Building a Healthy Barrio in San José
In Mexico, I knew where my food came from. My parents and grandparents cultivated their own food or we ate food that was grown locally. In this country, fast and processed food is cheap, abundant, and addictive. Our eating habits changed completely.” So says Sandra M., community leader from the Mayfair neighborhood of San Jose, California, speaking about the diabetes epidemic affecting her family and community.
Diabetes is a disease known throughout the world. But few people are aware of the dangers associated with it until it actually affects them or someone close to them. Sandra M., who immigrated to the United States from Ocotlán, Mexico, saw her mother-in-law struggle with diabetes for 10 years before succumbing to it. Now her mother—like many others in her community—has been diagnosed with the same disease and Sandra is determined to fight the epidemic through a campaign of education and awareness.
A Bellwether for Latino Health
It is often said that the United States, as a nation, is facing a crisis of obesity and diabetes, but the population hit hardest of all are Latinos with 50 percent of their children projected to develop diabetes in their lifetime. In fact, for a snapshot of the problem, you only have to visit east San Jose, California, in the neighborhood of Mayfair; a poor, working class community of about 20,000, made up largely of recent immigrants from Mexico. Denied access to healthcare and health education due to poverty, racism, language barriers, and undocumented status, the population registers as one of the most overweight among all ethnic groups in Santa Clara County.
Undoubtedly, some extraordinary efforts have been made in recent years to enroll most children in Santa Clara County in a healthcare plan. But lack of access to healthcare is only one part of the problem faced by Latinos living in low-income barrios like Mayfair. The greater problem is posed by the very environment of the barrio—with minimal access to safe public spaces for physical activity, healthy meals at school, or public facilities offering health programs. There is also a lack of affordable fresh foods, such as organic fruits and vegetables, in local markets.
Somos Mayfair (www.somosmayfair.org) is a place-based organization with a mission to cultivate the dreams and power the people of Mayfair through direct service, cultural activism, and community organizing. Since 1996, Somos Mayfair has fielded a team of community health educators called promotores who have worked with hundreds of local families to increase their access to health services. Faced with the growing epidemic of obesity and diabetes, over the past three years, Somos Mayfair has developed a unique and comprehensive approach to addressing the crisis.
Firstly, recognizing that any community organizing effort can only succeed with the support and commitment of individuals, Somos began by recruiting 50 Mayfair families annually to participate in a five-month intervention program to change behaviors that impact diabetes risk factors. The families participate in three months of weekly exercise and nutrition classes offered by partner organizations, following which, the participants are encouraged to initiate and lead a two-month community project focused on sustaining the health behavioral changes they have learned. Program participants are also urged to develop their leadership skills by passing on the health lessons learned to their neighbors in Mayfair.
Popular Theater Takes on the “American Dream”
On a larger scale, Somos works alongside community leaders to implement health education and dialogue campaigns using popular education and cultural activism, with the aim of increasing knowledge about the social, economic, political, and cultural causes of obesity and diabetes.
In the Fall of 2007, Somos collaborated with Teatro Familias Unidas de Mayfair, a Mayfair mothers’ theatre troupe, to develop a culturally relevant skit about the structural issues that contribute to poor health in the Latino community. The result was La Dulce Vida y la Amarga Muerte de Pancho Mojado (The Sweet Life and Bitter Death of Pancho Mojado)—a 25-minute play that uses humor and the traditional Mexican icon of death, La Catrina, to highlight the dangers of unhealthy eating and unmask the socio-economic causes of diabetes.
The story depicts La Catrina using the “American Dream” of excessive consumption to seduce people like Pancho to an early grave. With the help of the corporate food system and aggressive marketing, she takes advantage of the immigrant’s poor access to healthcare and healthy food to grow her business of death. Pancho’s wife struggles to convince him to change his habits and take diabetes seriously but he brushes aside her concerns and pursues his right to “the good life.” Ultimately, Pancho is shown the error of his ways by an indigenous woman who implores him to draw on his cultural and familial values and resist the false promises of the American Dream.
At the end of a performance, Somos facilitates a dialogue to deconstruct the messages within the play and assess their impact on the audience. To date, about 1500 people have seen the more than 35 performances, followed by participatory workshops to expand the analysis of the growing diabetes epidemic among Latino families.
Teatro Familias is currently exploring the connections between physical health and the ecological crisis affecting the global food system with a new street theater production called “The Cry of Mother Earth,” which premiered this April.
The Active Mothers of Mayfair
Also in 2007, Somos recruited a group of 16 Mayfair mothers—all of whom had a close family member with diabetes—to form Madres Activas de Mayfair (Active Mayfair Mothers), aka MAM. Over a five-month period, MAM conducted participatory action research to study the multiple environmental factors that contribute to the high incidence of obesity and diabetes in Mayfair. The women learned to use Photovoice, the community research method where resident leaders are given cameras to photograph the neighborhood and then analyze the environmental assets and barriers to exercise. The target for the group’s first health advocacy campaign was the neighborhood infrastructure for family physical activity and recreation.
The health infrastructure barriers in Mayfair are several: Firstly, the community has only one open space available for exercise, even though there are four elementary schools in the area; secondly, playgrounds in the affordable housing complexes are unsafe because of ill-maintained equipment; and thirdly, gang violence, drugs, and crime in the neighborhood effectively deter children and families from attempting outdoor physical activity.
MAM identified the new Mayfair Community Center, which reopened in January 2009, as key to implementing the goal of eliminating the environmental barriers to physical activity, obesity, and chronic disease among Mayfair families. They strongly advocated for health and wellness policies to be given priority at the Center and pushed for more community members to become engaged in promoting health. The Center, prior to opening, committed to prioritize health programming. Somos Mayfair and some of its partners have been selected as collaborating partners by the City of San Jose to deliver health programming in the community through the Center.
¡Sí Se Puede!
To successfully create a healthy community, the changes have to occur at many levels. Individual choices and institutional policies must both favor access to healthy food and healthcare, and a safe environment for exercise. Individual behavior changes, even within the most marginalized communities, can be influenced through outreach and education that is culturally relevant and community-led—as has been shown by the work of place-based organizations like Somos Mayfair. Once individuals are convinced of a need within their community, they must channel
Rebecca Bauen is associate director of Somos Mayfair. She formerly directed Women’s Action to Gain Economic Security, which helps low-income women establish eco-friendly cleaning cooperatives in the Bay Area. Aryeh Shell is the program director of Community Engagement at Somos Mayfair. She has worked for over a decade as a popular educator, organizer, and theater artist.