A quarter of a mile northeast of the University of Houston in the historic Third Ward sits Houston’s oldest and largest public housing complex. On this day in January, a man stands on the side of the street behind a folding table piled high with a bounty of fruit—pineapples, bananas, grapes—earning a little cash in a place short on fresh produce and money. Down the road, a police car sits on patrol across from several abandoned houses. Cuney Homes has more than 500 apartments and, as one resident put it, “The daily struggle is real.”

On the outside of the community center is a freshly painted mural depicting African-American leaders. Local kids helped design it. On the inside is another kind of transformation. Alongside UH students, Cuney residents are learning to become leaders in community health. This is where the UH Honors College holds its innovative Community Health Worker Training and Certification Program, marking a new partnership between UH and the Houston Housing Authority (HHA). In 2015, the HHA received a $3 million grant from the U.S. Department of Housing and Urban Development’s Jobs-Plus Program to help Cuney residents earn more and become self-sufficient.

Community health workers (CHWs) often live in the neighborhoods they serve, helping to disseminate health care information and motivate patients to manage chronic health issues while connecting them to available resources. According to program instructor and Honors College professor Dan Price, these frontline workers can change the landscape of health care by reducing cultural and socio-economic obstacles and becoming a bridge between doctors and patients. Price calls it “leadership from the middle.”

“A lot of the problems that doctors have with reaching some patients effectively stem from cultural misunderstandings. Community health workers are the voices that can make the translation between an expert system that seems foreign and unnecessary and people—the patients—who actually need to understand that medical expertise,” said Price. “Having the workers embedded in the community is really the genius of the model, because it fills the gaps.”

Single mother Timica Sanchez, 33, started taking the free class when it was first offered in fall 2016 but didn’t finish after giving birth to her fifth child. Now she’s back to finish what she started.

“One thing I know about life, through all my struggles, is it’s a learning experience. It’s not going to be easy, but I’m up for the challenge,” Sanchez said.

She just landed her first job in more than a year as a cashier but needs a second job to make ends meet. The median income for a CHW in Houston is $30,000 a year. “I already connect friends and neighbors to resources all the time, so why not get paid for it?”

Nour Haikal, a UH freshman from Richmond, Texas, was inspired to take the course for a different reason. Her parents immigrated from Syria 30 years ago. Now the 18-year-old pre-law liberal studies major helps local Syrian refugees navigate their health needs.

“I’m Syrian myself, so I know what it feels like to be judged and unwanted because you’re different. I can relate to how some of the Cuney residents may feel,” said Haikal. “Hearing them talk about what they’ve been through opens your mind and really humbles you.”

Communication between groups from such diverse socio-economic backgrounds has its challenges. Some Cuney residents—many of whom are in the process of getting or already have a GED—were admittedly intimidated about going back to school side-by-side with high-performing college students. One resident was so afraid of being judged for poor spelling that she didn’t do her part of a group assignment, which left some students upset. After realizing the importance of the project and the value of teamwork, enough trust was finally established and everyone was able to contribute.

“I love that people come from different walks of life, because it teaches you. We can really learn from each other,” said resident Deerica Cormier, a single mother of two boys who also has several relatives battling illnesses, including HIV and lung cancer.

Doctors, clinics and insurance companies often hire CHWs to address chronic care needs, including asthma management, diabetes, check-ins with the elderly and even home inspections for mold and lead.

Armed with a vision of working with the city to create a community health worker network of hundreds, Price believes it could be “transformative” if they can change the way people think about health care.

“If people start taking responsibility for their care differently, with a lot more self-management, that means less people go to the hospital for unnecessary treatment, and the cost for the entire system goes down,” he said.

In addition, they encourage class participants to become advocates and activists in the civic realm.

“To be able to share what’s going on in their communities with public office holders and elected leaders will change the conversation,” said program instructor Erica Fletcher, a UH graduate and Honors College visiting assistant professor.

UH students don’t receive any course credit for completing the program. After 160 hours of training, students and residents alike receive community health certifications from the state. While UH sociology major Dane Hall has no plans to work as a CHW, the experience is invaluable for his future career plans.

“It’s important to know what’s happening on the ground and how community health workers operate, because they’re going to play a larger role in how health care and social change is enacted in Houston,” said Hall, who is planning a career in public policy.

Change. That’s what Timica Sanchez is trying to accomplish by taking the class. “This opportunity given to us by the University of Houston could be life-changing for me and my family. I’m excited—speechless.”