This National Community Health Worker Awareness Week, NACCHO is recognizing the crucial role that community health workers (CHWs) play in supporting the health and safety of communities alongside our local health departments (LHDs). While CHWs work in various settings, the integration between the local governmental public health system and CHWs could be one way to support more coordinated programming and broaden the reach of programs, services, and resources within communities. However, whether and how LHDs work with CHWs is largely unknown. To better understand this, NACCHO included LHDs’ experiences around coordination with CHWs in the 2023 Forces of Change survey, a nationally representative study examining many emerging topics within public health.

Overall, results suggest that about half of LHDs across the U.S. are working with CHWs. There are around one in four LHDs that hire CHWs and one in 10 that have CHWs as volunteers. However, most LHDs work with CHWs who are employed by partner organizations. When LHDs do work with CHWs, they commonly report that CHWs are connecting community residents with resources (both LHD-specific and other health resources) and providing public health education. Fewer LHDs report that CHWs are supporting clinical services (36%) or disease intervention work (28%) in the community.
There are key challenges and resources needed to support LHDs in their ability to work with CHWs. More than six in 10 LHDs that work with CHWs said that identifying funding to pay CHWs was a barrier. Over half of LHDs need resources to pay CHWs competitively or to build knowledge regarding CHWs’ roles to better integrate them into programming and service planning in LHDs.
There is an opportunity for LHDs to better integrate CHWs into their work, especially in this time where rebuilding trust in science and bolstering the public health systems are vital for communities’ health. To learn more, check out this model from the Oklahoma City-County Health Department working with CHWs in different capacities to meet the needs of their communities!