For decades community health workers have helped people from underserved communities navigate their way through the health care system.
These workers, many of whom work or volunteer with community agencies or charities, help people overcome barriers like lack of insurance and transportation to find affordable health care.
For Krischele Brown, a former nurse who is now a community health worker, her devotion for the work came from being able to “come from behind a desk and work on the forefront.”
Brown’s personal experiences, including caring for a schizophrenic sister and a mother with congestive heart failure, trained her be an advocate for the people that she serves at NAESM, an organization that focuses on the health and wellness of Black gay men in Atlanta.
“We observe the people in our families and our communities that need and we fill those needs,” she said. “It takes a village to raise everybody, not just children.”
Earlier this week, community health care workers from across Georgia gathered to raise awareness of their work. At the State Capitol in Atlanta they spoke to legislators to showcase their services, which became more needed and valuable when the pandemic put extraordinary strain on the health care system.
“It’s important for community health workers to understand that their voices are power for their community members, especially as we are trying to build the workforce,” said Natasha Taylor, senior director of policy and access at Georgia Watch, a consumer advocacy organization. “Now is the time for their voices to be loud.”
In 2021, the Centers for Disease Control and Prevention awarded more than $300 million nationally for community health workers to organizations aiding in the pandemic response. The Georgia Department of Public Health will receive $3 million annually from the CDC over three years to provide training and resources for workers in Georgia.
In 2016, DPH teamed with the Atlanta Regional Collaborative for Health Improvement, Grady Health Systems, Kaiser Permanente, Morehouse School of Medicine, United Way of Greater Atlanta and several other organizations to expand the number of health workers stationed in communities.
Christine Wiggins, a former DPH employee who is now the vice president of community health systems at the Fulton-DeKalb Hospital Authority, said, “This has been a true collaborative effort. That’s why I feel like it has been sustained for all of these years. We have worked together as a true partnership to say what can we do to help support this workforce.”
Additionally, federal investments have been made for this effort. In September, the Department of Health and Human Services gave nearly $226 million to fund an estimated 13,000 community health workers across the country. A 2020 Health Affairs study found that every dollar spent on workers would yield a return of $2.47 to the average Medicaid payer.
“The pandemic highlighted what a benefit (the health workers) were to communities and how trusted they were by communities, especially communities that don’t typically trust the health care system,” said Taylor. “Once it was revealed how impactful they could be and how beneficial they could be to improving health care, we decided to continue to focus on that development.”
Credit: Steve Schaefer
Credit: Steve Schaefer
Morehouse School of Medicine has been a leader in community health worker development. Dr. Arletha Lizana, associate vice president for health innovation and strategy at the school described the workers and their training as part of the school’s culture, adding that when the school receives new grants or creates new programs, the roles these workers will play are immediately considered.
“Morehouse School of Medicine has trained community health workers for over 25 years. Thousands of community health workers,” Lizana said. “Community health workers are a vital aspect of any type of community health improvement.”
The school has developed training curriculum for this work, including programs targeted to Haitian American and Indigenous communities, with a pilot program specifically created to reach Alaskan Native populations as well. They also have program adaptations to train young adult mental health workers, opioid reduction specialists and high school students as community health workers.
Community health workers play a variety of roles depending upon the communities and populations they serve. From connecting community members to medical services, to helping with food security.
“It’s more of just a passion to serve your community, and if you have that passion, you can use your voice to raise issues that are in your community and find solutions for them,” said Frank Sutton, a program manager at the medical school’s Innovation Learning Laboratory for Population Health.
When Amber Mullen’s son was murdered in 2021, shortly after her husband’s murder in 2019, she poured her pain and trauma into helping people through her work as a community health worker at Walmart Health. Outside of her full-time job in Marietta as a community health worker, Mullen travels on weekends to the South Carolina town where her son was murdered to participate in and oversee community outreach events for victims of crime.
“Most of us live in the communities that we serve. We’ve either been homeless, without health care, childcare, food, whatever it might be,” said Mullen. “It’s very important to have community. We’re all just one paycheck away from being any and all of those things.”
A cause for concern is sustainability of the services the workers provide. Many positions are grant funded and lack benefits. According to Lizana, a large share are women from low-income backgrounds. Additionally, there is no national standardized training or credentialing of the workers, something that many want to see changed.
“It’s been a long road, but I feel like we’re getting to the top of the goals we originally set,” Wiggins said. “The biggest thing is that we’re just wanting people to know that this workforce exists.”
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