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'Promotoras' Help Texas Border's Poorest Seniors Make Healthy Choices

Some of the poorest seniors in Texas live in Hidalgo County in the Rio Grande Valley.

Many only speak Spanish and don’t have access to the basics, like food or medical care. But a Texas A&M professor and his team of community health workers – or "promotoras de salud” – are trying to find ways to help seniors along the border improve those conditions. 

They're working in places like the colonia border town of Progreso, near the Mexican border. Progreso is  one of the poorest places in the one of the poorest counties in the United States. The unemployment rate is more than 10 percent.

There, three promotoras – Elva and Diana Beltrán and Mayté Garza – took me to where the Aranda family lives. It's on a plot of land in a home made from makeshift materials. There’s no indoor plumbing.

They found Maria Guadalupe Aranda and her elderly mother, Maria Luisa Aranda, standing by a fire pit to keep warm.

Maria Luisa is in her 70s. She’s not sure how old exactly.  But she's certain, however, that she doesn’t need anything.

I asked her in Spanish whether she needs medication. She said no. Does she have enough food? She said yes. Is she withstanding the cold? She said yes again.

"It’s not uncommon to talk to folks, especially to seniors, and everything’s fine," says Professor Joe Sharkey, who directs the Program for Research In Nutrition and Health Disparities at the Texas A&M School of Rural Public Health. "'Yeah, I’ve got everything I need. I always have something to eat.' But it’s once they get to working with them closely and they establish this trust that people can really give them the honest answer."

They don’t want to present that they can’t handle their well being on their own, Sharkey says. "Because right away they’re thinking their kid or someone is trying to get them out of their home, into a nursing home, into some kind of custodial care, and they want to live independently."

For the past year, Sharkey and his team of promotoras have been going door-to-door to assess the food security of people in Hidalgo County.

"The numbers here are enormous," Sharkey says. "When we speak about colonias, the last count is there are better than 2,000 colonias along the border from El Paso to Brownsville and about 70 percent of them are in Hidalgo County. So you have a lot of these neighborhoods that have a lot of people."
The promotoras have been working with a team of nutritionists in College Station to develop lessons to help seniors make good choices. They’ll start taking the lessons to the seniors’ homes this month.

"These are lessons that will help them eat healthy with little money," Elva Beltrán says. "We’ll teach them how to cook. We’ll give them recipes. We’ll teach them to read nutrition labels. How to eat small portions. That the refrigerator’s temperature needs to be safe, how to wash the cooking tools and how to maintain hygiene when they’re cooking."

It’s a tough challenge in Hidalgo County. In Austin, community health workers might tell people not to drink so many sugary sodas. But here in Progreso, many families don’t have any food at all.

Mayté Garza says that’s one of the hardest things they see when going door to door – a fridge that’s totally empty.

"Sometimes when there’s an emergency because they haven’t gotten their food stamps or they ran out early, so then we come in," Garza says. "We buy the food and distribute it."

Over the summer the team surveyed hundreds of seniors in the Texas heat.

"In a lot of the areas they’d been to, people had never heard of promotoras," Sharkey says. "They didn’t know. Because they live so far away from areas that they were not receiving any kind of outreach at all."

But the promotoras are determined to educate seniors about everything from how to make a dollar stretch to buy vegetables, to proper hygiene.

"Something else that we see here that we also need to address is that there are a very large number of grandparents raising grandchildren," Sharkey says. "So that puts a whole other dynamic on how do people age healthy if they’re also having to be responsible for a very young child and they really are the ones raising them. And we’re seeing more and more of that here, too."

Maria Luisa Aranda’s daughter, Maria Guadalupe Aranda, says the person who owns the land they live on has told them they will need to leave the property soon. She’s selling it. The Arandas have nowhere to go.

Maria Guadalupe says the hardest thing is not that they have to go, but it’s finding a place where she can live with her kids and her two parents. Like many Latino families, they refuse to live apart.

This story is part of the MetLife Foundation’s “Journalists in Aging Fellows Program” – organized by The Gerontological Society of America and New America Media.

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