Community health workers deliver essential public health services, meeting people where they are. (Photo credit: Rebecca Drobis)
Health systems are constantly adapting to epidemiological, political, and socioeconomic influences on population health, driving them to be more culturally competent and interpersonal in meeting community needs. This warrants leadership from the front line, especially among those with deep ties to their communities. Increased investments in community health workers (CHWs) can help to bridge gaps in access to care and strengthen the public health workforce.
What Makes Community Health Workers Unique
CHWs are frontline public health workers who are trusted members of their communities, serving as a crucial link between health and social services to provide social support, system navigation, health coaching, and advocacy.
They reflect the multicultural communities that health systems aim to serve, representing a range of races, ethnicities, and age groups. It is through their diversity of backgrounds and experiences that CHWs can foster an inclusive environment to help all people feel welcomed, respected, and empowered in health and social care programming.
This makes CHWs highly effective and compassionate in addressing racism, health inequities, and other injustices encountered by certain populations, as many CHWs share life experiences with the people they serve.
Their position within communities supports systems by delivering essential public health services such as:
- Assessing and monitoring population health
- Providing culturally appropriate health education and information
- Facilitating local partnerships
- Conducting outreach
- Participating in evaluation and research efforts
Expanding the Use of Community Health Workers Through Partnerships
As trusted advisors who share many of their communities’ issues, CHWs can bolster the public health workforce by expanding the capacity of health and social service agencies through adjacent work in partnership with trusted agencies. Strategic partnerships within and among agencies that upskill and sustain CHWs may also help to address persistent gaps in funding.
System leaders can develop and support workforce development initiatives that embrace CHWs in public health and community settings by:
- Developing sustainable non-degree career pathways for public health workers who lack skills and competencies in public health practice
- Supporting bridge programs that aim to increase access to care in underserved communities by hiring trained CHWs with lived experience
- Establishing traditional and nontraditional partnerships to upskill and sustain CHWs
One example is Morehouse School of Medicine, whose CHW training program teaches high school students and young adults how to interface with families, peers, and community members in underserved areas. This program was the first in the U.S. to train high schoolers as CHWs in skills ranging from cultural competency to community engagement to service coordination. The curriculum also offers shadowing opportunities, self-guided activities, and interactive sessions led by public health and health care professionals.
Students in the program have emphasized its value, as many seek advanced pathways to support communities in addressing challenges often burdened by health inequities. Students also reported increased proficiency in providing essential services such as motivational interviewing, basic screenings, and goal setting to help community members achieve optimal health.
Another example is the Mecklenburg County Public Health Department and Care Ring partnership, which employs CHWs to address maternal and child health disparities by connecting women to health care and other supportive services through the A Guided Journey program. This program enhances CHWs’ skills by providing specialized training on specific knowledge, techniques, and resources for supporting new and expecting families during the perinatal period.
Program participants have commended CHWs in providing community resources, advocating for individual and family needs, and facilitating coaching and social support to access essential public health services. As of 2024, the program has served approximately 1,400 women and families over three years with tracked improvements in access to care.
Investing in CHWs succeeds when system leaders acknowledge their skills and abilities to build equitable and thriving communities. Developing pathways and partnerships for CHWs to advance within systems is not only sustainable but proven to enhance public health efficiency and cultural competency when addressing health equity.
