HERSHEY, Pa. — When she met Cristel Woodcock, tears welled up in Maria Hernandez’s eyes. They’d found one another just in time.

Maria and her daughter, Jaileah, had moved to Harrisburg from El Salvador six months earlier. Jaileah has cerebral palsy and needs constant care. Maria has to spend so much time looking after her, she said, that finding work has been impossible. During the school year, Jaileah brings home food she obtains through a Pennsylvania-run school lunch program, which gives them enough to live on.

But when summer arrives, the family has to improvise, so Maria walks to local food banks for sustenance. At one nearby pantry, she said, she was treated so rudely she felt she couldn’t return. So, on this day in early August, she walked into Brethren Community Ministries on Hummel Street to give BCMPeace a try.

By 9:30 a.m., her Allison Hill neighbors were already clustering into the waiting room near the church sanctuary and trying to align themselves with breezes from a box fan positioned to tamp down the already sweltering temperatures. Like Maria, many in the gathering crowd spoke only Spanish.

While waiting in line, she went to the table marked United Way and struck up a conversation with the young woman with the empathetic smile.

It turned out to be transformative. Woodcock is the Contact to Care Community Health Worker for Penn State Health. For residents in this neighborhood, Woodcock is the face of the partnership between Penn State Health and United Way of the Capital Region’s Contact to Care program.

Woodcock connects people with what they need. She helps them find medical, dental and vision care. She also nudges them in the direction of other United Way programs that can help them find work, food and shelter.

“We find people who fall through the cracks,” she said.

Maria and Jaileah were teetering on the edge of one. They’d attempted to get health insurance but were denied. Now the care they depended on from another local clinic was threatened.

Enter a community health worker.

‘They’re a conduit’

Community health workers like Woodcock cover the front lines of Penn State Health’s grassroots efforts to extend mental health, health equity and wellness and disease prevention to people in need in the region it serves.

A 2021 survey of six counties from which Penn State Health serves patients found that:

• Almost half of all respondents can’t afford health insurance, and a quarter are ineligible for employer-paid coverage.
• Between 8% and 11% of all respondents reported limited access to healthy foods.
• Forty-two percent reported being told they have high blood pressure, and 39% had high cholesterol.

Language, socioeconomic and geographic barriers prevent many local residents from accessing health care or even simply buying fruits and vegetables for their families. That’s where community health workers come in. Throughout the region, they plant community gardens, connect patients with care and even help figure out rides to doctor’s offices.

“They’re a conduit,” said Ashley Visco, community health director at Penn State Health. “Community health workers are part of their communities and provide a vital connection between resources and the people who need them most. Every day, they’re bringing Penn State Health to the people who can’t get to Penn State Health.”

Veggies and strolls

In Berks County, community health workers are the driving force behind two outreach programs.

They help organize and bring walkers to Walk with a Doc, a national effort to connect doctors with their communities. For 12 weeks every summer since 2020, a different doctor from Penn State Health St. Joseph Medical Center takes a 2- to 3-mile stroll through a local park with a growing group of people from the neighborhood. During the winter of 2022, the group partnered with the GoggleWorks Center for the Arts, which operates out of a tall building on Washington Street in Reading. The walkers rode the elevator to the top floor and then made their walk through the building to the bottom floor.

Usually, local residents pick a topic — something like heart disease or diabetes. The doctor — sometimes it’s a dietician or other health expert ― shares their expertise during the walk.

Many of the participants don’t speak English, and that’s one of many ways community health worker Madeline Bermudez comes in handy.  

Not only does Bermudez live close by — she’s from Lititz — she’s also a fixture in the Hispanic community and speaks Spanish. She draws from personal experience. Bermudez knows what it’s like to be Hispanic and have family members struggling with health needs in an English-language dominated culture.

“We’re really very fortunate to have her on the team,” said Monica Rush, director of rehabilitation and downtown services and community and wellness initiatives at St. Joseph Medical Center.

Bermudez is also well-acquainted with how hard it is to find healthy food in a food desert, which is what makes her invaluable to another Berks County community outreach program, Veggie Rx. Launched in 2018, the program rewards local people who have diabetes for taking a class about healthy eating and fitness with vouchers they can use to purchase only fruits and vegetables for themselves and their families. The program is nationally recognized for lowering hemoglobin A1C levels among its participants by significant percentages, Rush said.

Bermudez serves as a teacher for some of the classes and is also one of the program’s biggest cheerleaders. Community health workers like her are often the most adept communicators for getting out the word about programs like Veggie Rx.

But community health workers do more than just teach and advertise, Rush said. Participants sometimes come to Veggie Rx with other complaints. Maybe they’re having trouble paying an electric bill or can’t catch a ride to see an out-of-the-way doctor. Bermudez has the right connections and phone numbers and can help knock down language barriers.

“They are advocates for our patients to make sure [the patients] they are aware of all the resources that are available to them in the community,” Rush said.

A connection

Woodcock meets community members like Hernandez at places like BCMPEACE and listens to their challenges. The same morning she met Hernandez, another man dropped by her table. He pulled a card from his wallet and showed it to her. Woodcock grinned. Her voice rose, and her hands fluttered as she spoke to him in Spanish.

He’d been unable obtain health insurance, she said. Woodcock had invited him to the office she keeps at Centro Hispano in Harrisburg and helped him fill out the proper forms. The card was the man’s new insurance card.

The connection with someone who speaks the language and knows the culture can often be profound, Woodcock said. She was born and raised in Guatemala City. Her parents still live there, but in 2011 she moved to the U.S. with her husband, who is from Washington state originally. In her home country, she worked as a care coordinator at an oncology clinic. When the couple moved to central Pennsylvania two years ago, she saw the Penn State Health job opening and thought, why not?

As Maria waited to collect some food for her daughter, she and Woodcock made arrangements to meet later to help get Jaileah the care she needs at a Penn State Health facility.

As they spoke, tears began to scald Maria’s eyes. She reached out and grasped Woodcock’s hand. For a moment they looked like two sisters who’d found one another.

“I lived in El Salvador,” Woodcock said.

Helping families overcome disparities in health care is part of the Penn State Health strategy to improve wellness and disease prevention. Learn more in the Penn State Health Community Health Needs Assessment and Implementation Plan.