This article is part of a partnership between The Jersey Bee and Next City exploring segregation in Essex County, New Jersey, and the solutions to building a more just and equitable county and state.

When Ahuru immigrated to New Jersey from Peru, he didn’t expect to have so much trouble finding his HIV medication. He was uninsured, and most of the information he could find online was in English.

“It was really frustrating, and I was only [in the U.S.] for two weeks,” said Ahuru, who requested that his real name be omitted to protect his safety. He had not shared his sexual identity with family or friends yet.

It was only after he asked strangers on the LGBTQ+ dating app Grindr for help that he found a free clinic in nearby Newark. While no one at the clinic spoke fluent Spanish, the staff was able to see him and provide HIV medication that day.

Soon after, Ahuru learned about an opportunity to help other Latinx immigrants navigate reproductive and sexual health care as a promotora de salud, or community health worker, through the Abortion Justice Committee of New Jersey. Drawn to the opportunity to help others understand their medical rights, he spent the rest of the summer talking to more than 300 Latinx residents about abortion access in the state.

Based on an approach developed in Latin America in the 1960s, the promotoras model is a community health framework in which local residents serve as trusted messengers to collect insights and share information. In New Jersey, the Latino Action Network Foundation, a nonprofit advocacy group and proponent of the promotoras effort, said it has successfully implemented the model for outreach on census, school segregation, and redistricting within Latinx communities over the years.

In June, thanks to the work of advocates and promotoras like Ahuru, the group released the first-of-its-kind community survey on the state of reproductive health services for Latinx immigrants in New Jersey. 

The study — a collaboration between the Abortion Justice Committee of New Jersey, the Latino Action Network Foundation and Latina Civic Foundation — collected more than 730 responses from Latinx respondents residing in more than 70 towns or cities.

While New Jersey has some of the country’s most permissive laws on abortion, the study found nearly 70 percent of respondents did not know if abortion was legal in the state. 

Forty-two percent of respondents said it was hard or very hard to access reproductive health services in their area, and those who had lived in the United States for less than five years reported the highest difficulty rates in accessing services.

“There’s just a severe lack of understanding in general for immigrants about what their rights are, but in particular on this issue [of] abortion access,” said Kay Escobar, founder of the Abortion Justice Committee of New Jersey.

Escobar said that many immigrants, especially those who have recently arrived, are confused about the Supreme Court’s overturning of Roe v. Wade and mistake it as an abortion ban in all states. Low wages and immigration status only heighten Latinx immigrants’ barriers to exercise their medical rights even if they are aware of them, according to Escobar.

Lack of targeted messaging for Latinx and undocumented immigrants also restricts abortion access, said Jesselly De La Cruz, executive director of the Latino Action Network Foundation.

“A lot of community members feel off-put by the narrative [around reproductive health] because it’s not really culturally inclusive,” she said.

De La Cruz added that the study found that language about choosing to become a parent and bodily autonomy was more effective in breaking the stigma around abortion than just saying the word “abortion.”

Reproductive health care comprises a broad umbrella of care including cancer screenings, abortion care, STD testing, HIV screenings and more, but De La Cruz fears the lack of culturally sensitive messaging makes Latinx immigrants feel like accessing such services goes against their faith or is about politics.

Both experts point to the promotoras model as one of the most effective ways to make sure Latinx immigrants get the information they need — but say the state needs to step up its support for this population.

As New Jersey lags, a promising community-led model

Prior to the Supreme Court ruling overturning Roe v. Wade and ending the constitutional right to an abortion, New Jersey Gov. Phil Murphy signed the Freedom of Reproductive Choice Act in 2022 to protect the right to an abortion under state law.

But the coalition’s report suggests that these protections aren’t reaching Latinx residents in New Jersey, who comprise more than 20 percent of the state’s population. 

De La Cruz said that the state often “looks like [they] are doing things on the surface” but fails in its execution.

“When you really look at how [reproductive care] has been implemented, it’s not being accessible to everybody,” De La Cruz said. “That’s a chronic issue in New Jersey.” 

In January, Murphy signed into law a historic bill that would require agencies in the executive branch to translate “vital” agency documents into New Jersey’s seven most common languages, including Spanish, so residents can access health care, public benefits and other social services.

Eight months after the bill was signed into law, New Jersey’s Reproductive Health Information website is still only in English. The legislation states translations must be wrapped up by January 2025.

Nancy Kearny from the New Jersey Department of Health’s Office of Communications said the department has “begun the process to have the Reproductive Health Information Hub translated in Spanish.” However, no timeline was provided. 

