Diabetes Forecast

Community Health Worker Leticia Aranda

Leticia Aranda is on the frontline of diabetes care

By Kimberly Goad ,

Leticia Aranda
Photography by Eric Hinders

Leticia Aranda is talking with a woman about type 2 diabetes—specifically, the woman’s risk for developing the disease. What may seem like a casual conversation between friends (the two women, after all, live in the same Colorado Springs community) is actually shoptalk for Aranda. As a community health worker with the American Diabetes Association (ADA), Aranda is charged with spreading the word about diabetes and prediabetes to the people in her community. Because of the woman’s family history, Aranda suggests she consider attending a local class on diabetes prevention.

“I want her to know she may be at risk because her mother has type 2 diabetes,” says Aranda, who is aware of the possible connection from her training as a promotora—as community health workers are known in her largely Latino community—as well as her own experience. “My mother died of complications from the disease,” says Aranda, 48. After ignoring warning signs for five years, Aranda was diagnosed with type 2 in 2012.

It was the wake-up call she needed to change her lifestyle. In the years since her diagnosis, she’s lost 95 pounds through a combination of diet and exercise. With the help of medication, she’s successfully met her A1C goals. Now, she helps other Latinos in her community access the information she wishes she’d had in the early days of her diagnosis.

Perhaps the least-known member of a diabetes care team, the community health worker acts as a liaison between people with or at risk for developing diabetes and helps them get the services they need. That’s especially important in areas like Aranda’s, where access to health care is limited.

She is part advocate, educator, mentor, interpreter, role model, and doctor-appointment-keeper. Although she received training through the ADA, her greatest credential just might be the one that can’t be taught: She’s a member of the community she serves. “We don’t really trust people who aren’t from our community,” says Aranda, who moved to Colorado Springs, Colorado, from her native Cuernavaca, Mexico, in 2000. “It’s important to have someone working in our community who comes from [a Latin country such as] Mexico, Cuba, or Venezuela.”

Living in the same community, sharing a similar background, and knowing firsthand the challenges of living with type 2 diabetes all help to build trust. So when Aranda talks about the benefits of exercise or suggests eating smaller portions of culinary staples—such as tamales, the fried pastry known as sopapilla, and soups such as pozole or menudo—she’s speaking from experience. Sometimes the messenger is just as important as the message. For Aranda, “it’s a really good feeling to see that what I’m doing is working, that I’m helping somebody.”

At a Glance

Community Health Workers (CHWs)

What is a CHW?
A public health worker who acts as a link between the people who live in the community and the services they need in order to prevent or manage diseases such as diabetes. CHWs have a close understanding of the community they serve.

Why do I need one?
If you live in an area with inadequate access to health care, a CHW can help connect you with the tools and resources you need for diabetes self-management education and support.

How do I find a CHW?
CHWs aren’t common in many communities, so in most cases, a hospital, health care center, or outreach program will connect you with a CHW if possible.

What credentials does a CHW have?
It varies. “Increasingly, credentials are based on formal training, but many very experienced and skilled CHWs do not have formal credentials,” says Carl Rush, MRP, a CHW policy specialist and advocate with the Institute for Health Policy at the University of Texas. “What makes a CHW is their ability to establish a trusting relationship with the community member.”



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