After Sarai Hernandez-Ramirez had her son Brian two years ago, her mother expected her to quit school and stay home to care for him. But staff who run the Aqui para Ti program at Hennepin East Lake Clinic want Sarai back in school.
Aqui para Ti, or Here for You, is located near 27th Avenue and East Lake Street in Minneapolis. The program provides medical services to 11- to 24-year-olds, including physical exams, pregnancy tests, vaccines, mental health services and more.
The program is for Latino teens and its mission is to eliminate the differences in health between Latinos and white residents of Minnesota.
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For example, Latina teens in Minnesota have the highest birth rate among the state’s ethnic groups – 99.6 births per 1,000 girls 15 to 19 years old, according to the Minnesota Department of Health. This compares to 16 per 1,000 Caucasian teen girls.
“There is a big need for multi-culturally and linguistically appropriate services,” said Rosemarie Rodriguez, the Latino health coordinator in the state Office of Minority and Multicultural Health.
That office funds Aqui para Ti through the Eliminating Health Disparities Initiative, a state effort to improve the health of minorities by funding community-based programs.
The reason the program exists, Hurtado said, is so that Latino parents know where to find help. And because the staff members are all Latino immigrants, they understand what the parents are going through.
“By empowering community-based organizations to develop health improvement strategies built on cultural and community strengths, community members will be more likely to be reached, engaged, and impacted,” according to a report about the initiative.
Sarai Hernandez-Ramirez with her son Brian
Veronica Svetaz, the doctor on staff, wanted to start a program focused on youth ages 11-24 because of a survey of patients done at West Side Community Health Services, where she used to work. The two biggest needs were help with back pain, and raising teens.
Because of the absence of the tightly knit community left behind, some Latino families have a harder time raising teens, said Manuel Sanchez-Mejorada, a social worker at the clinic.
The Latino population has gone from 101 in 1990 to almost 900 people in 2000 in the Corcoran neighborhood where Aqui Para Ti is located, according to the U.S. Census Bureau.
Sanchez-Mejorada, who emigrated from Mexico, said in some small towns, the entire community helps raise kids. After moving to a place where everyone is a stranger that support can disappear. Parents can feel “immobilized,” he said.
Sarai, who goes by Sara, said she started going to Aqui para Ti “because I liked their advice and the way they were able to understand, and they are always trying to help in what ever way they can.”
Teen Age Medical Services, or TAMS, referred Sara to Aqui para Ti when she became pregnant because of its specialty in treating Latino teens. Aqui para Ti sees about 150 patients a year, and since 2002, about 880 youth patients total, said Hurtado.
The first visit, patients have a two-hour appointment and are given a questionnaire with about 90 questions.
“We look at what’s going on in school, what’s going on at home, we try to engage the family as much as possible,” Monica Hurtado, the program’s health educator, explained.
“Adolescence is … a special stage in the life of all human beings, but having that change … in your life, and at the same time the transition to adjust to a new culture, a new system, is challenging,” said Mónica Hurtado, a clinic health educator.
When the program started in 2002, care was largely preventative: providing vaccines, telling youth to wear a helmet when biking and advocating the use of birth control. Teen patients wanted other services.
“Because of their requests we have changed a lot. Mental health became the most important part of what we do,” Hurtado said.
The staff advocated safe sex to young Latinos like Sara because they were medical professionals, and reducing teen pregnancy is a big goal in American medicine.
Then Hurtado had a 16 year-old patient who stopped coming because she became pregnant and was happy about it. Another teen girl went to the clinic because she was worried she was infertile after she failed to get pregnant. Both of these girls made the Aqui para Ti staff change their thinking.
The staff understood the different attitude toward teen pregnancy because they are immigrants too.
“Not to say that [Latino families] are happy that a 13- or 14-year-old girl is pregnant, but it’s not the same,” Hurtado explained.
Sanchez-Mejorada agreed. “Motherhood, in Latino culture, there is a huge value attached to it. A whole new status is given to the girl who becomes pregnant and has a kid.”
There are some big differences between health care in the U.S. and Latin American countries that can affect Latino immigrants’ perspectives.
“(In Mexico) if you have money you can go to a hospital,” the young mother said. “If you don’t have money you can’t.”
She emigrated from Mexico about 11 years ago and now lives in Minneapolis.
Another big difference is the confidentiality rights minors have here. When Hurtado lived in Columbia about 10 years ago, for example, minors wouldn’t have been able to have a confidential visit with a doctor.
Hernandez-Ramirez has been a patient at Aqui para Ti for more than two years. Her mother thinks she goes to the clinic to get check-ups, or because she’s sick, but really she goes for counseling. And no one from the program would ever tell her mother why she really goes.
Through counseling, she has learned to think of herself first, she said.
“You have to think about yourself first, and everyone else after, because people are never going to be happy with what you do,” she said.
Her mother doesn’t want her to go back to school, she said. In her mother’s culture, if a woman has a child, she stays home with him or her.
But because of the staff at Aqui para Ti asking her when she’s going back to school, she plans on returning to South High School to earn the few remaining credits she needs to graduate.
“I think they’ve helped a lot,” Sanchez-Mejorada said. “I use a lot of the advice they’ve given me. They’re always here when I need them, even if I don’t have an appointment.”