Chicago research team assesses the health of community health workers

Community health workers (CHWs) represent an essential part of the U.S. health care workforce. Their vast experience, community connections, and ability to navigate difficult health and social challenges provide fundamental health-support services. Yet little information is known about CHWs’ own health and wellness. Although studies have shown that those working in health care overall experience higher rates of cardiovascular disease and mental health challenges, little has been done to include CHWs in this line of study.

Understanding that CHWs may experience some of the same challenges — such as poverty and chronic illness — as those in the communities they serve, researchers from the Chicagoland CEAL Program set out to take a closer look. As part of a three-phase study, the researchers first administered a survey to 179 CHWs that looked at general health, chronic illnesses, health behaviors, and mental health. Phase 2 consisted of interviews with Phase 1 participants, and Phase 3 included a year-long follow-up survey.

The researchers’ findings

• Compared to the Chicago population as a whole, CHWs reported worse results in general health, mental health, emotional support, and sleep. CHWs had fewer instances of hypertension, obesity, and high cholesterol.
• Economic difficulties were widely reported, with 36% of respondents earning below $25,000 annually. More than half of the respondents reported delaying medical treatment because of cost.
• Current workforce interventions to address these issues have shown mixed success, with most interventions excluding CHWs altogether.

The evidence-informed opportunities

• Systems-level solutions can help to sustain the crucial CHW workforce.
• For example, at the employer level, improving protection of CHWs may involve ensuring proper work–life balance, increased wages, and improved health care.
• Follow-up from Phase 2 interviews and Phase 3 presents the opportunity to expand on these findings.
• As CHWs become more embedded into health care delivery systems, programs can help promote, support, and protect CHW health.