The Problem: Few health care providers understood the languages or cultures of the Asian immigrants settling in the San Francisco Bay Area in the 1970s. Patients needed to join together to advocate for the care they deserved.
Grantee Background: Sherry Hirota was in her teens when she gave birth, and not much older when she left her marriage. When the young single mother took her son for a school physical in 1976 to Asian Health Services, a free primary care clinic in Oakland, Calif., she had no health insurance and little income, like many of the clinic’s Asian American clients.
A friend mentioned that the clinic—just a storefront then, with a tiny staff—needed an office manager. Hirota thought the job might be a fit. Though she had left college after a year, she’d worked from 1972 to 1973 as a community organizer with the Asian Women’s Center in Los Angeles, and later as an administrative assistant in a Bay Area social services agency. “The clinic had a clear vision of how social services could be combined with community organizing to advocate for Asian health,” Hirota recalls. “My community organizing skills and background were a perfect match for what was happening.”
Founded in 1974, Asian Health Services was structured as a membership organization; all staff, volunteers and patients had voting rights regarding its operation. In 1977, the clinic called its first general meeting about important health care issues. Only one patient showed up—proof to some staff that patients weren’t interested in getting involved in their own care. “I said, ‘It’s not that they aren’t interested,” Hirota says. “‘It’s how you approach the organizing.’”
Before the second annual meeting, Hirota and staff personally invited patients during office visits and called to follow up. The strategy worked—100 patients attended, with more the following year.
As the group’s numbers grew, so did its powers for advocacy. In 1978, when California’s Proposition 13 threatened to cut off funding to community-based organizations, patients and staff demonstrated with members of other disenfranchised groups across the state to assert their right to health care. The clinic did not lose its funding, but it was a close call.
When Hirota became executive director of Asian Health Services in 1982, she made it her mission to integrate advocacy into the fabric of the organization. As the clinic grew to a comprehensive primary-care facility serving some 8,000 families, Hirota and staff continued to advocate for multilingual, multicultural health care at the local, state and national levels. “It’s not just about providing services,” Hirota says. “It’s about looking at the broader policy environment that impacts the lives of patients—doing the work ‘beyond the walls’ of the doctor’s office. It’s never over, because policy can change in an instant.”
In 1994, the Robert Wood Johnson Foundation designated Hirota a Community Health Leader, in recognition of her advocacy work on behalf of low-income, immigrant and limited English-speaking groups.
Results: In 1996, Hirota was named a founding board member of the California Endowment, a private health foundation that provides grants to community-based organizations in California. She believes that honor was due to the visibility the Community Health Leader’s award granted Asian Health Services’ model of integrating advocacy with affordable services. “The power of community and the power of organizing can get overlooked,” Hirota says. “Community Health Leaders invested in that model. That was really important at a time when people had dismissed it as a marginal thing, as not important.”
Hirota used part of the CHL award to buy headsets for simultaneous translation at the Asian Health Services’ annual meetings, which now draw some 500 patients speaking eight Asian languages, plus English. “It’s almost like the United Nations,” Hirota says. “The goal is to inform patients about major issues that affect their health and health care, as well as how to move forward and understand their rights under any given change in the law.” The elevated visibility granted by RWJF’s award eventually enabled Asian Health Services to buy its own high profile building in Oakland’s Chinatown neighborhood.
“We have a saying at Asian Health Services, that the measure of our success is not how many services we provide but how much our patients understand and assert their right to health care,” Hirota says. “To feel that I was able to be a voice for patients … that is fulfilling. That is why I do this.”
Today, Hirota not only continues to explore new ways of helping her center’s clients, but works with several other organizations, too. She is a founding board member of the Association of Asian Pacific Community Health Organizations (AAPCHO), a national coalition formed in 1987 that promotes advocacy, collaboration and leadership to improve the health status of Asian Americans. She has been honored by numerous organizations, including the California Wellness Foundation, the Alameda County Women’s Hall of Fame and her state assembly district.
Hirota is also a board member of the Chez Panisse Foundation, founded by food pioneer and activist Alice Waters in 1996 after her famous Berkeley restaurant, Chez Panisse. The Foundation has established model school programs that help students understand the impact of their food choices on their health and the health of their communities.
“Developing the next generation is important,” Hirota says of her work in and out of the clinic. “My contribution going forward in mentoring the next generation is to keep developing a very vibrant, community-based sector by focusing on the importance of coalitions, and building leadership and good management.”
RWJF Perspective: Since 1993, RWJF has recognized unsung and inspiring individuals who work in their communities—often among the most disenfranchised populations—to address some of the nation's most intractable health care problems. Formal recognition by the Foundation of these and their programs often launches them to greater levels of influence and extends their reach to serve more vulnerable populations.
RWJF provides a financial award to 10 individuals and their organizations each year, and connects the with one another so they can build their programs upon the wisdom and experience of their peers and previous award winners.
“Community Health Leaders are characterized by three specific traits—they are courageous, they are creative and they are committed,” says National Program Director Janice Ford Griffin. “The Foundation recognizes the tremendous resource of experiences among the Leaders and we look forward to mining that resource as we consider future initiatives.”