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- Health Affairs (February 2020)Evidence-Based Community Health Worker Program Addresses Unmet Social Needs and Generates Positive Return on Investment
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Community Health Workers
Community health workers (CHWs) are frontline public health workers with a close understanding of the communities they serve.1 CHWs usually share ethnicity, language, socioeconomic status, and life experiences with community members.2 This community knowledge enables CHWs to serve as highly effective liaisons between health services, social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.3
Ultimately, the goal of a CHW is to improve access to health and social services, address unmet health and health-related social needs and reduce the need for emergency and specialty services.4 A CHWs’ potential to connect with community members on a more personal level facilitates the effective provision of services such as care coordination and home-based health support services, as well as links to other social services and supports. For this reason, CHWs play an especially crucial role in making health more equitable for populations experiencing disproportionately poorer health outcomes.5
Under best case scenarios, the roles and activities of community health workers are tailored to meet the unique needs of their communities. Roles that CHW’s may perform include but are not limited to:6
- Creating connections between vulnerable populations and health care systems.
- Facilitate health care and social service system navigation.
- Manage medical care and care transitions for vulnerable populations.
- Determine eligibility and enrolling individuals into health coverage.
- Increase cultural competency among health care professionals serving vulnerable populations.
- Educate health providers and stakeholders about community health needs.
- Provide culturally appropriate health education on topics related to chronic disease prevention, physical activity and nutrition.
- Advocate for underserved individuals to receive appropriate services.
- Collect data and relay information to policymakers to inform policy change and development.
- Provide informal counseling, health screenings and referrals.
Current research supports investing in CHWs as part of an interdisciplinary care team by documenting how their role reduces costs and improves health outcomes.7 Innovative health systems, like Hennepin County Medical Center, Camden Coalition of Healthcare Providers, University of Pennsylvania Health System, and Molina Healthcare, are increasingly integrating CHWs as full and, often, lead members of their care teams.
Resources for Advocates include:
Community Catalyst, Trusted Voices: The Role of Community Health Workers in Health System Transformation, which highlights the role community health workers can play in health care delivery, identifies possible means of funding and includes potential partnerships for involving community health workers in health system transformation.8
Families USA launched the Community Health Worker Sustainability Collaborative to expand the use of community health workers. The Collaborative promotes strategies for securing sustainable funding for CHW programs and better integrating CHWs into the health care system.9
The goals of this collaborative are to:10
- Raise awareness among health care advocates, providers, and policymakers of the value of CHWs for increasing prevention, improving outcomes, reducing disparities and bending the health care cost curve.
- Create and disseminate educational resources that highlight successful CHW models, viable pathways for sustainable funding and other best practices.
- Partner with advocates and other stakeholders to advance sustainable funding for CHWs.
The National Academy for State Health Policy has an interactive map that highlights state activity to integrate CHWs into evolving health care systems in key areas, such as financing, education, training, certification, and state-level roles and scope of practice.11 The map includes state laws regarding community health workers and provides links to state CHW associations and other leading organizations working on CHW issues in states.
The National Heart, Lung and Blood Institute has created an education campaign called the Community Health Worker Health Disparities Initiative with the goal to promote heart health in the community. The educational materials provided by the initiative are designed to be taught by CHW’s, who are trained to use the materials for educating the community.12
Notes
1. Community Catalyst, Trusted Voices: The Role of Community Health Workers in Health System Transformation, Washington, D.C. (2015).
2. National Heart, Lung and Blood Institute, Role of Community Health Workers, (June 2014).
3. http://www.nejm.org/doi/pdf/10.1056/NEJMp1502569 and/orhttp://www.commonwealthfund.org/publications/newsletters/transforming-care/2015/december/in-focus and/or http://www.mass.gov/eohhs/docs/dph/com-health/com-health-workers/achieving-the-triple-aim.pdf
4. National Heart, Lung and Blood Institute, Role of Community Health Workers, (June 2014)
5. Community Catalyst, Trusted Voices: The Role of Community Health Workers in Health System Transformation, Washington, D.C. (2015).
6. Rural Health Information Hub, Roles of Community Health Workers, https://www.ruralhealthinfo.org/community-health/community-health-workers/1/roles (accessed October 2, 2017).
7. Rural Health Information Hub, Roles of Community Health Workers, https://www.ruralhealthinfo.org/community-health/community-health-workers/1/roles (accessed October 2, 2017).
8. Community Catalyst, Trusted Voices: The Role of Community Health Workers in Health System Transformation, Washington, D.C. (2015).
9. Families USA, Expanding the Use of Community Health Workers, http://familiesusa.org/c-h-w (accessed October 2, 2017).
10. NASHP, State Community Health Worker Models, http://nashp.org/state-community-health-worker-models/ (accessed October 26, 2017).
11. Ibid.
12. National Heart, Lung and Blood Institute, Role of Community Health Workers, (June 2014).
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