Building bridges to the Latino community

February 23, 2001

Madeline Vann

Hector Giovanni Antunez is modest about his accomplishments. He downplays the fact that he moved to the United States five years ago from his native Honduras with no knowledge of English and is now working on his doctorate in health education from the Tulane University School of Public Health and Tropical Medicine.

He refrains from going on about his artistic skills, the food bank he runs from his home and the impact of the Latino Health Outreach Project he co-founded. Antunez, a practicing physician in Honduras, came to the United States in 1995 with his wife, Leyda, and their two sons. He had received a Fulbright Scholarship through the U.S. Embassy in Honduras to study in the United States and decided to attend Tulane because, he says, the university is very well respected in Honduras.

The Fulbright allowed Antunez to complete his master's degree in 1997. During that time, he began developing the Latino Health Outreach Project (LHOP) with Tulane University clinical assistant professor Marian McDonald, who would become the project's faculty director. The project grew in part out of a student assignment in McDonald's class on community organizing.

"It arose from a misunderstanding of the word 'project,'" says Antunez. In Spanish, the word proyecto implies a program of work that is being done. When McDonald spoke to his class about "housing projects," and in particular one populated by Latin Americans, Antunez concluded Tulane was doing outreach with that community.

"The next semester I realized they didn't have any projects for Latinos," says Antunez. "So I met with other students who wanted to work on this and together we decided to design a program for Latinos."

The purpose of LHOP was health education in communities that do not fluently speak English and have limited access to health services. Antunez and his fellow students developed a program of charlas or "chats" during which health issues could be discussed. The charlas were held in housing developments with a high Latino population, and were broadcast on Hispanic radio.

"It was an answer to a big need, because no one was talking about outreach or research for Latinos," says Antunez. The major barriers to Latinos getting health care, according to Antunez, are finances and language.

Many Latin Americans, he says, do not have health insurance. Those who do may not use it because they do not know who to call to set up an appointment, or are put off by the time involved in going to a clinic to set up an appointment and then returning at a later time to actually see the physician. Antunez is now working on his doctoral prospectus, which focuses on identifying the barriers to access to health care for Latinos living in New Orleans.

Also, he is a research assistant to William Steinmann, director of the Tulane Center for Clinical Effectiveness and Prevention (TCCEP), which has a program for Latino health called Hispanic Organization of Physicians to Improve Health Outcomes (HOPTIHO).

"I realized that he really knew the Latino community better than anybody else around here," says Steinmann. "There's this enormous opportunity in New Orleans because no one has addressed Latino health needs here."

Antunez is in charge of the Latino health programs being developed through HOPTIHO, which includes partnerships with the Latino physicians at Tulane who want to do community health assessments and interventions. Antunez hopes he can continue to work on building the Latino outreach infrastructure in New Orleans after he receives his doctorate.

"His heart is almost too big. He is a lovely man," says Steinmann. "I am pleased to have him." Additionally, Steinmann notes that the Latino outreach work at TCCEP is resulting in a new model for medical and public health partnership as McDonald and others from the School of Public Health and Tropical Medicine continue to work closely with Antunez in developing community networks.

The TCCEP has submitted three grants to expand funding for its work, and has two more in the pipeline. The opportunities for cross-cultural and multidisciplinary training that arise from this work have inspired in Steinmann an integrated view of medical education.

Exposure to public health should be in the medical school curriculum at least as an elective, he says, and exposure to medical practice theory should be in the public health curriculum.

Tulane University, New Orleans, LA 70118 504-865-5000