Community health workers (CHWs) have been introduced in Canada in 1962, where representatives work with band councils to provide care to indigenous communities. However, these community health representatives can still be considered undervalued and under-recognized, with technicalities like inconsistent titles making them unable to fall under the reclassification in 2000 that can warrant them with comparable wage as with Health Canada workers of the same functions as them in the community.
Even with their crucial role in promoting public health and community development especially in remote communities, best seen in their mobility in low- and middle-income countries, community health workers in high-income countries like Canada and United States seem to continuously be overlooked members of the healthcare workforce.
As such, in this article, we'll highlight and emphasize the importance of community health workers in the primary care setting by exploring core community health worker roles and functions, and the steps we can take to empower them and help them succeed in briding health disparities and making health care services more accessible to marginalized community members.
Community health workers (CHWs) are trained health providers who immerse themselves in rural environments, where they interact firsthand with the communities they serve. They play a vital role in bridging the gap between health systems and the people who need them most, including marginalized members of the community and vulnerable populations.
Despite the lack of credentialing and regulation, they are typically trained to provide basic health services, health promotion and education, and community outreach. Some examples of these healthcare workers who concern themselves with community health needs include:
These individuals are essential in reaching underserved and marginalized populations, ensuring that everyone has access to the healthcare they need.
Community health workers are instrumental in improving access to primary healthcare and achieving equitable universal health coverage. Through close collaboration with the communities they serve, community health workers can recognize and tackle the specific obstacles that individuals and families encounter when trying to access healthcare services.
Community health workers play a crucial role in ensuring that everyone, regardless of their socioeconomic status or geographic location, has access to the primary healthcare services they need. Specifically, CHWs play an important role in doing the following:
The core functions of community health workers highlight their multifaceted role in primary care, demonstrating their ability to improve patient outcomes and promote health equity. Hartzler, et al. (2018) list the following as the core patient-facing functions that community health workers typically perform in primary care settings:
Community health workers play a diverse range of roles in the primary care setting, addressing the unique needs of the communities they serve. These diverse roles demonstrate the versatility of community health workers and their ability to address the unique needs of the communities they serve, ultimately improving health outcomes and promoting health equity. Hartzler, et al. (2018) clustered the roles CHWs can take on into three major groups, which are as follows:
Community health workers play a vital role in understanding the specific health needs of the community that they're rendering their services into. For this purpose, they may conduct basic health assessments, such as measuring vital signs, and provide guidance on lifestyle factors like diet and physical activity.
Moreover, CHWs can assist with routine exams and communicate findings to physicians, who can then provide remote medical advice and oversight. They may also help patients navigate the healthcare system, schedule appointments, and follow up on recommended treatments.
Community health workers can act as the bridge that connects patients with community-based services. For this purpose, they commonly concern themselves in referrals and follow-up phone calls, and, less commonly, in education and literacy support.
For example, "Promotoras" can check out risk factors and conduct relevant health screenings for mental health concerns by interviewing community members about contextual factors, such as unemployment or housing instability. They can then help patients access relevant community resources, such as vocational training programs or social services, to address these underlying barriers to health.
Community health workers have the responsibility to offer relevant and appropriate health education to members of the community that they serve. CHWs may act as community health advisors who guide patients in planning and goal-setting for their health. This then allows patients to take a more proactive role in taking care of themselves.
For example, care guides may facilitate goal setting, care coordination, and self-management strategies for patients, empowering them to take an active role in looking after their health and wellbeing.
To fully harness the potential of community health workers in primary care, we must take steps to empower and support them. Here are some key steps that key stakeholders in the healthcare industry can take to help community health workers succeed in their chosen career path:
Community health workers are essential in bridging the gap between healthcare systems and the communities they serve. CHWs can enhance primary care access, tackle social determinants of health, and advocate for fair and comprehensive healthcare coverage by utilizing their distinct abilities, expertise, and community networks.
At Caring Support, our comprehensive services are specifically designed to build a more inclusive and accessible healthcare system. We empower our healthcare professionals by showing that they're all valued members of the workforce, supporting them with their needs, from job search to self care.
If you're a community health worker looking to succeed in your healthcare career, create your free account with us today to experience the benefits of our services in your healthcare practice. Similarly, if you're an employer looking for competent healthcare workers, contact us today to learn more how we can work together towards a future where everyone has the opportunity to lead a healthy and fulfilling life.
Hartzler AL, Tuzzio L, Hsu C, Wagner EH. Roles and Functions of Community Health Workers in Primary Care. Ann Fam Med. 2018 May;16(3):240-245. doi: 10.1370/afm.2208. PMID: 29760028; PMCID: PMC5951253.
Hernandez, A. (n.d.). Home - Community Health Workers (CHW) Network of Canada. https://www.chwnetwork.ca/
Najafizada SA, Bourgeault IL, Labonte R, Packer C, Torres S. Community health workers in Canada and other high-income countries: A scoping review and research gaps. Can J Public Health. 2015 Mar 12;106(3):e157-64. doi: 10.17269/cjph.106.4747. PMID: 26125243; PMCID: PMC6972431.
Torres, S. (2023). Community Health Workers. Optometrists. In I.Bourgeault (Ed.), Introduction to Health Occupations in Canada. (p. 75-84). Ottawa: Canadian Health Workforce Partners, Inc.
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