Twin Citites Initiative Interprets the Impact of Welfare Reform on Access to Health Care

If you listen carefully, you'll hear the jangle of Spanish, Somali, Amharic, Oromo, Hmong and Khmer on the streets of Minnesota's Twin Cities. Yet there is little evidence of this diversity in the media, except on KFAI-FM. That's where new immigrants can tune in each week to restore the spirit: to find what a local editorial writer called "A familiar voice speaking in a familiar language addressing issues close to home."
To heal the body, they can turn to the Neighborhood Health Care Network (NHCN) and its multilingual staff, who provide culturally competent health care regardless of a patient's ability to pay.
Now, thanks to Sound Partners, KFAI and NHCN are working together, appealing to both mind and body to promote affordable health care options to communities they once approached separately. Both on and off the air, the partnership is addressing changes in Medicaid eligibility under the 1996 welfare reform bill, which hit low-income and new immigrants especially hard.
Interpreting the impact of these changes on access to health care is difficult in English. Language and cultural barriers exacerbate the task for clinic workers trying to explain how the new state and federal health care eligibility requirements apply to residents and non-resident aliens, mothers, children and the elderly. A combination of pride, fear and a lack of information can cause immigrants to delay seeking treatment until an illness or condition becomes serious or life-threatening. According to NHCN's community relations coordinator Jolee Mosher, explaining welfare reform is just part of the job. "Through the partnership, we want to encourage people to establish a relationship with a clinic to take advantage of preventive care and break their reliance on emergency services." A phone number announced during each one-hour program links listeners to NHCN.
The project matched established program hosts with frontline, bilingual clinic workers to produce live, call-in broadcasts. KFAI program director Michael Wassenaar says that since all the on-air presenters were volunteers, the station brought in veteran public radio journalist Dick Brooks to conduct a crash course in interviewing and story telling techniques to bolster on-air skills. The goal was to get the producers, whose shows feature mostly music, and the health care providers, all inexperienced public speakers, to "think creatively about the radio medium ... to add different flavor and different voices to the mix," says Brooks.
Each program was as individual as those taking part, says Wassenaar. Though the core message was the same, "a one-size-fits-all approach just wouldn't work," he stresses.
The unique histories of each group—Hispanic, Hmong, Cambodian, Ethiopian, Eritrean, Somali, Oromo and East Indian—as well as ethnic and language distinctions within them almost scuttled some of the programs, requiring sensitive negotiations to get them back on track, notes Wassenaar. For example, KFAI airs two weekly programs aimed at the sizeable Hmong population, one in each of its principal dialects. But because of the project, differences were bridged, and the producers of the two Hmong shows worked in tandem for the first time.
"People are hungry for information in their own language," says clinic nurse and novice broadcaster Norma Autesta. "From the calls on and after the programs, I realized how big a need there was for information in the Latino community. We come from countries where if you don't feel sick, you don't seek treatment. So people need to understand that it's better if they don't wait ... also that they will be treated no matter what their legal status ... and that they have a right to understand what they are being told."
"I expected callers to be shy," says Cambodian social worker Hoen Hach. "But I was surprised at how open people were to discussing everything from personal problems to husband-and-wife relations to how to discipline children—even the role of women in America!"
Though the Asian/East Indian community tends to be self-supporting, Sarjit Bains and Mukhtar Thakur, co-hosts of "Sangam," thought their listeners should understand the consequences of the welfare reform legislation. "The issues cut across status and income boundaries; it's not just for people at the bottom of the pile," says Bains.
"The shows worked because the weekly hosts already have the people's ears," says Stacey Taylor, who provided technical support for the live call-in broadcasts.
The programs tapped the language, norms and cultural cues of their respective target audiences to "build trust and reassure people that if they reach beyond their families or even their tight-knit communities, they'll find people and institutions to help," says Brooks.
In addition, observes Wassenaar, "the project improved cross-cultural communication," bringing together disparate groups who not only discovered common ground but also learned to appreciate one another's differences.

For more information, contact NHCN community relations coordinator Jolee Mosher at (651) 603-6081; or trainer Dick Brooks, Action Media, at (218) 327-2737.