“[New Jersey] looks blue… we look progressive, but when you’re really in the weeds of some of these policies, we’re continuously lagging, particularly [for] Latinos,” De La Cruz said.

In New Jersey, 3.5 percent of White residents are uninsured, compared to 8.3 percent of Black residents and 17.9 percent of Latinx residents, according to the New Jersey Institute for Social Justice. That means Latinx residents are over five times more likely to be uninsured than White residents.

With those coverage gaps, Escobar of the Abortion Justice Committee of New Jersey raised concerns about predatory practices from the state’s anti-abortion centers on undocumented Latinx residents. 

With more than 50 anti-abortion centers located across the state, the centers appear to be free reproductive health clinics but are often religious ministries that do not provide abortion care. While New Jersey does not provide any public funding for such centers, Jessica Moreno said they remain successful in providing misleading information.

“[Anti-abortion centers] use disinformation and emotional and religious manipulation to scare people or try to convince them into carrying a pregnancy to term, which may or may not be what that person actually wants,” said Moreno, a member of the Abortion Justice Committee.

In December 2022, New Jersey Attorney General Anthony Platkin issued a consumer alert on anti-abortion centers in December 2022, but Escobar and other advocates grew tired of waiting for legislative action.

During the summer of 2023, the collaborative trained 25 promotoras to interview more than 730 community members across New Jersey. On warm summer days, promotoras scattered across the state — at street fairs, food pantry lines, laundromats, and taquerias — to understand the challenges to reproductive health care. Following interviews, promotoras distributed more than 600 information pamphlets in Spanish warning residents about anti-abortion centers. 

What the promotoras heard offered a more nuanced take on the issue. While Latinx people are often characterized as religiously and politically conservative on abortion, the community-led survey shows more diverse perspectives from New Jersey’s Latinx community.

The study highlights that more than 43 percent of respondents thought abortion is acceptable in certain situations, such as “when there are health risks to the birthing person or as the result of sexual assault.”

Nicole, a promotora from New Brunswick, said community members often do not want to talk about abortion at first.

“But when we explained the subtleties [of why someone would have an abortion], they were much more open to supporting it,” said Nicole, who immigrated to New Jersey from Mexico one year ago and requested her name be changed to protect her privacy. “It could be someone [who was] raped or abused crossing the border.”

Nicole spoke to more than 100 residents, the majority of whom self-identified as immigrants. She said that overwhelmingly many respondents wanted accurate information from community health clinics. They just couldn’t find it, especially in Spanish.

“What you don’t find are trustworthy clinics where people can go, talk more, or get mental health [support] and make [informed] decisions,” Nicole said.

Ahuru also noted that people often think Latinx people are apathetic about their reproductive health. His conversations with more than 300 community members told a different story.

“Women want to get checked every six months, especially women who are sexually active. Men want to get condoms and information … even older women who are not sexually active are looking for pap smears,” Ahuru said.

Tailored solutions for a growing demographic

Expanding language access continues to rise to the top of the list of how to improve reproductive health care for Latinx immigrant communities, especially among recently arrived immigrants, according to the community survey. 

Escobar said that solutions like the promotoras model are key to access.

“We found [promotoras] to be one of the most effective ways of being able to communicate information and people’s rights,” they said. De La Cruz of the Latino Action Network Foundation added that government pilot funding for outreach programs like the promotoras model would be critical. 

“Latino communities are more engaged with grassroots outreach,” De La Cruz said. “Funding a promotora[s] model would bridge the gap in the reproductive health disparities that we found in our survey.”

In June, New Jersey state Sen. Teresa Ruiz introduced the Reproductive Freedom and Health Equity bill, a package that would require insurance and Medicaid to cover abortions, lower barriers for reproductive health providers, and expand health care access on college campuses in New Jersey. 

Ruiz said the bill could address “financial, informational, staffing and insurance barriers” — the same kind of barriers respondents shared in the promotoras survey. The bill passed through the Senate in June and was referred to the Assembly.

Escobar said their organization is also advocating for more regulations to curb the impact of anti-abortion centers. 

“We need to work hand in hand with policy institutions and policy attorneys to be able to figure out constitutionally permissible regulations that will not bump up against current Supreme Court precedent,” Escobar said.

Many of those solutions are already in motion at the community level, they added.

“Solutions are all here in front of us. It just takes work,” they said.

Read the full report on opinions on reproductive health care from the Latinx community in Spanish and English.