Community health workers reach patients doctors can't

Community health workers (CHWs) may help patients with conditions like diabetes in ways more traditional healthcare practitioners cannot, according to a New York Times blog post.

For example, in Philadelphia, Penn Medicine's IMPaCT (Individualized Management for Patient-Centered Targets) program sends CHWs to visit patients living in high-poverty areas, those with multiple chronic illnesses and the uninsured. Since 2011, they have treated nearly 2,000 patients, and the program plans to expand from its current seven CHWs to 30 next year, according to the post. 

The healthcare industry is interested in expanding the presence of CHWs within the industry; other healthcare systems have launched their own CHW programs as well, including Children's Mercy Kansas City's Healthy Homes for Community Health Workers initiative, a one-day training course for healthy-home education.

In poorer nations, CHWs often fill the role of doctors in isolated rural areas, but in the United States, they often have no medical training. Rather, CHWs are usually from the same community as the patients they interact with and are valued for their skills in listening to and supporting patients.

Their community roots make CHWs particularly valuable, as they "understand what is meaningful to those communities, communicate in the language of the people, and recognize and incorporate cultural buffers (e.g., cultural identity, spiritual coping, traditional health practices) to help community members cope with stress and promote health outcomes," according to the Centers for Disease Control and Prevention.

"The DNA of a lot of these programs comes from an activist, almost anti-bottom-line perspective. They are grant funded," Prabhjot Singh, a Columbia University professor who co-chairs the One Million Community Health Networks, told the Times, "and there's a lot of academic interest but there is not a way to systematically invest in CHWs."

Structured interventions led by CHWs can drastically improve glucose control among low-income Latinos with type 2 diabetes, according to a study published this month in Diabetes Care. A 2013 study found CHWs can improve hospital outcomes as well, FierceHealthcare previously reported.

To learn more:
- read the blog post
- here's the Children's Mercy program
- here's the CDC document
- check out the study abstract