Community-Based Health Model for policy and systems change with Community Health Workers at the center

Achieving improved population health requires new strategies that align clinical practice, redesigned health systems, and community-based approaches that directly address the social determinants of health. Much of health care reform focuses on redesigned health systems, which leaves out two essential strategies that are necessary to achieve the triple-aim: social determinants and community engagement. The Community-Based Health Model, currently being piloted by a regional multi-sector coalition, the Healthy Living Collaborative (HLC), braids all three strategies. Central to the model are Community Health Workers (CHWs).

The model aligns three key elements: multi-sector, multi-disciplinary partnerships for systems change; braiding health care and social determinants data for prioritization of community-based strategies; and creating authentic community engagement through CHWs who link local wisdom to reform and systems change efforts, while working to improve the health of their neighborhood. 

The HLC currently has a regional network of 25 CHWs, who are natural leaders and experts in their communities, whose experience positions them to build their neighborhood’s capacity to seek out and address the root causes of poor health. The CHWs have been recruited from priority neighborhoods, have been trained, and already are working to connect community priorities to the HLC coalition’s systems and policy work.

The presentation will focus on this model’s incorporation of CHWs as part of larger policy and systems change work, and how coalition policy and systems work can help support and sustain the CHW workforce and programs. Presenters will be a CHW from the HLC cohort and a representative of the HLC.