What Community Health Workers Do
Community Health Workers (CHWs) are frontline health advocates working with underserved groups that traditionally lack access to care. While the health care system increasingly struggles to meet the needs of patients and communities, CHWs have filled the role of advocate and a bridge between the community and health system. Health system challenges are exacerbated by the adverse influence of social determinants of health on the ability of the individual and community to seek and maintain good health. Additionally, health disparities often impact an individual’s ability to connect to and utilize the health system, which also impacts a person’s ability to achieve positive health outcomes. As health care costs continue to rise, insurance companies, employers, and the government are searching for methods to improve the quality of health care and health outcomes, while at the same time reducing costs. The CHW model is an important component of broader initiatives that aim to help communities understand and identify ways to assist residents to live healthy lives.
For the first time since the 1930s, the per capita number of physicians is projected to drop, increasing disparities in access to care. Estimates suggest that the United States will see severe shortages in health care professionals over the next 20 years. According to the Association of American Medical Colleges (AAMC), the nation will have a shortage of 91,500 doctors by 2020, with a shortfall of more than 60,000 primary care providers and 31,000 specialists (Association of American Medical Colleges, 2008; Dill & Salsberg, 2008; Newton & Grayson, 2003). Similar shortages are predicted in STEM (Science, Technology, Engineering, and Mathematics) professions (Building Engineering and Science Talent, 2003), many of which support health care through discovery and innovation. One new and innovative approach to reducing the impact of physician shortages is the use of CHWs. Community Health Workers are uniquely trained to facilitate access, improve knowledge, and engagement of the health care system, and are an important part of the comprehensive health care team.
Community Health Workers and the Healthcare System
Community Health Workers are a critical part of the future health care system. Through their training, expertise, and knowledge of the community, they will fill the gaps within the system that no other profession can currently fulfill.
The Affordable Care Act directly states that chronic diseases should be diminished and public health improved (Title IV). Many of the services mentioned within this section can be directly impacted and enhanced by usage of CHWs. More specifically, the Affordable Care Act identifies preventive services and services which slow the progression of chronic disease as services, which initiated by a licensed provider can, in fact, be provided by a CHW.
Many other states have already incorporated CHWs into the health care system through hospitals, physician’s offices, and other community based organizations, and have begun to realize the fiscal benefits of Medicaid reimbursement for CHW services. This comprehensive inclusion of CHWs into all health areas has shown a dramatic decrease in emergency room usage, decreased health care costs, and overall improved health.
“I found myself in 2011 diagnosed with breast cancer and went through that whole ordeal, not knowing anything, having no support. As a librarian, one of the things we do is we bring information to people. So, I felt like [being a CHW to provide information] was a calling for me. I think people relate to you more when they know that you’ve kind of gone down that journey.”
A local librarian who also is in training to become a Community Health Worker