Community Health Workers Can Be a Public Health Force for Change in the United States: Three Actions for a New Paradigm

Abstract

Community health workers (CHWs) have gained increased visibility in the United States. We discuss how to strengthen the role of CHWs to enable them to become collaborative leaders in dramatically changing health care from “sickness care” systems to ones that provide comprehensive care for individuals and families and support community and tribal wellness. We recommend drawing on the full spectrum of CHWs’ roles so that they can make optimal contributions to health systems and the building of community capacity for health and wellness. We also urge that CHWs be integrated into ”community health teams” as part of “medical homes” and that evaluation frameworks be improved to better measure community wellness and systems change.

The Impact of State Certification of Community Health Workers on Team Climate Among Registered Nurses in the United States

“…Because CHWs are from the community, they are thought to possess a greater degree of homophily with many community members than do other health care professionals with more education or who do not share cultural backgrounds. Moreover, CHWs often speak local languages and dialects, allowing them to communicate more effectively, and they have a better understanding of cultural norms and values [5][6][7][8][9].…”

Assessing the Value of Patient Navigation for Completing Cancer Screening

“…Both of these barriers seem to be giving way. The Affordable Care Act defines a future health care system that is more patient centered, that delivers evidence-based interventions more effectively, and that is more accountable for population health outcomes; and research such as that published in this issue of CEBP will help to define the value of patient navigators within our health care system (1,2).…”

Society of Behavioral Medicine (SBM) position statement: SBM supports increased efforts to integrate community health workers into the patient-centered medical home

“…There are numerous opportunities for CHWs to support and enhance primary care [2], and integration could be facilitated by (1) establishing standards that ensure a skilled CHW workforce, (2) clearly defining roles for CHWs, and (3) expanding the scope of reimbursable prevention and primary care services to include those provided by CHWs. SBM supports specific actions that would promote sustained development of a well-qualified CHW workforce, consensus on how to best integrate CHWs in a PCMH team, and compensation guidelines that are transparent and equitable.…”