7 Aug, 2024
National CHW Awareness Week: Celebrating CHWs
CHW Education, CHW News, CHWs

Community Health Workers (CHWs) are vital in improving health outcomes, particularly for underserved populations. These frontline public health workers bridge gaps between communities and healthcare systems, offering resources, support, and advocacy. National CHW Awareness Week, hosted by the National Association of Community Health Workers (NACHW), will be held from August 26th to August 30th. This is an opportunity to recognize and support the crucial work CHWs do. In this blog post, we will explore the history of CHWs, their roles and responsibilities, the importance of recognizing and supporting them, CHWs and the Triple Aim framework, and advocacy efforts that benefit CHWs.

 

What is a Community Health Worker?

According to the American Public Health Association, CHWs are frontline public health workers who are trusted members of and/or has a uniquely close understanding of the community served ¹. CHWs provide culturally competent health education, direct services, care coordination, and social support, and have many other roles and responsibilities ². CHWs work in various settings, including community-based organizations, health departments, clinics, and hospitals. Their deep community ties and cultural awareness make them invaluable assets in addressing health disparities and improving public health outcomes.

The History of Community Health Workers 

CHWs have a long, global history rooted in traditional practices. From the 1950s to the 1970s, informal healers such as shamans, elders, and sobadores began receiving training to better serve their communities. ³ Around the world, programs emerged to meet the needs of underserved populations: Russia’s feldshers provided care in rural areas, China’s “barefoot doctors” filled gaps left by providers, and Latin America’s Promotores de Salud advocated for the health and rights of their communities. ³

In the United States, the Black Panther Party opened free health clinics, showcasing CHW functionality by recruiting doctors as volunteers, promoting sickle cell screening, and demonstrating health as a social justice issue ⁴. Key studies, such as the 1998 National Community Health Advisor Study and the 2007 HRSA National Workforce Study highlighted the importance of CHWs and has since then led to the Bureau of Labor Statistics assigning an occupational code to CHWs in the 2010 consensus ⁵,⁶.

In 2016, the CHW Core Consensus Project (C3 Project) further defined CHW roles and responsibilities, helping to professionalize and bring recognition to the field ⁷. By 2019, the establishment of the National Association of Community Health Workers (NACHW) marked a new chapter by uniting CHWs across the U.S and advancing their role in promoting health equity.

Roles and Responsibilities of CHWs

The roles and responsibilities of CHWs are diverse and essential. According to the C3 Project, CHWs perform ten core roles. This includes cultural mediation, culturally competent health education, care coordination, coaching and social support, and advocacy. CHWs also build individual and community capacity, provide direct services, implement individual and community assessments, conduct outreach, and participate in evaluation and research ⁷.

Given their comprehensive skill set and critical contributions, CHWs are positioned to be the future of public health. Their ability to bridge gaps in healthcare access and address social determinants of health makes them indispensable in advancing health equity and reducing healthcare costs.

For a more detailed exploration of how CHWs are shaping the future of public health and to understand their roles and responsibilities further, we encourage you to read our in-depth blog post here. Additionally, you can gain a foundational understanding of CHWs by watching our “CHWs 101” webinar recording. This webinar thoroughly introduces the impactful work CHWs do and their significance in our health care system.

Importance of Recognizing and Supporting CHWs

Recognizing and supporting CHWs are crucial for several reasons. They serve underserved communities as frontline public health workers and advocates, especially during crises where social determinants of health are magnified ⁸. CHWs provide culturally appropriate care, serve populations with limited English proficiency, and assist rural populations, resulting in significant healthcare savings ⁹.

CHWs act as a bridge within communities, leveraging their lived experiences to communicate effectively by advocating for underserved populations ¹⁰. Studies have shown that CHW interventions improve post-hospital outcomes, enhance chronic disease management, and increase cancer screening rates among patients with low socioeconomic status ¹¹.

Triple Aim Framework

The Triple Aim Framework, developed by the Institute for Healthcare Improvement (IHI), aims to improve health, reduce healthcare costs, and enhance care quality. CHWs are instrumental in achieving these goals by addressing social determinants of health, promoting preventative care, and connecting individuals to necessary services ¹². Programs involving CHWs have demonstrated a positive return on investment, with savings ranging from $1.09 to $3.16 for every dollar invested ¹³,¹⁴.

