Throughout our communities, many people need guidance to access services and resources that help improve their overall well-being. Oftentimes, a Community Health Worker (CHW) bridges the gap by assisting members of their community and advancing health equity.
The American Public Health Association (APHA) defines a CHW as “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.”
In 2022, the U.S. Department of Health and Human Services (HHS) announced $225.5 million in funding to launch CHW training programs as part of the American Rescue Plan. The goal is to increase the number of community health workers who play a critical role in connecting people to care with a particular focus on chronic disease care. With funding through Iowa HHS and through a partnership with Iowa Chronic Care Consortium, HealthTeamWorks, Des Moines Area Community College, the University of Iowa Institute for Public Health Practice, and Iowa Workforce Development, a CHW Registered Apprenticeship Certification and a CHW Professional Skills Training Certification Program were launched in spring 2023.
Over several years, I have supported efforts to elevate the critical role of CHWs in our community through opportunities, including adapting a curriculum and serving as lead facilitator for the CHW certification program and developing content and facilitating an asynchronous CHW Professional Skills Certification. Most recently, I have connected this work with an issue I’ve passionately strived to address through my HealthConnect Fellowship: heart health.
Heart disease is the number one cause of death in America, with disparities in rates for African Americans. Here is how I believe CHWs can be a critical part of promoting prevention and early intervention methods that ultimately will lead to equitable health outcomes with heart health.
Oftentimes, a CHW is recruited from the community in which they live. This is beneficial because there is an understanding of the community, culture, language, and social norms. In addition, there may be a level of trust already established with the community. When relationships are already built, CHWs have more opportunities to share information and educate community members.
A CHW who is familiar with a particular population may know about the common dietary options, physical activity locations, and someone’s family health history to help develop care management plans that are tailored to each person and the community environment in which they live. The connection allows individuals and the community to feel more comfortable and more open to learn about changes to help improve their heart health and overall wellness.
People within communities may not be aware of their risk of heart disease or the steps to help improve their heart health. The CHW can bring more awareness through community outreach. A CHW can meet one-on-one, host group sessions, go directly into neighborhoods, or invite the community to a designated location to share information.
One of the best defense strategies is prevention through a strong public health system. CHWs can also bring more awareness to the importance of heart health during the intake process at health care appointments or when people access other services. The intake process allows the CHW to identify the needs of the individuals, learn their family history, and overall health. This step helps with determining any risk of heart disease, which opens up the discussion for quality referrals.
CHWs are a great resource to educate about the risk of heart disease. A CHW can be trained to offer workshops and webinars to discuss topics, such as hypertension (high blood pressure), stroke, signs and symptoms of heart disease, and postpartum preeclampsia – all health issues that are tied to heart health. Offering educational materials in the form of booklets, flyers, or websites may be helpful to provide more information about a person’s risk of heart disease. Demonstrating how to meal prep or manage medications are ways to show people in communities how to live healthier.
If the CHWs scope of practice includes home visits, they can learn more about each person and their family. Taking time to listen and learn can help a CHW work directly with people to determine the next best steps to address their needs.
Navigating the health care system can be a challenge for some people. Identifying resources that are available within a community may be difficult for others. Not everyone knows the steps to take, which can prevent them from accessing services. This is when a CHW can help by knowing who to speak to, the location and the criteria to access services. Many CHWs have partnerships with multiple organizations, clinics, pharmacies, and agencies that offer direct services for heart health. Oftentimes the agencies are listed in a resource guide that may be used by the CHW and the community.
When the needs of the community are beyond the scope of practice of the CHW, a referral can be made. Many CHWs are part of a multidisciplinary team of professionals, which is beneficial to identifying which services a person needs. The CHW can make a referral to a cardiologist or cardiovascular genetic counselor if they see concerns.
Through community partnerships, the CHW can make quality referrals, identifying the right referral at the right time to the right person. Through relationships with those they serve, they can also make referrals to services that a person wants and needs.
Through established relationships, trust may already be built between the CHW and the community that help people make informed decisions about their health and wellness to prevent heart disease. Early detection and diagnosis may also prevent severe complications or help identify treatments to manage conditions.
Supporting the work of CHWs to help reduce heart disease can save lives.
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