Community Health Workers - Expanding Healthcare Access in WNC

Photo by Sasirin Pamai, via Vecteezy

Facing a dramatically shrinking healthcare workforce, Western North Carolina has identified innovative ways to support and expand the influence of a key role for increasing access among those most vulnerable and most often left behind - Community Health Workers.

Community Health Workers in WNC

Although our region has long struggled with the additional challenges of rural living and poverty, there have always been community members who have learned how to navigate regional healthcare systems and provide guidance to their family and neighbors. These community health workers (CHWs) are a motivated and effective part of the healthcare landscape and, when integrated into the workforce, can help to address both the regional workforce shortage and the quality of healthcare outcomes across the communities they live in. 

As President of the NC Community Health Worker Association (NCCHWA), Honey Yang Estrada, describes in the WNC Health Policy Initiative Podcast, many CHWs (such as her mother) came to this work as a result of experiencing healthcare gaps firsthand. The teenage daughter of a Hmong family resettled in WNC after their support during the Vietnam War, Honey’s mother became a bridge between her parents’ generation and the community around them through her ability to understand both languages and cultures. She was able to help her community access healthcare resources “because she looked like the community, she spoke the language, she understood all of those cultural nuances,” Honey recounts. 

Now herself a CHW, Honey says “it's because of that lived experience - it allows me to connect with the people from my community because I know the struggle.” Having “a seat at the dinner table” in their communities, CHWs understand the experiences of their communities and the barriers they have to receiving effective healthcare. Using this deep knowledge and trust, they can then point the way towards existing resources. These bridges connect to over 90 different healthcare areas, including maternal child health, diabetes management, prisoner reentry, interpretation, and mental and behavioral health. Within each of these health domains, CHWs’ work also serves to remove some of the pressure felt by the rest of the healthcare system’s workforce. Whether by connecting community members to care sooner than they might otherwise be able to, supporting the healthcare team in understanding the challenges of their patients, or facilitating understanding by community members themselves, CHWs reduce strain across the system, saving money and lives.

CHWs and the COVID-19 Crisis 

CHWs have recently received increased attention in NC due to their effective roll-out of resources during the first years of the COVID-19 pandemic. Recognizing their unique role in connecting resources to communities who are not well-served by regional healthcare systems, the Dogwood Health Trust and the Mountain Area Health Education Center (MAHEC) supported CHWs in WNC with funding and technical support. Using their strong networks and newfound infrastructure to learn about best practices and point community members towards the resources they needed, CHWs became a vital resource to many communities. As health concerns of their patients extended beyond COVID-19, this newly supported workforce then worked to address chronic diseases (see results collected by the NCCHW here). 

Now that the COVID-19 funding has ended, there remains the question of whether WNC will continue to support this unique workforce, even outside of a global pandemic. As Honey says, “We still have not yet identified what sustainable funding is gonna look like for CHWs, right? [W]e know it makes sense. We know it's the right thing to do. We have seen the outcomes. The financing piece continues to get lost.” 

Listen and learn more…

In this month’s installment of the WNC HPI Podcast, host Andrew Rainey speaks with the President of the NCCHWA, Honey Yang Estrada, to learn more about this healthcare workforce opportunity in WNC, including strengths, challenges, and potential policy or strategy areas to continue community health work.

Click here to listen to Episode 8 - Community Health Workers in WNC