RESUMO
The REACH Su Comunidad Consortium worked with 10 communities to address disparities in access to healthy food and physical activity opportunities among Hispanic populations through policy, systems, and environmental (PSE) strategies. Community health workers took leadership roles in the implementation of PSE strategies in partnership with local multisector coalitions. This article describes the role of community health workers in PSE change, the technical and professional development support provided to the REACH Su Comunidad Communities, and highlights professional development needs of community health workers engaging in PSE strategies.
Assuntos
Agentes Comunitários de Saúde/normas , Promoção da Saúde/métodos , Disparidades nos Níveis de Saúde , Hispânico ou Latino , Mudança Social , Determinantes Sociais da Saúde/economia , Agentes Comunitários de Saúde/organização & administração , Agentes Comunitários de Saúde/tendências , Relações Comunidade-Instituição , Planejamento Ambiental , Exercício Físico , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/normas , Promoção da Saúde/organização & administração , Humanos , Liderança , Modelos Organizacionais , Noroeste dos Estados Unidos , Segurança , Sudoeste dos Estados UnidosRESUMO
Pervasive, lifelong inequalities in physical health begin in early childhood and are driven, in part, by social gradients in risk factors such as smoking and obesity. Yet not all low-income children have elevated physical-health risks as adults. The relation between income-to-needs ratio at age 9 and smoking prevalence and body fat (body mass index) at age 17 was examined in a sample of 196 rural adolescents. Income-to-needs ratio is the U.S. federal government's defined index of household income as a proportion of the poverty line. This is the first study to show that links between childhood poverty and subsequent physical-health outcomes can be loosened. At-risk youth in communities with a relatively rich array of social capital did not smoke more or have greater excess body fat compared with their more affluent counterparts.