How Do CHW/Ps Impact Health Equity?

People of color, immigrants, people with low incomes, and other populations marginalized by systemic inequities experience the impacts of racism, xenophobia, discrimination, and trauma, which can impact their access to health care and social supports in a variety of detrimental ways. Interventions to reduce health disparities often seek to improve the quality of care as well as support people’s health-related social needs such as housing, nutrition, personal safety, and transportation. MCPs and CBOs frequently struggle to successfully address these issues, due to the funding silos for health care and social services and the underfunding of social services in the United States.

CHW/Ps help to improve health outcomes among people who face unacceptable barriers to care because of their race, ethnicity, socioeconomic level, or immigration status by engaging patients with open communication, trust, empathy, and empowerment. As part of the communities they serve, CHW/Ps have shared experiences with patients that help them build authentic and trusting relationships. They are familiar with community needs and strengths and can help patients navigate medical and nonmedical resources. Across health care settings and conditions, CHW/Ps advance health equity in communities because they understand the root causes of the challenges that members face and can partner with members to develop tailored approaches more likely to be effective.

Racism is a root cause of health inequities, and any effort to address this must be community-led. While health systems are not currently set up to meet the needs of our communities, working with CHW/Ps can make this change possible.

^{—Mayra E. Alvarez, The Children’s Partnership}

What Is the Evidence for CHW/Ps Improving Health Outcomes and Reducing Costs?

Research confirms the effectiveness of CHW/Ps in improving health outcomes and quality of care, reducing health care costs, and advancing health equity. Multiple studies clearly demonstrate that CHW/Ps contribute significantly to improvements in members’ access to and continuity of care, screening and other prevention activities, and adherence to treatment. Managed care CHW/P programs show a return on investment for MCPs ranging from $2.28 to $4.80 for every dollar spent on CHW/Ps. Exhibit 4 in the Resource Guide (PDF) summarizes research confirming the value of CHW/P interventions, and can be used to demonstrate the evidence for the impact of CHW/P programs.