Department of Health community health workers: greatest potential for improving population health

CHWs are quickly recognized as essential to improving population healthwhere health services are redirecting their focus as they strive to implement the strategies set out in the Public Health 3.0 model.

Community health workers (CHWs) are a generic term this to understand community health representatives, promotions, outreach educators, community health representatives, peer health promoters, and peer health educators, among other titles. Typically, an ASC is defined as someone who has a close relationship with the community they serve, enabling them to act as a link between health/social services and the community to help build the individual and the community ability (the ability of all members of the community, including the poorest and most disadvantaged, to develop knowledge, skills and abilities and to have greater control over their lives). One of the ways CHWs build individual and community capacity is by working to improve social determinants of health (SDH) and equity within the community. SDOH are the environmental conditions in which people are born, live, learn, work, play, worship, and age that affect their health, functioning, risks, and quality of life. They are often grouped into five domains: (1) economic stability, (2) access and quality of education, (3) access and quality of health care, (4) neighborhood and community. built environment, and (5) social and community context. Equity is the recognition that each person has different circumstances and needs and involves meeting communities and their members where they are, allocating resources and opportunities to achieve equal results for all members of the community.

CHWs are quickly recognized as essential to improving population healthwhere health services are redirecting their focus as they strive to implement the strategies set out in the Public Health 3.0 model. Evidence dramatically increases the value of interventions focused on population health outcomes conducted by CHWs (from approximately 15 studies from 1964-1973 to almost 600 studies from 2014-2016). Here are some notable search results:

  • CHW interventions are more often effective than alternatives.
  • CHW interventions are more cost-effective for the management of certain chronic conditions in underserved communities.
  • CHW interventions have a high return on investment.

Therefore, as local and state health departments consider strategies to address population health, they should consider hiring CHWs as part of their workforce. Since May 2021, the US Bureau of Labor Statistics estimates that there are approximately 61,000 CHWs across the United States. Data from the Public Health Workforce Interest Needs Survey (PH WINS) found that only about 1,000 CHWs currently work in national and local health departments (about 2% of the total public health workforce). While both of these are likely underestimated, the data still demonstrates the need for a larger CHW workforce in the United States and within state and local health departments in particular. Additionally, an increased number of CHWs within the workforce can improve the diversity of the public health workforce, as they are often indigenous to the communities in which they work and the communities served are often historically marginalized and in the minority. populations. Together, these strategies can enable public health agencies to implement targeted approaches in needed communities, create systems to meet community needs, provide more effective solutions to address health disparities , create more innovative public health approaches and facilitate improvements in overall public health. results.

When considering hiring CHWs within health services, here are some key considerations:

  • Learn more about CSAs on the national and At the state level.
  • Get to know your States CHW laws and education model.
  • Use previously created tools and reports to understand the impact CHWs could have in the community your agency serves.
    • This data should drive conversations with agency decision makers about how best to integrate CHWs into your agency.
  • Integrate mental health and burnout prevention measures for your staff, especially for CHWs.
    • CHWs are at high risk of burnout due to the same traumas and challenges as the community they serve, increasing the number of staff turnover. Mitigating burnout can increase retention and therefore the impact of CHWs on the community.
  • To recruit the most effective CHWs, consider non-traditional ways such as advertising in community settings (eg, churches, hair salons, community groups, recreation centers) and using word-of-mouth strategies (eg, speaking with associations or groups CHWs, community and religious leaders), in addition to routes (e.g. Indeed).
    • Consider placing more emphasis on a candidate’s life experience than education, as the former will likely increase their ability to connect and have meaningful impacts on priority populations. Sometimes the person with the least skills traditionally on paper can have the best relationship with the community.
  • When hiring, ensure equity is built into the entire position, starting with a living wage. CHW employment is an investment in the community and one way to increase potential success is to provide CHWs with the support they need from day one.

Author profile

Chelsey Kirkland

Chelsey Kirkland, PhD (c), MPH, CHW (she/she) is a research fellow at the Center for Public Health Systems at the University of Minnesota, School of Public. While there, she collaborated on numerous national mixed-methods research projects aimed at supporting and strengthening the public health workforce. Her experience spans a variety of public health issues including health equity, health disparities, social determinants of health, community health workers and physical activity. When she’s not working, she enjoys being outside with her family and her two dogs. His favorite activities are running, water skiing and playing the violin.

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