Accessing health care is something that can be difficult for various communities for reasons that range from language barriers to distrust.
That’s where cultural health navigators like Sidney Johnson and Ashley Toledano-Solis come in. Both work in Hennepin Health’s Health Equity Department and help Minneapolis’s Black and Latino populations interact more successfully with providers. Both communities, say Johnson and Toledano-Solis, need education about their health. For Johnson, who is the cultural navigator for the Black community, the need for education comes from a mistrust of health care systems, meaning that building patient trust – in both herself and Hennepin Healthcare – is highly important.
“We just present … an extremely high level of mistrust with health care systems,” said Johnson. “(Patients) feel like there’s an agenda for providers not to properly care for (them) because (they’re) Black. And a lot of people express that they have a lot of fear (of) getting care.”
For Toledano-Solis, who works with – and is part of the Latino community – education is needed to ensure Latino patients are able to navigate the U.S. health care system, which can vary greatly from what recent immigrants are used to in their countries of origin.
“They expect to just be better, like, ‘Just give me medication,’” said Toledano-Solis, noticing that the patients she works with can be used to going to “small clinic shops” only when they become “really, really sick,” rather than having ongoing medical visits. She also noted that members of the Latino community she works with may be undocumented, and so may not be able to get paid time off or time off of work at all to access health services.
“Once that pain is unbearable is when a lot of my patients come,” Toledano-Solis said.
Both navigators have developed relationships with community-based organizations as part of their outreach and engagement. This is part of their efforts to build trust, especially since, Johnson said, trust-building takes more than just being a part of the community. It involves “show(ing) up in ways that are authentic and genuine.”
“A lot of people have said to us, ‘Man, what is this role that you guys are doing? I’ve never heard of this,’” said Johnson. “Or, ‘I’ve never, in all the years that I’ve received care at Hennepin or (anywhere) else heard of something like this and it’s so great to see somebody who looks like me, who cares about what I’m going through, who wants to advocate and just be here, even just to listen. It makes a world of a difference.’”
Building relationships with other community organizations has been beneficial to the cultural navigators for more than just building trust. In 2023, each cultural navigator created a guide for members of the community they assist, which list out various resources. These resources provide forms of help from mental health assistance to food, clothing and shelter.
“Since a year ago, we’ve been going to community (organizations and … just ask(ed) them, ‘Hey, do you have a resource for this or this or this?’” said Toledano-Solis. “and they (gave) me their own resource guide(s), so I just jumbled all of it up into one big (guide).”
Those for whom English is not a primary language, said Toledano-Solis, there are resources in the Latino guide that are provided in Spanish. There are also resources for people who are undocumented and may be uncomfortable providing identification or addresses.
In addition to the resource guides, the cultural navigators at Hennepin worked in community groups partnered with community organizations in 2023 to reach out to community members about health topics. For Toledano-Solis, her efforts focused on older Latina women, in recognition of her own mother’s health while caring for her family.
“I look at my mom and I look at how she is the person (who) always takes care of us and she never takes care of herself, ever since I was younger,” said Toledano-Solis. “It’s that Latina mom thing where the mother is always the caregiver for everyone, but … she never specifically took care of (her own health) in that way until now. A lot of Latinos, specifically Latin women, end up with diseases and illnesses that could have been preventable. She now has so many illnesses that could have been preventable if she would’ve just thought of herself a little bit more. That’s why I wanted to specifically aim towards educating and having that safe space and conversation with Latina women.”
During these conversations, immigration status was a consideration, since the majority of the women attending the meetings are undocumented. As a result, they aren’t able to see the same doctors on a consistent basis.
“Thankfully in 2025, undocumented people will be added to MNsure,” said Toledano-Solis. “But it’s been a long time coming for many undocumented immigrants.”
Johnson focused on reaching out to all members of the Black community 18 years old and older, meeting at North Regional Library in north Minneapolis to create a space where “people come and … define their own wellness and what wellness means to them, instead of it being defined for them” by providers and people outside their community.
“In (the) Black community, we are so easily overshadowed,” said Johnson. “Other views and ideals are impressed (and) imposed upon us because we’re Black, we’re American, we also have faith values similar to maybe (the) white community … so it doesn’t seem like our culture or things specific to us are important.”
Having a space where members of the community can speak freely about and be empowered to take charge of their health, according to Johnson, is highly valuable.
“We face so much as a Black community, different things from … predominantly white communities or the way systems are set up to serve people,” said Johnson, who added that having the space to bring in Black medical providers to educate community has led to questions being asked and answered about topics as varied as hypertension, when someone should go to the hospital for care and personal fitness.
Daily, Johnson and Toledano-Solis educate health professionals about the needs of their communities, reach out to community members and organizations and follow up with current patients at Hennepin. It’s a job that, Toledano-Solis said, has its share of both joy and sadness.
“I got to name a baby once … and I was like, ‘Oh my God, this is the best day ever,’” said Toledano-Solis. “And then, it could be two days later and somebody died.”
“If I explain to you the things that I’ve witnessed people go through … it breaks your heart,” said Johnson, “But I think we’re also very grateful and so very blessed to be able to show up in the ways that we’ve been able to. We understand that every day is not going to yield the results that we always wish for, but we keep fighting and we keep trying to just make outcomes different for our communities. And that’s what keeps us going. That’s what drives us.”
Deanna Pistono
Deanna Pistono is MinnPost’s Race & Health Equity fellow. Follow her on Twitter @deannapistono or email her at dpistono@minnpost.com.
