Can Cell Phones Improve Latinas’ Health?

This article was originally published on Colorlines. 

“Remember that your legal status does not matter. If your children are citizens, they can use public services like MediCal without affecting your residency process.”

“Instead of junk food, choose a healthy meal from your country. Eat cactus, chia seed or verdolagas to take advantage of all their benefits.”

“Nobody wants to get involved in problems, but if a friend’s husband hits her, tell her there is a way out. Give her the Marjaree Mason Center number, 559-237-4706.”

Every few days, text messages like these pop up on the phones of more than 1,000 women in Fresno County, in California’s Central Valley. The messages come in Spanish, alternately offering referrals for affordable healthcare and domestic violence services, legal tips and affirmations. Any resource offered via text has been vetted by a team of women behind the project, called Únete Latina, to confirm that providers there speak Spanish and won’t ask for a Social Security number.

Those are the conditions Latina immigrant women in Fresno need in order to feel safe taking care of their own and family members’ health, according to Alejandra Olguin. Since late last year, Olguin has led the project as a staffer at Youth Tech Health (YTH), an Oakland, Calif.-based organization that uses technology to educate young people about health. Long before setting up Únete Latina’s text blasts and mobile website, YTH showed up at free legal clinics where people learned how to apply for Deferred Action for Childhood Arrivals (DACA) and surveyed hundreds of women there as they waited for counsel related to immigration questions. The results pointed to the barriers of isolation and intimidation the project’s organizers would have to overcome.

“Immigrant women experience a palpable fear every single day,” Olguin told me via email from Oaxaca, Mex. “Whether it’s driving their children to school without a license or being asked for their Social Security number at a clinic, there’s fear about being involved in anything that seems ‘official,’ including our text messaging program.” Immigrants comprise nearly a quarter of Fresno’s population and two-thirds of those born outside the U.S. have come there from Mexico, drawn in part by agricultural jobs in this largely rural county. Nearly 40 percent of Latino immigrant adults in the county are undocumented.

Despite the skepticism someone might have around texting the word “unete” (which means “join us”) to a short code, women have signed up since the launch late last year. They’ve been encouraged by the dozen Fresno residents who have worked with Olguin and San Francisco’s Immigrant Legal Resource Center to design and run the project. But they’re also drawn by the low barrier to entry. One clear message that came out of the surveys YTH conducted was that the best way to reach people is through their cell phones.

Nationwide, Latinos have lower rates of access to broadband Internet at home than other racial and ethnic groups, and California is no exception. Just over half of Latinos in the state use broadband, compared to 71 percent of blacks, 75 percent of Asians and 81 percent of whites, according to the Public Policy Institute of California. Using a computer to get online is a particular challenge in the Central Valley. Just 60 percent of the region’s residents have broadband access at home, compared to 80 percent of Bay Area residents, 77 percent in Orange County and San Diego and 64 percent in Los Angeles.

Sasha Costanza-Chock, an assistant professor of civic media at MIT, is part of a growing movement of organizers and activists addressing this divide in digital access. In 2006, he began working with day laborers in Los Angeles and the Institute of Popular Education of Southern California to develop a cell phone-based journalism tool called VozMob (Mobile Voices/Voces Movíles).

“For low-income folks, particularly first-generation immigrants and especially Spanish-speaking recent immigrants from Mexico and Central America, their primary means of communication access is through a mobile device, and not necessarily an Internet-enabled one,” Costanza-Chock said.

YTH’s research in Fresno bears this out. Seventy percent of the women surveyed said they had access to the web on their phones and a data plan, compared to 90 percent who said they use text messaging. Cost plays a role as well: 84 percent said they had an unlimited texting plan, compared to just half who had an unlimited data plan.

The design of Únete Latina’s website makes it easy to search for health and legal services on a phone, but the texts—including the uplifting messages sprinkled among them—help build the rapport and trust needed to draw women to the resources. “It’s like these text messages come right at the moment you need them most,” one undocumented woman told YTH in a focus group. Another said, “I like the text messages that remind us that we are important, because if you don’t believe that you will just stay in your fear.” Four out of five women who received the texts say they intend to use the resources as well, according to Jamia Wilson, YTH’s executive director.

The sensitivity with which texts are written is also part of Únete Latina’s strategy to address high rates of intimate partner violence in the county. All of the 250 women YTH surveyed said they knew someone who experienced domestic violence. Experts have found that intimate partner violence is no more common in immigrant communities than among other groups, but getting help can be especially hard for women in Fresno.

“Undocumented women in particular are more vulnerable because of their immigration status,” said Kimberly Inez McGuire, director of public affairs at the National Latina Institute for Reproductive Health (NLIRH). “Abusers will often use a woman’s status against her as a tool of control and intimidation.”

The threat of being exposed to immigration officials, potential loss of a partner and co-parent to deportation and financial dependence are among the reasons women may stay in an abusive situation, says McGuire, whose organization lobbied to include provisions protecting immigrant survivors of domestic violence as part of the reauthorization of the Violence Against Women Act last year. 

Únete Latina’s approach has been to craft culturally relevant messages that will resonate with recipients, Olguin of YTH said via email. “Instead of asking, ‘Are you a victim of domestic violence? Call this number,’ we would say, ‘Did your husband drink too much over the weekend? You are not alone. There is an organization that can help you. Call this number. They speak Spanish and do not ask for your Social Security number.”

Wilson, YTH’s director, said the organization intends to expand the project into other parts of California, where a quarter of residents either don’t speak English well or at all, according to Census data.

“Even for Latinas who live in urban areas where there’s less isolation, language is a huge barrier,” said McGuire of NLIRH. “The likelihood of finding a provider who’s culturally competent, linguistically competent and with whom someone’s comfortable—It’s a tall order and many Latinas can’t find that.

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