Date of Award

Spring 2023

Document Type

Open Access Thesis



First Advisor

John Doering-White

Second Advisor

David S. Simmons


This research engages with promotores de salud in South Carolina to examine sustainability challenges in their work to support Hispanic and Latino communities through advocacy-as-care approaches. This thesis contributes to scholarly literature on CHWs in the United States at a time when the profession is working to legitimize itself through professional advocacy, which includes the organization of state CHW associations, regional CHW networks, and the National Association of Community Health Workers (NACHW). Their work to support communities is, at times, made more difficult because of their positioning within formalized neoliberal systems of care, while also being marginalized by their lack of professional citizenship, or their membership as care workers. Previous ethnographic research has examined CHWs in places like Guatemala, Nicaragua, Ethiopia, and the state of Indiana. This research focuses on how medical citizenship, social determinants of health (SDOH), and moral economies of care giving—or how morals, societal evaluations of deservingness, and values influence interactions between different communities—have impacted the work of CHWs. I similarly employ these theoretical frameworks in my own analysis of promotores de salud in the Palmetto State: a location that has not been examined much in anthropological studies of CHWs. However, unlike these works, I focus specifically on Hispanic and Latino communities. Through an analysis of ethnographic field notes and semi-structured interviews, I examine the impacts of sustainability challenges that promotores de salud report encountering in their work in South Carolina, and I provide best practices for their continued professional support.


© 2023, Richard Lyle Strater

Available for download on Thursday, May 15, 2025

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