Health Equity: Trusted Messengers in the Community

By Terrell Richardson, MSW & Kelcy Walker Pope, PhD

For decades, communities across the United States have benefited from the expertise of Community Health Workers (CHWs).  Previously known as lay health advisors, peer health educators among many other titles, CHWs have garnered more attention over the past few years, particularly during one of the world’s most notorious pandemic…the coronavirus.  Oftentimes, the work and impact of CHWs is overlooked yet this seasoned profession helps bring resources to communities and individuals, who may not be aware of where or how to access what is needed.  Many CHWs share similar experiences with members of their community and thus know how to relate and build relationships.

The Connector

A voice for the underserved, CHWs advocate for historically marginalized communities such as African Americans, Hispanic/Latinx, Native American, and others.  Community Health Workers are trusted messengers who are equipped with knowledge and resources to assist residents with health care concerns, health education, and questions.  CHWs serve as a bridge to connect members of the community to services and programs to meet their needs.  CHWs have helped to break barriers between community and health care systems.  Building and maintaining trust is paramount among populations and communities across the nation.

Trained Health Professionals

Community Health Workers are important and play an essential role in improving health outcomes for all.  CHWs possess a core set of skills.  In North Carolina specifically, CHWs complete a standardized statewide training program which covers nine competencies (https://www.ncdhhs.gov/divisions/office-rural-health/community-health-workers/about-nc-community-health-worker-initiative):

• Communication Skills: CHWs will develop communication skills such as being an effective listener to learn about client’s experiences and needs and communicate effectively during conflict or stressful situations. CHWs should be well versed in group communication skills to provide health education and community advocacy to the groups they serve.  
• Capacity Building Skills: CHWs will support their clients and communities through building new skills and promoting confidence in their own health such as building upon communication skills, reducing of risk behaviors, community organization, and advocation skills.
• Service Coordination Skills: CHWs will need service coordination skills to coordinate the care of their clients. They may create plans to follow for improving health for their client or community that will require the coordination of services.
• Interpersonal Skills: CHWs will need interpersonal skills to work with the diverse groups of people and develop relationships with clients, community members, supervisors, nurses, social workers, and policy makers to improve the lives of their communities and meet the needs of others.
• Advocacy Skills: CHWs must be able to advocate for their clients and communities among agencies, service providers, and to support changes to public policies. They must speak up to create change that would improve the health and well-being of their clients and communities.
• Personal Skills and Development: CHWs will develop personal skills that will enable them to get a job or volunteer position and to advance in their career. They will allow you to be more effective in promoting and advocating for their clients and communities.
• Outreach Skills: CHWs will provide outreach to individuals and communities about services that are available and encourage enrollment of those services.
• Education and Facilitation Skills: CHWs must be able to educate their clients and communities on how to prevent and manage health conditions, provide support in developing healthy behaviors, and advocate for social change.
• Knowledge Base: CHWs will need to know and recognize social determinants of health and health topics that impact their clients and communities to be able to give support and provide information on these topics.

Health Equity

One ripple effect of Community Health Workers serving within the communities in which they live, work, play and worship in, is that their efforts work to address health equity.  CHWs play an instrumental role in mitigating barriers related to access to health care, language, cultural, and socioeconomic factors.  Integrating trained CHWs as collaborators within the health care system can promote bi-directional learning amongst clinicians and community.  Increasing knowledge and understanding among clinicians about community needs through a trusted messenger is a step in the right direction to tackle health inequities.

The Future of Community Health Workers

With the public health landscape constantly changing and evolving, the utilization of CHWs remains critical to the health of communities.  While some neighborhoods have similar needs and level of resources, others are unique and require a touch that is personal, trusted, and well received.  CHWs are positioned to help navigate and connect members of their community to the programs and services needed.  As we continue to see this health profession grow, the collective impact gives credence to the power of investing in community and the assets within.  CHWs will continue to be influential suppliers of pertinent health information and resources to communities across the nation.