The Valuable Contributions of Community Health Workers in American Health and Social Service Programs

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University of South Florida

Community health workers are members of America’s health and social services workforce who are uniquely poised to improve individual and community health and wellbeing. They typically come from the groups they serve, and thus may have strong ties to communities they work within and possess special understandings of the health challenges they face.

Community health workers can be employed by government health or social service agencies or by nonprofit organizations. They build individual and community capacity and self-sufficiency by engaging in community outreach and educational projects and by providing the people they serve with informal counseling, social support, and advocacy for their needs. Such workers usually share similar educational and economic backgrounds with the community members they serve, so their connections and backgrounds often set them apart from other professionals in the health and social services workforce.

Many social factors affect people’s health and access to appropriate services, including economic conditions, educational levels, transportation, and public safety in areas where they live. Such factors are especially important for marginalized groups of people such as immigrants, refugees, and those in living in poverty. Community health workers cannot correct all of these environmental conditions, but they can reach out effectively to hard to reach groups and connect them to health and social service organizations. Community health workers use their intimate knowledge of their own communities to build deep, trusting relationships that allow them to improve not only individual health outcomes for their clients but also the overall wellbeing of communities.

What Community Health Workers Do

Community health workers have been deployed utilized in the United States since the 1960s, but their roles have waxed and waned. Many states have integrated such workers into their healthcare workforces – and have given them a variety of roles:

  • Addressing the social factors that affect health Personalized and community specific outreach strategies are vital for improving access to health and social services. Community health workers are well-equipped to provide such outreach because they know their communities and the specific barriers that keep their clients from accessing health and social services. As they connect people to resources, these workers empower their clients to overcome barriers and take control of their own health and wellbeing.

  • Establishing a community presence – Community health workers are unique among other health and social service positions in that they spend they spend the majority of their days not in offices but out in their communities. They may go door-to-door, attend health fairs, or seek out local gathering places to create new relationships with people in need.

  • Improving health education – Community health workers improve key health outcomes by spreading basic information. As nonclinical workers, their work is primarily focused on educating people and can foster improvements in nutrition, chronic disease prevention, and chronic disease management.

  • Advocacy – Community health workers engage in advocacy on behalf of individuals and community needs. They can ensure forms are in languages other than English, work with town councils to make facilities more accessible to all people or increase resources for popular programs. They can work with local, state, and federal representatives on legislative solutions or public awareness campaigns. Although such advocacy efforts may not seem as closely tied to community health and wellbeing as the other functions these workers perform, these workers are often the first to encounter, identify, and push authorities to address the special problems and challenges they learn about in the course of working with their clients.

Proven Effectiveness

Research has documented the effectiveness of community health workers who improve nutrition, prenatal and maternal health, and a myriad of other health outcomes. Additionally, they help connect community members to social resources including housing, legal services, poverty supports, and food resources.

  • These workers are particularly effective at preventing costly chronic health problems and at helping clients manage existing chronic conditions to prevent further complications or the advancement of diseases. This matters because, according to a report from Centers for Disease Control and Prevention, “86 percent of the nation’s $2.7 trillion annual health care expenditures are for people with chronic and mental health conditions.”

  • Community health workers can not only save and improve people’s lives, but also reduce costs for state and health systems by improving health education and helping clients managing chronic conditions. Some states have even been able to reimburse the community health workers services through Medicaid and other funding streams.

Integrating Community Workers into Health and Social Services

Overall, community health workers address key gaps in the provision of health care and social services in the United States. They are uniquely effective members of the health and social services workforce and it is vital that policymakers, public health advocates, and others concerned about community health deploy them to improve public health through grassroots contacts with clients outside of clinics and hospitals.

Community health workers should be formally integrated into the healthcare workforce, and people hired into these valuable jobs should include both full-time and part-time workers with stable employment and adequate benefits. As community outreach jobs are designed, steps should be taken to ensure that responsibilities are not defined in narrowly medical ways. These jobs must include space for those who hold them to engage with people in the community and do advocacy on their behalf as appropriate. Community health workers, ideally, should serve as distinct members of interdisciplinary teams – to fill gaps, build bridges, and increase access for everyone in the communities they represent and serve.