IVAN MORENODENVER (AP) ¿ It has all the hallmarks of the beloved telenovela: Heart-wrenching dialogue. Doors slamming amid tears. Over-the-top theatrics. But the titillating story lines are laced with medical advice. An expecting but bickering couple is encouraged to seek prenatal care. The uncle of a boy injured in a car wreck caused by a drunk teenager learns about state-funded health insurance. A character who doesn't like her figure gets some advice from a health care adviser: Stop eating so many tamales. The telenovela was created by Colorado officials to spread important health messages to Latinos, taking themes that normally would be the realm of public service announcements and packaging them in a format that is hugely popular in Latin America. "It's a soap opera. So it's got the teenager who has some substance abuse issues. We have a family who is undocumented, and we talk about what their options are. We're seeing these characters develop. It's not a boring public service announcement," said Joanne Lindsay, a spokeswoman with the Colorado Department of Health Care Policy and Financing, which administers health care programs for low-income families.
"Encrucijada: Sin Salud No Hay Nada," or "Crossroads: Without Health, There Is Nothing," follows the lives of four health information workers and focuses on issues that affect every demographic, such as alcohol abuse and depression, and others that affect Latinos at disproportionally high rates, like diabetes and lack of insurance. Viewers are encouraged to call a toll-free number if they face the same issues the characters do on the show. "Encrucijada" has a small but devoted following in Colorado ¿ about 17,500 households tune in each month, according to the Colorado Health Foundation. The foundation has spent $966,000 to produce and air the show. Filmed in Southern California, its stars include Roberto Medina, whose credits include "21 Grams" and "Frida," and Socorro Bonilla, a veteran of Spanish soaps. Viewership is comparable to local ratings for the Spanish-language version of "Desperate Housewives," said Jesus Fuentes, who wrote "Encrucijada." That's one reason producers are moving "Encrucijada" from a monthly time-slot to weekly this Sunday. In the first episode, a young woman known as "La Chiquis," a nickname given to daughters who share their mothers' name, gets drunk at a party and insists on driving home. A man at the party persuades her to let him drive her home. On the way, she tries to wrestle the steering wheel from him and they collide with another vehicle, injuring a boy.
A doctor tells them the boy suffered fractured ribs but, luckily for him, he qualifies for Child Health Plan Plus, a state program for uninsured children and pregnant women who can't afford private insurance but earn too much to qualify for Medicaid. Lindsay said most people in Colorado who are eligible for public health insurance are Latino but are "very hard to reach." Some 62 percent of Colorado children who qualify for the program and Medicaid are Latino. Almost 20 percent of Colorado's estimated 4.8 million residents are Latino. About 40 percent of the state's adult Latinos don't have health care coverage, more than any other ethnic group, according to the Colorado Department of Public Health and Environment. Latino children ages 2 to 14 have the state's highest obesity rate at 24.1 percent. Almost 37 percent of Latino women older than 40 did not have a mammogram from 2004 to 2007, also the highest rate among any other group in the state. And Colorado Latinos have the highest mortality rate for diabetes at 45 percent, compared to 29.2 percent for blacks, the state's second highest rate. Language barriers are sometimes a factor. Other times, it's trying to navigate a complex and unfamiliar health system. "Some of them come from very small communities where they would get sick and just go to the town doctor," said Mauricio Palacio, director of the state department's Office of Health Disparities.
A fear of deportation also prevents illegal immigrants from seeking help, said Palacio, who was an adviser for "Encrucijada." About 800 people have called the hot line for help since "Encrucijada" first aired in May. One of them was Regina Amador, an uninsured "Encrucijada" devotee who cleans offices for a living in Denver. After watching the show, Amador, 40, applied to get her 7-year-old son enrolled in Plan Plus. Call center advisers also told her she could go to a neighborhood clinic to get a Pap smear and a physical for $20. Amador, a native of Mexico's Guerrero state, hadn't had a checkup for about 10 years. "When you hear people talking about health, you start to worry about not having insurance," she said. "Now that they've checked me for everything, I feel more calm." While the telenovela has Colorado-specific information, health officials in New Mexico, Texas and other states have expressed interest, Lindsay said. Some who have tried the format before report success. In 2003, students at the University of Alabama at Birmingham produced a radio series called "Bodylove," featuring characters working at a beauty salon of the same name. "Bodylove" targeted African Americans, and its health themes were those the state health department said affect blacks the most ¿ hypertension, heart disease, diabetes.
A survey of "Bodylove" listeners found they had changed their eating habits because of the show, which featured a character going into a diabetic coma, said Connie Kohler, an associate professor at the university's health behavior department. Each 30-minute episode airs on Denver's Univision affiliate, operated by Entravision Communications Corp., based in Santa Monica, Calif. Smith said it cost about $150,000 to promote "Encrucijada" on TV and radio, a sum paid in part by Entravision, which also provides free air time. "They're really behind this thing," Smith said. "Sure, they're happy to have the money, but they're also committed to community health."