CHWs and Social Determinants of Health: How Far Upstream Are We Looking?
The presenters—a CHW leader and a former state health official—will describe risks associated with imprecise thinking about CHW impacts and the growing emphasis on support for licensed clinicians as the primary CHW role. One is the risk of marginalizing effective work many CHWs do in communities and outside the health care delivery system. Another is the risk of diminishing advocacy as a CHW core competency, especially since CHWs must often confront institutional barriers to quality care within their own organizations. Third, we risk placing excessive expectations on CHWs and obfuscating the distinction between linking people to services and transforming institutionalized racism, gender discrimination, oppressive power structures, and inequitable resource allocations that underlie health disparities.
The session will combine practice-based examples with a critical literature assessment to document ways in which CHWs help ameliorate ill effects of social determinants of health. It will emphasize that achieving the Triple Aim requires social justice, fidelity to the WHO Marmot principles, and political and community organizing. Promoting primary prevention is a responsibility for all health and public health professionals, not just CHWs.
Learning Areas:Advocacy for health and health education
Diversity and culture
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health
Identify ways in which Community Health Workers help ameliorate ill effects of social determinants of health. Describe risks associated with imprecise thinking about Community Health Worker (CHW) impacts and the growing emphasis on support for licensed clinicians as the primary CHW role. Explain the distinction between linking people to services and transforming systems of oppression and inequitable resource allocations that underlie health disparities.
Keyword(s): Community Health Workers and Promoters, Health Disparities/Inequities
Qualified on the content I am responsible for because: I served as founding chairman of the Massachusetts Board of Certification of Community Health Workers and have been involved in CHW workforce promotion since 2002 as director of the Massachusetts APHA affiliate and as a senior manager of the Mass. Department of Public Health. Both authors will present. Geoff Wilkinson is listed as the presenter for the sake of abstract submission only.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.