, we can partner with people with diabetes so they can better manage their condition, gain access to medical services, obtain medications and avoid or manage complications. We can do this, while in the long-term, supporting the family to start eating better, in order to prevent and reduce obesity. We can advocate together to have parks and to be able to use them. We can support efforts to have access to health insurance and health care practitioners, to change school menus, and to make the city safer so people can go outside and be active.

We make the health of the organization and each member of our team a priority

Because we believe that the quality of our work depends on the quality and maintenance of our team and that the community we want to improve outside of LHA, is also represented as staff in our organization; we invest time and resources in activities that help our team to be healthy and cohesive. LHA invests time in training, meetings, and retreats helping the entire team to align with the strategies we are collectively conceiving and implementing. We take the duty of the ongoing assessment of our capacity and challenges very seriously. Staff is provided the space where they can create, innovate, and feel taken care of. There is an ongoing investment of time and resources to understand our individuality, emotions, desires, and problems as well as to help team members physically, mentally, socially, and spiritually. We work to build team unity by engaging in dialogue and reflection within a culture of respect, mutual aid, and the value of each individual. The principles that guide the organization outside in the community, also guide us internally. We are all experts; are all part of the team; all contribute; all have responsibilities and rights. We establish reciprocal and transformative relationships where everyone learns from everyone else; create processes to have relationships that respect the experiences and positions of others; know that sometimes we stray. Sometimes we want to tell others what to do without consulting with them. We know that at times we forget to honor others or their experiences. In these cases, we stop, evaluate, and correct in order to be accountable to each other and the community.

We are programmatically accountable, evaluate our programs, and share results

Because we believe in the responsibility to learn from our work, we strive to be accountable and to demonstrate the value of what we do. All staff members are trained to understand the value of data, and how to obtain it and organize it. We dedicate resources and time to evaluating our activities and programs. We create systems that allow us to know whether we are achieving our objectives. We constantly ask ourselves if we are really doing what we say we are doing. We gather data with the community and share results with the community. We have discussions about what the results mean, and what to do about them. We seek, find and accept errors or omissions. We evaluate and correct course when necessary. In the same way, we keep an open mind to incorporate changes in our strategies and programs based on what we learn.

LHA is an organization that is constantly learning and trying to analyze the processes and results of what we do and to incorporate the lessons we learn along the way. We have systems and procedures that allow us to do the job in an efficient and transparent manner, yet still, protect the agency. Such systems and procedures must be improved and strengthened by the lessons of our practice, the experiences of other organizations, and by external regulations. The health of our organization depends in great part on the creation, review, and continuous improvement of our systems and procedures.

We use financial resources responsibly

Because we believe in taking very seriously the responsibility entrusted to us by the community, we want to use resources wisely, and we work hard to be financially accountable to everyone who is involved in our work, from the funders to the community, and create systems to ensure transparent financial processes. We maximize the use of resources by partnering with other organizations and welcoming in-kind services, donations, and volunteers.

We reject invitations for division

Because we understand that unity is a strength and diversity makes us stronger, we try to avoid the trap of division. Societies, by design, often create reasons for division. For many of us, a way to protect our beliefs, our jobs, our funding, or our truth, is by separating ourselves from the “other.” This separation is a critical barrier to building common ground. We do not allow ourselves to be distracted from the goal of a creating healthier community by people who want to divide us, consciously or unconsciously. We recognize the existence of prejudices, even inside our own organization, and make a conscious effort to work on them. We are aware that we grew up in this society, so we have internalized many prejudices. Our agency is not different. LHA is composed of people who are a part of our society. We acknowledge the risk of division and so are proactive at setting the expectation that we all make a conscious effort to at least tolerate and respect, if not understand and embrace, the differences that we have amongst ourselves at all levels. It is important to remind each other often that we believe in working together across lines of race, gender, age, religion, sexual orientation, national origin, experience, physical abilities, etc. Diversity informs what we do and enriches us. In a proactive, humble way, we remind each other of this principle when we hear or see prejudice in action. When we see hatred or contempt we try to confront it in a way that helps the person hear and learn. Ignoring the existence of these forces is not healthy. If there are difficulties working with a person or sector, we make an effort to work on the issue and overcome limitations.

We recognize the risks that can derail us from our work and from practicing our other principles .

Because we believe there are many risks, we are careful and attentive, so we can sustain our work and adherence to our principles.

These risks may include:

Underestimating the oppositional agenda

There are people and sectors whose agenda may oppose or conflict with our work and our agenda of social justice. Often our agenda touches controversial areas in the country's politics such as those related to health care reform, immigration reform, low-cost and fair housing, and more. We cannot underestimate oppositional agendas. We are aware that we can also learn from opposing perspectives and are willing to build bridges when there is a genuine desire to find common ground without compromising our core beliefs in social justice. In order to be stronger and more effective, and to avoid becoming an easy target, we think strategically and in partnership with others who share similar agendas.

Losing our humility

We need to be cautious in two areas, first in recognizing that university training is a great help in the work we do, but it is not all that is needed. Community experiences and life experiences are of vital importance. Teamwork between the community and university-trained workers, and the ongoing conversation between these partnerships, is a practice that protects against academic arrogance. We pay particular attention to the relationships between the university-trained people and the community members in our training, meetings, and conversations to be sure the environment is safe, non-intimidating, and fosters the free expression of ideas for all, Second, we need to be aware of the risk of starting to feel that we know it all, that we have reached a “nirvana” state of knowing how to build a healthy community or the holy grail of community organizing or training promotores. When you think you know it all, you stop learning; and when you stop learning you stop growing. We need to remind each other to be humble and be open to the lessons we are offered every day from our community members and be open to the challenges that other perspectives add to our work.

Losing the balance between short-term services and long-term changes

Managing the balance between short-term work and long-term change is challenging. Sometimes we focus on providing services and lose sight of working on the root causes that created the need for those services. Likewise, sometimes we get very involved in changing policy and power dynamics and forget that the community has critical needs that require immediate attention. This is especially challenging because resources such as time, staff, and money are, as we all know always, limited so we need to be always paying attention to the balance between the short and long term and be ready to make adjustments.