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A guide through difficult times: Community health worker helps people access services

Jessica Martinez looks at a necklace belonging to Darlene Subialka of Cloquet. Clint Austin / caustin@duluthnews.com1 / 3
Jessica Martinez of Duluth with Community Action Duluth talks to Anthony Smith Jr., 6, of Cloquet during the Fond du Lac Health Fair at the Ojibwe School in Cloquet on Thursday. Clint Austin / caustin@duluthnews.com2 / 3
Jessica Martinez with Community Action Duluth jokes with people at a booth near her during the Fond du Lac Health Fair at the Ojibwe School in Cloquet on Thursday. Clint Austin / caustin@duluthnews.com3 / 3

There were children, adults and walking veggies during Thursday's health fair at the Fond du Lac Ojibwe School. Jessica Martinez noted someone dressed as a blueberry. "I want a picture with the carrot," she said with a smile.

Along with Caitlin Vander Wal, Martinez manned the Community Action Duluth table, promoting the agency's programs and upcoming farmers' markets in Lincoln Park and Central Hillside.

You can get $4 worth of fresh goods, she said to Anthony Smith, 6. "What are you going to buy, cucumbers?"

Martinez is a community health worker at CAD. Her job includes outreach on nutrition and local services, but it's also often "on the fringes." That means getting a call from someone who's panicked, going with a client to a doctor's appointment or the food pantry, reaching out to a health insurance company.

The system can be hard to navigate, and we expect people to know how to do those things, Martinez said. Add acute anxiety or depression, and nine times out of 10, a person in need may not reach out. Despite whatever is holding them back, her job is about making it happen, and her goal is to create a safe space for people to receive care, she said.

Community health workers help navigate health care systems and the social determinants of health, such as housing, employment, food access and education, said Mary Rapps, executive director of Generations Health Care Initiatives in Duluth.

That's giving assistance if there's a language or cultural barrier, or if a person is uncomfortable in a certain setting because of past trauma. They also follow up with clients on health care directives from physicians.

"They can provide a bridge for folks that are falling through the cracks, for folks that haven't been able to get their needs fully met. It's a holistic approach to a person's health," Rapps said.

These positions don't replace the work of care coordinators in the clinic; they're another member of the team. "They can be a great asset as we try to figure out how to improve our city and understanding at that next level," Rapps said.

In 2014, Rapps' organization launched an effort to research the role of community health workers, and available federal funding. There are now positions at Rural Aids Action Network (RAAN), Public Health & Human Services, Duluth Community School Collaborative, and Essentia Health West Duluth clinic.

The position is newer in the world of medicine and Community Action Duluth, said Sarah Priest, director of outreach, communications and development. Along with the agency's health coach, Priest sees Martinez's role as complementary to their services like BikePlus, employment or finance classes, GED preparation.

Martinez understands the community perspective, and: "She's really bubbly, which describes her all the time. Good energy," Priest said.

Sitting in Martinez's space in the shared office, she offered an egg roll from her lunch. On another visit, almond milk and cookies. During the health fair, she pointed to another table's rhubarb water. She's animated, she talks with her hands. Her head nods back when she laughs.

Martinez moved to Duluth from Milwaukee almost a year ago, and she had strong first impressions. "There's a spirit of 'Let's create equality among different people,'" she said, noting the Clayton Jackson McGhie Memorial and jingle dress dancer mural on the exterior wall of the American Indian Community Housing Organization.

Martinez knew her calling was in community health care when she worked as a case manager for people with special needs. "It's all about equality of life, accessibility, knowledge — supporting somebody in the small ways, so they can make the big steps," she said.

In her work in Duluth, many clients have co-occurring conditions, and homelessness and dental care are big issues.

"If you're homeless and you're diabetic, where do you keep your storage? What if you're homeless and you're taking injections for insulin. Where do you store that, where do you keep your needles, how do you get your refills? Because you need to have an address," she said.

Martinez can help a client navigate housing, and assist or suggest other social services in or outside CAD.

A regular week is based on the needs of the people, Martinez said. Her life is in her calendar with meetings of public hearings, doctor's appointments, transportation engagements.

With her clients, the agreement is that their work be collaborative.

"I'm not here to be your cheerleader; I'm here to be your support. I'm not here to be the decision-maker, I'm here to help you find your direction, to decide what that is, and to go in that direction," she said.

Her first meeting is explaining the nature of the relationship, the second is digging into the client's goals. It's important to let the client lead because their goals coincide with their willingness to accept help.

A lot of her job is building relationships, and it's all about knowing whom you're serving, she said.

It's significant help that doesn't always come in big increments. "It's along the lines of, 'I feel so much better after being here. ... 'I feel it's not as bad as I thought,'" she said.

Martinez tries to leave work at work, but it can be difficult. "I struggle a lot to figure out how to trust that the Creator's going to take care of that person and let it go." What helps is prayer, laying out tobacco — and she's taken up golf.

Her tips for the field are listen with your heart, set aside expectations, let people change.

"And know there's going to be heartache because we care," she said.

Connecting with a person can change how they feel about their lives, and that's an act that Martinez takes seriously, along with her role.

"We get to be the segue, we get to be the conduit to change," she said. "Community health workers, they don't give up, but they just patiently wait."

Melinda Lavine

Lavine is a features and health reporter for the Duluth News Tribune. 

(218) 723-5346