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NCDHHS, Office of Rural Health 1
Impacting the Social Determinants of Health:
The Role of the Community Health Worker
Public Health Leaders
ConferenceJanuary 23, 2020
NCDHHS, Office of Rural Health 2
A “frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.
NCDHHS, Office of Rural Health 3
Job Titles
Promotoro/a de saludLay Health Advisor
Outreach Worker
Patient NavigatorFamily Support WorkerOutreach WorkerFamily Advocate
Community Advocate
Traditional Healthcare Worker
Community Health Educator
Health Advocate
Enrollment Worker
Peer Leader
NCDHHS, Office of Rural Health 4
NCDHHS, Office of Rural Health 5
Whole Person Health
NCDHHS, Office of Rural Health 6
▪ Community leaders engaged in health initiatives
▪ Cross-sector collaboration
▪ Resource sharing
▪ Transportation
▪ Food
▪ Shelter
▪ Local healthcare providers committed to public health
▪ Active faith community
▪ Initiatives to combat substance abuse
6
A Multi-Sector Approach to Whole Person Care
NCDHHS, Office of Rural Health 7
• Develop, train and strengthen workforce needed to support SDoH/Trauma Informed Care
• Case Managers
• Staff of Advanced Medical Homes (Care Coordinators, Nutritionists, Health Coaches, Pharmacists, Advanced Practice Nurses, Social Workers)
• Community Health Workers
7
Workforce Needs to Address Health
NCDHHS, Office of Rural Health 8
Four Roles
Nine Competencies
Statewide Standardized Core Competency Training
Certification Processes
NCDHHS, Office of Rural Health 9
Community Health Worker
Roles
• Cultural Liaisons
• Health Navigators
• Health & Wellness Promoters
• Advocates
NCDHHS, Office of Rural Health 10
9 Core Competencies
Communication Skills
Interpersonal Skills
Service Coordination
Skills
Capacity Building Skills
Advocacy SkillsEducation and
Facilitation Skills
Outreach SkillsKnowledge
Base
Personal Skills and
Development
NCDHHS, Office of Rural Health 11
NC CHW Health Issues Addressed
NC Community Health Worker Survey 2017
55%
45%47%
40%
36%
31% 31% 31%
27%26%
24%
17%
Diabetes Heart disease Mental health Obesity Cancer HIV/AIDS Substance use Maternalhealth
Injuryprevention
Oral health Tobaccocessation
Asthma0
10
20
30
40
50
60
70
NCDHHS, Office of Rural Health 12
NC CHW Resource Connections
NC Community Health Worker Survey 2017
80%
54%
46% 46%
37%
34%
28% 27%26%
23% 22%
17%
13%11%
6%
0
20
40
60
80
100
120
NCDHHS, Office of Rural Health 13
NC CHW Relationship to Clients
NC Community Health Worker Survey 2017
57%
51%
35%33%
26%
18%
11%
Same spoken language Same race/ethnicity Attend same church Neighbors Same health condition Other Not applicable0
10
20
30
40
50
60
70
80
90
NCDHHS, Office of Rural Health 14
NC CHW Populations Served
NC Community Health Worker Survey 2017
52%
47% 46%
42%41%
34% 34%
30% 29%
21% 21%
11%
6%
0
10
20
30
40
50
60
70
80
NCDHHS, Office of Rural Health 15
The Role of CHWs
The role of the CHW/What
is a CHW?
NCDHHS, Office of Rural Health 16
Tish [email protected]
16
North Carolina Department of Health and Human
Services Website
North Carolina Office of Rural Health Website
