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By Dory Benford | April 14, 2017
Chronic stress can be a constant, unwanted companion in underserved communities. While you are struggling to make ends meet, providing for your family or simply trying to stay afloat, it may not even register that you are experiencing stress.
And once you do realize you have a problem, how can you seek mental health resources when they are either too difficult to access or too expensive?
April - Minority Month - Chavez 3 Noe Chavez, Ph.D.
To solve the various health problems associated with stress, change must occur from within the community first, says Noe Chavez, Ph.D., a community psychologist at City of Hope. Making it easier for people to find healthy coping mechanisms within their communities is a big step toward positively, and more meaningfully, impacting individuals.

We spoke with Chavez about how to bring positive change to underserved communities, and the best ways to reach the individuals who call those communities home.

1.    Focus on communities, not just individuals

To really help people individually, we must first focus on the communities in which they reside. At the root, a person’s social environment greatly impacts the likelihood that they will suffer with chronic stress. Positively influencing underserved communities is our best chance at helping individuals understand and conquer chronic stress, and better yet, change the social or environmental factors at the root of stress.

All communities have their fair share of problems, but also strengths. In underserved communities, we need to capitalize on the resources that are already there, and the social and cultural capital available. This is key to health improvement and positive change.

2.    Act before the problem starts

We need to be more proactive. Some say we need more primary prevention focused on health and well-being, others would say it is more about social justice and changing the systems to make them more equitable — so that we lessen the toxic stressors that exist, or build resources and support systems in under resourced communities to better cope with stress.

Whatever you focus on, I think it’s about acting before the problem starts and changing the environments to make them healthier, not just changing individuals.  

3.    Collaboration is key

Health care providers need to step outside of the medical setting and work with community folks to make these changes. Creating new treatments will only serve as a Band-Aid. We need to become advocates and work with partners in multiple sectors to improve our environments using community intervention and policy change.

Behavior is critical and we need to improve how people cope and behave as a response to stress (because oftentimes poor behavior results) and this exacerbates the problem. However, without changing our social environments and systems, healthier behavior will be hard to come by. Many contexts make it harder for one to behave healthier, that’s just the reality. We need to make it easier for folks to behave healthier.

4.    Look beyond traditional health services

More traditional health services, including mental health, definitely need improvement.

The Robert Wood Johnson Foundation has, for example, been a leader in creating new initiatives and grants to support groups of partners — not just academic and medical — but in the community. In all their work, including community members with lived experience is central.

It’s about pushing the boundaries of what is possible to think more holistically. One interesting intervention I learned about some years ago, happening in Los Angeles, involved community health workers and Latina immigrant women from the community, working together and talking to folks about organizing for positive change.

These "promotoras" (promoters) ended up creating spaces in churches and homes, allowing people to talk about their stressors and be there as "familia" to support each other. They served as lay mental health workers offering an ear to listen and deep understanding since they all shared the same experiences from living in the same community.

5.    Look to religious and spiritual centers for support with mental and emotional health

Church and spiritual forms of support, in many cases, are the most important in many communities. You still need additional educational support to get the right services to folks, but the spiritual support is oftentimes what people are seeking and really need. Here at City of Hope, for example, the spiritual leaders are doing such great work to support patients and providers.
Stories of Hope is a monthly series that explores important issues in health care. To commemorate National Minority Health Month, we are dedicating the entire month of April to health care disparities.



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