Improving Health Equity: The Promising Role of Community Health Workers in Canada

Abstract

This article reports findings from an applied case study of collaboration between a community-based organization staffed by community health workers/multicultural health brokers (CHWs/MCHBs) serving immigrants and refugees and a local public health unit in Alberta, Canada. In this study, we explored the challenges, successes and unrealized potential of CHWs/MCHBs in facilitating culturally responsive access to healthcare and other social services for new immigrants and refugees. We suggest that health equity for marginalized populations such as new immigrants and refugees could be improved by increasing the role of CHWs in population health programs in Canada. Furthermore, we propose that recognition by health and social care agencies and institutions of CHWs/MCHBs, and the role they play in such programs, has the potential to transform the way we deliver healthcare services and address health equity challenges. Such recognition would also benefit CHWs and the populations they serve. Résumé Cet article fait état des résultats d'une étude de cas sur la collaboration entre une organisation communautaire qui emploie des travailleurs en santé communautaire (TSC) et des courtiers en santé multiculturelle (CSM) pour desservir des populations immigrantes et de réfugiées ainsi qu'une unité locale de santé publique en Alberta, Canada. Dans cette étude, nous avons exploré les défis, les succès et le potentiel non réalisé des TSC et des CSM pour faciliter l' accès aux services de santé et autres services sociaux par les nouveaux immigrants et les réfugiés. Nous estimons qu'il est possible d' améliorer l' égalité en matière de santé pour les populations marginalisées telles que les nouveaux immigrants et les réfugiés, et ce, en accroissant le rôle des TSC dans les programmes liés à la santé des populations au Canada. De plus, nous croyons que si les agences et institutions de santé et de services sociaux reconnaissent les TSC et les CSM, ainsi que leur rôle dans de tels programmes, cela pourrait transformer la façon de fournir les services de santé et de traiter les défis en matière d' égalité. Une telle reconnaissance serait aussi avantageuse pour les TSC et les populations qu'ils desservent.

Understanding behavioural changes through community-based participatory research to promote oral health in socially disadvantaged neighbourhoods in Southern Sweden

“…As members of the community, they also had deep knowledge and experience of the common problems faced by these communities particularly in relation to access to healthcare. 43 Oral health was one of the challenge areas identified by the community and addressed among the activities initiated as a part of the larger project. This was considered a priority area since dental caries was on the rise in families with young children.…”

Addressing refugee health through evidence-based policies: a case study

“…Torres et al used multiple evaluation strategies to evaluate the effectiveness of community health works (CHW) employed by a service provider organization compared to independent CHW. They used direct observation, in-depth interviews, analysis of policy documents and quantitative analysis of a caseload database [58]. This method allowed identification of nuances as well as evaluation [58].…”

“…They used direct observation, in-depth interviews, analysis of policy documents and quantitative analysis of a caseload database [58]. This method allowed identification of nuances as well as evaluation [58]. The Australian Changing Cultures project used mixed methods evaluation including routinely collected data, group interviews with refugees and staff, program audits and observation of management meetings [45].…”

Development and evaluation of a physical activity intervention informed by participatory research- a feasibility study

“…The health promotional activities are coordinated by representatives from the locality, often known as community health workers or multicultural health brokers or gatekeepers in an international context [37], but in Swedish context they were known as health promoters. The health promoters were among the citizens who were part of the initial future workshop who expressed their interest in assisting the research team and being change agents for their community.…”

“…In addition, they have in-depth knowledge and experience of the issues faced by these communities in accessing health and services, and are likely to offer culturally appropriate support to the research project. Previous research indicates that individuals who share a similar background with the target groups are better able to respond to the health needs of these subgroups [37].…”