Promoting Advocacy Efforts for CHWs

Advocacy efforts are essential to address challenges faced by the CHW workforce. Challenges such as: role recognition, integration into the healthcare system, sustainable funding, and standardized training negatively impact the CHW workforce. Policies should be developed to support CHWs, including competitive compensation, standardized curriculums, and common research standards ¹⁵.

Collaboration between CHWs and subject matter experts on topics such as health service delivery models and public health policy can enhance workforce standards. Policies regarding CHW standards and credentialing should involve CHWs in policy development workgroups and governing boards to ensure diverse representation and minimal barriers ¹⁶.

Community Health Workers are indispensable in bridging gaps and improving public health outcomes. National CHW Awareness Week is a time to celebrate and support their contributions. By understanding their history, roles, and the importance of recognizing and supporting them, we can better advocate for policies and initiatives that empower CHWs to continue their essential work.

Call-to-Action!

Join us in celebrating National CHW Awareness Week by sharing this blog post and recognizing the vital role of CHWs in Mecklenburg County communities. For more information on how to support and advocate for CHWs, download our CHW Workforce Awareness Toolkit, follow us on LinkedIn, and share our blog!

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References

  1. American Public Health Association (APHA). (n.d.). CHW definition. 
  2. CHW Core Consensus Project (C3 Project). Roles and Responsibilities.
  3. Perry, H. B., Zulliger, R., & Rogers, M. M. (2014). Community health workers in low-, middle-, and high-income countries: An overview of their history, recent evolution, and current effectiveness. *Annual Review of Public Health*, *35*(1), 399-421. https://doi.org/10.1146/annurev-publhealth-032013-182354
  4. Rosenthal, E. L., & Brownstein, J. N. (2016). Community health workers: Part of the solution. *Health Affairs Blog*. https://doi.org/10.1377/forefront.20160721.055738
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  7. U.S. Bureau of Labor Statistics. (2024). Occupational outlook handbook: Community health workers. https://www.bls.gov/ooh/community-and-social-service/community-health-workers.htm
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  9. Peretz, P. J., Islam, N., & Matiz, L. A. (2020). Community health workers and Covid-19 — Addressing social determinants of health in times of crisis and beyond. *New England Journal of Medicine*, *383*(19), e108. https://doi.org/10.1056/NEJMp2022641
  10. CMS Office of Minority Health. (2021). Improving access to care through innovative partnerships. https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/community-health-workers
  11. Hernández-Salinas, A., Pérez-González, R., & González-Carrillo, M. (2022). The role of community health workers in health equity: Perspectives from the field. *Health Promotion Practice*, *23*(2), 224-234. https://doi.org/10.1177/15248399211034639
  12. Kangovi, S., Mitra, N., Grande, D., White, M. L., McCollum, S., & Sellman, J. (2014). Evidence-based community health worker program addresses unmet social needs and generates positive return on investment. *Health Affairs*, *33*(11), 2109-2117. https://doi.org/10.1377/hlthaff.2013.1297 
  13. Kim, K., Choi, J. S., Choi, E., Nieman, C. L., Joo, J. H., Lin, F. R., … & Han, H. R. (2016). Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: A systematic review. *American Journal of Public Health*, *106*(4), e3-e28. https://doi.org/10.2105/AJPH.2015.302987
  14. Massachusetts Department of Public Health. (2015). Community health worker program survey report. 
  15. Kangovi, S., Grande, D., Trinh-Shevrin, C., & Mitra, N. (2020). Evidence-based community health worker program: A blueprint for achieving health equity. *Journal of General Internal Medicine*, *35*(1), 1-8. https://doi.org/10.1007/s11606-019-05397-1 
  16. MHP Salud. (2023). Community health worker core competencies. https://mhpsalud.org/
  17. American Public Health Association (APHA). (2009). Community health workers: Key to a healthy future. 
  18. American Public Health Association (APHA). (2014). Support for community health workers to increase health access and reduce health inequities.