Possible Unifying Frameworks for CHWs in State Policy

[SPEAKER]

Before we discuss policy and system change concerning CHW employment, it may be useful to look at some of the potentially unifying reasons for pursuing such changes. CHWs can contribute to policy goals in a number of areas, such as:

• Improving patterns of utilization of services
• Reducing health inequities
• Health literacy and patient navigation
• Chronic illness prevention and management
• Community development
• Preparedness, including population resiliency and emergency communication

The last two subjects may be less familiar, but they are relevant to public health. CHWs work in many non-healthcare settings, helping to increase community participation in a variety of community improvement efforts, such as housing, education, transportation, schools and parks, as well as enhancing economic opportunity. Through their impact on community connectedness and self-sufficiency, CHWs can also help the community respond more effectively to emergencies, especially health-related disasters. CHWs may be particularly well positioned to help the community protect its most vulnerable residents in the event of emergencies, and they are among the most trusted communicators available to convey emergency messages.

Any of these policy contexts can form the basis for engaging stakeholders, but you may find it useful to focus your message fairly narrowly to avoid confusing your audience. At other times, using the entire list, or even adding to it, may be useful.

Finally, before moving into specific policy discussion, we'd like to reinforce some key points that may affect efforts toward policy and systems change.

First, we cannot take for granted that stakeholders have even the most basic level of understanding of the CHW workforce. Concerted efforts will be required to raise awareness and understanding.

Second, change cannot take place unless CHWs themselves participate. This participation will require some form of infrastructure, such as networks or associations of CHWs at the local, state, and national levels. Such infrastructure takes time to develop, and each state or local network will operate in its own style and within its own cultural context.

Now we will turn to workforce development as a policy arena.