Shirley “Bella” Borghi shares how long-term community partnerships, promotoras, and data-driven programs are changing health outcomes across Georgia.
At a recent regional meeting held by the American Cancer Society (ACS), Shirley “Bella” Borghi, who is the Executive Director of the Hispanic Health Coalition of Georgia (HHCGA), discussed how over thirty years of community work is improving cancer and chronic disease outcomes for Hispanic families in Georgia.
Founded 38 years ago by two nurse practitioners at Mercy Care, HHCGA began with a straightforward goal: reach Hispanic communities in Georgia who were not being served through traditional health systems.
That mission has grown from local outreach to a statewide and national presence, supported by universities, health systems, and community-based organizations.
During the COVID-19 pandemic, Georgia CEAL (a National Institutes of Health and U.S. Department of Health and Human Services initiative) was created to effectively serve communities that health systems were not.
Bella described Georgia CEAL as a coordinated effort that includes HHCGA, Emory, Morehouse, IRB partners, and clinicians throughout the state, all working alongside similar teams across the country and in Puerto Rico.
While CEAL began as an emergency public health response, its focus now extends to:
The core principle has remained the same: meet people where they are, rather than expecting them to come to hospitals or clinics.
Bella reminded attendees that there are approximately 63 million Hispanic residents in the United States, representing about 19% of the nation’s population.
In Georgia alone, over 1.1 million residents identify as Hispanic or Latino, and those numbers are growing.
These residents live across the state, from Savannah on the coast to communities near the Tennessee border.
HHCGA’s work must account for:
Many community members work in jobs that do not provide health benefits, which often means entire families lack coverage. Georgia’s decision not to expand Medicaid has widened gaps in access to preventive and specialty care.
These system-level limits intersect with transportation barriers, food insecurity, housing instability, and mental health stressors that show up in the data as higher risks and delayed diagnoses.
HHCGA’s approach centers on trust and cultural familiarity.
The coalition works with:
For up to six months at a time, HHCGA collaborates with university faculty to bring students into real-world environments. Students join HHCGA teams in neighborhoods, clinics, and community events, and this experience is paired with classroom learning.
This approach strengthens care for today’s families while preparing the next generation of clinicians to understand how language, culture, and trust shape health behaviors.
Bella also emphasized that “Spanish” is not a single, uniform language. You must adapt messaging for people with roots in Mexico, Peru, Venezuela, Colombia, and many other countries.
Medical terminology and health education materials need to be accurate and understandable, while avoiding jargon that feels like a scientific thesis.
Bella outlined several interconnected challenges that shape cancer and chronic disease outcomes for Hispanic communities in Georgia:
Fear surrounding immigration enforcement adds another layer of complexity. Even when services are available, some families hesitate to attend events or visit clinics.
To respond, HHCGA has increased its community presence, spending more time listening, explaining, and rebuilding trust.
For HHCGA, chronic disease and cancer programs are never separate from mental health. Bella explained that a serious diagnosis affects both the body and the mind.
To address this reality, HHCGA works with a team that includes neuroscientists and mental health experts who help design programs that integrate:
For cancers such as prostate and breast cancer, HHCGA uses a “buddy system” and family education. Men are encouraged to speak with other men about prostate health, and women can speak with other women about breast health.
Spouses, partners, and adult children receive information about how to support their loved ones and navigate care.
Bella also recalled a common experience in immigrant households:
children acting as translators for their elders at a very young age.
HHCGA works to change that pattern by educating older family members and improving access to trained interpreters so children can remain in age-appropriate roles.
Nutrition counseling is another area where cultural context matters.
Rather than asking families to abandon traditional foods, HHCGA and its partners focus on:
Participants see side-by-side comparisons of how much salt, sugar, and fat they can reduce with these changes. The goal is not to shame people about what they eat, but to show that they can maintain cultural dishes while protecting their health.
This work grounds itself in economic reality.
Many families cannot spend more on groceries, so recommendations must rely on ingredients they can already access and afford.
A technology backbone operated in partnership with Microsoft supports HHCGA’s programs.
This infrastructure allows the organization to:
Workshops, webinars, focus groups, and community events focus on topics such as diabetes, mental health, breast and cervical cancer, heart disease, and more.
On average, HHCGA leads at least six major events each month and brings mobile units, clinicians, promotoras, and other partners together in one place.
Through Georgia CEAL and related initiatives, HHCGA continues to coordinate with clinics, FQHCs, big-tech institutions, medical schools, and ACS partners.
In a recent year of the ACS Environment and Health (EH) program, HHCGA reached 11,000 people in Georgia in person, not counting social media and digital outreach.
The coalition serves on steering committees such as:
HHCGA has built a network that includes:
These efforts have been recognized nationally.
HHCGA and Bella have received a CDC and National AIM award for statewide excellence in immunization education and impact.
Bella closed her remarks by emphasizing that everyone in the room is an agent of change - from community organizations to academic institutions, health systems, and ACS staff and volunteers. HHCGA knows its primary focus is Hispanic communities in Georgia, but its partnerships extend to other racial and cultural groups facing similar barriers.
She used a simple image to describe how collaboration works:
HHCGA is prepared to “fly its own plane,” but is equally willing to sit in the jump seat or even coach on someone else’s flight when a partner needs support.
The goal is not who pilots the plane; the goal is whether communities reach safer, healthier ground.
For ACS and regional partners, the message was direct:
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