The Six Pillars

1 – CHWS ARE A UNIQUE WORKFORCE

Community Health Workers (CHWs) are a one-of-a-kind group of public health workers. CHWs as a profession have a designated workforce classification by the US Department of Labor, and are recognized health professionals by the ACA. When the COVID-19 pandemic began, the US Department of Homeland Security deemed CHWs essential and critical infrastructure workers. With a unique set of core competencies recognized by local, state, and federal governmental organizations, CHWs are an underappreciated yet crucial workforce that promote social justice and help to achieve health equity and wellbeing for all.

2 – CHWS ARE A COMMUNITY-BASED WORKFORCE

Grounded in and committed to community advocacy, CHWs build relationships with those around them and help build treatment capacity in underserved areas. Trust, respect, and dignity for all human beings are core values among CHWs, and these public health workers are central to efforts to address clinical and community integration and the social determinants of health. CHW Networks and Associations help train and mobilize CHWs and provide support for local communities, from low-income city neighborhoods to remote rural villages, tribal nations, and territories.

3 – CHWS ARE A HISTORIC AND DIVERSE WORKFORCE

The history of CHWs goes back hundreds of years in the US. They’ve been here since the very beginning, in the form of tribal healers, and today are known by many different titles — community health representatives, promotoras, aunties, peers, outreach workers, and many others. As a reflection of the country they call home, they are diverse in ethnicity, language, and culture — the majority of CHWs are female people of color. These health workers have lived experience and cultural alignment, and deal with similar issues and suffer from many of the same chronic conditions as their ancestors, which makes them uniquely qualified to tackle community-based health problems.

4 – CHWS ARE A CROSS-SECTOR WORKFORCE

CHWs reduce barriers to healthcare and build capacity in underserved communities, helping their communities achieve optimal health and wellbeing. The social determinants of health are of particular interest to CHWs — they approach health with a holistic philosophy, considering socioeconomic and cultural factors in their attempt to achieve true health equity. CHWs establish formal and informal networks in local contexts and beyond to better leverage their collective strength and to serve their communities to the best of their abilities.

5 – CHWS ARE A PROVEN WORKFORCE

In terms of effectiveness, CHWs have proven how integral they are to clinical, public health, and social systems. 60 years worth of evidence of their effectiveness has been acquired through the study of CHWs in maternal and child health, chronic disease interventions, immunization, oral health, HIV, primary care, and many other disciplines. The results are clear: CHWs play a crucial role in societal healthcare efforts, as documented in countless randomized control trials, systematic reviews, and ROI studies of CHW interventions. In recent years, CHWs have increasingly been recognized for their contributions to addressing racial equity and the social determinants of health – by connecting individuals to basic needs and by organizing communities to address inequitable social conditions.

6 – CHWS ARE A PRECARIOUS WORKFORCE

As a majority-female workforce, CHWs face similar challenges to other female-dominated fields. They are among the lowest paid public health professionals, and frontline community work exposes them to communicable diseases, violence, and other forms of secondary trauma. Exacerbating these issues are an inconsistent professional identity and lackluster state and national-level legislation. Given the field’s issues, it’s not surprising that the CHW profession lacks sustainability in many areas such as recruitment, training, legislation, professional development, career ladders, and financing.