Our Mission

The mission of Puentes de Salud is two-fold: First, to partner with Philadelphia’s rapidly growing Latino immigrant community to build long-term prosperity by addressing immediate education, health and social service needs. Second, to create a responsible learning environment for future generations of advocates, educators, and healthcare providers to examine Social Justice and Structural Violence, and to explore their impacts on the Social Determinants of Health within a marginalized community.

Puentes de Salud believes that a comprehensive strategy to promote wellness in any community must work towards diminishing the effects of Structural Violence and supporting Social Justice efforts, specifically access to healthcare, economic opportunity, and education. Because most of the underlying causes of inequality are social and structural in nature, our actions must be too. For this reason, we offer integrated services to support full mental, emotional, and physical well-being from the individual to the community. Our goal is to provide the social, economic, and health resources necessary for individual and community empowerment.

 

Over the past 40 years, the United States has experienced a profound demographic shift. Throughout the late 1980s and early 1990s, domestic demand for low-wage agricultural labor fueled the influx of predominantly-male Mexican immigrants. By the late 1990s, as demand spread into industries such as food service, the ratio of male to female Latino immigrants reached parity. By 2000, census data officially recognized Latinos as the largest minority group in the United States. From 2000 to 2010, Latinos accounted for more than 50 percent of the nation’s population growth. Today, growth of the Latino community extends beyond border states, rural America, and traditional urban centers. As is clearly evidenced in South Philadelphia, where the number of Latino immigrants has risen from 6,220 in 2000 to an estimated 30,000 at present. Working in low-paying jobs, lacking health care benefits and facing linguistic and cultural barriers, a high percentage of this population exists precariously with respect to health. Despite these obvious challenges, the South Philadelphia Latino community abounds with robust, rapidly growing, and hardworking families.

In order to best serve the immediate health care needs of Philadelphia’s burgeoning Latino community, Dr. Jack Ludmir and Dr. Steven Larson organized a series of meetings with local health care stakeholders in 2003. The convening participants—representing academic institutions, social service organizations, and health care establishments—ultimately concluded that a traditional biomedical model of health care delivery would prove ineffective in meeting the complex needs of this immigrant population.

In 2004, Dr. Matthew O’Brien joined Drs. Ludmir and Larson at which point they decided to design and build a new immigrant health and wellness center. Beginning with grassroots advocacy efforts, including a series of town meetings, health fairs, and screenings, the doctors created a forum in which community members could share their ideas about how to improve the health and wellness of their community. Using the information gathered from these efforts, the doctors clarified the foundation of Puentes de Salud: involving practitioners directly in the community, partnering to provide health care and educational programs, all while focusing long-term efforts on addressing the social determinants of health.

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Social Determinants of Health, Social Justice, and Addressing Structural Violence

Social Determinants of Health

Health is not merely absence of illness, but rather wellness in a holistic sense.  Social factors, such as education, socioeconomic status, and political/legal environment effect health as much, if not more than, biological processes.  However, the social factors that influence health are often neglected by healthcare in general and practitioners in particular.  It is these social factors that are crucial in creating the health inequities that are so prevalent today.  Health disparities can be dangerous to individuals and society as a whole.  Addressing health disparities and social factors that influence health outcomes is crucial to the future of healthcare.

Social Justice

Social justice is defined as “Justice in terms of the distribution of wealth, opportunities, and privileges within a society.”2  Working for social justice in our communities necessitates an understanding of larger power structures that impact community well being, specifically structural violence.  Essentially,“…a commitment to social justice requires that we not limit our sense of justice simply to the more equitable provision of health care to those who are ill, but demands that we examine injustices in the distribution of health and the underlying reasons for unjust burdens of illness.”

Structural Violence

Structural violence refers to societal or institutional factors that preserve inequity, injustice, and human misery—the ways that the unequal distribution of suffering becomes embodied and experienced as violence by the powerless.

Within the concept of structural violence, it is essential to recognize that there may not be any one person who directly harms another; rather, the violence is built into the structure of society and shows up as an unequal distribution of power (resources) and consequently, unequal life chances.

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Puentes de Salud operates on a multidisciplinary, community-based collaborative model that promotes health and wellness through low-cost, high-quality health care, innovative educational programs, and community building. Since its founding, Puentes de Salud has prioritized the development of a comprehensive plan for Latino health in South Philadelphia, guided by three objectives:

  • To provide medical services targeting the immediate acute and chronic health needs of the population
  • To design sustainable, long-term strategies for health promotion and disease prevention
  • To create a research partnership between local universities and the community in order to develop best practices for the care of the Latino population, locally and nationally

Puentes de Salud embraces a grassroots approach to health and wellness that values the community’s input in identifying health care needs and priorities. Reinforced by a long-term community presence and commitment, Puentes de Salud has earned the trust and respect of the people it serves. This trust has been a key ingredient of Puentes de Salud’s success, strengthening the organization’s ability to fulfill its mission.

Trained in the traditional biomedical model of health care that favors a hierarchical structure for providers, Puentes De Salud’s founders experienced the model’s limitations in effectively serving vulnerable communities. Over the course of their careers, the founders gained firsthand experience with nurse-managed clinics in under-served communities.

Convinced that a team approach is essential to optimize the unique, complementary skills of every individual, Puentes de Salud decentralizes the role of the physician, creating a truly interdisciplinary model in which promotoras, nurses, nurse practitioners, students and physicians all collaborate in the care of our community as equal partners.

The centerpiece of Puentes de Salud’s innovative model is the community nurse liaison (CNL), who operates as a health care provider, community advocate, and social worker. The CNL, much like a public health nurse, serves to bridge the community and its needs with health care providers and stakeholders, mobilizing resources to areas of need.

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