Courtesy San Antonio Express News
The key to unlocking improved health outcomes in the United States has been in our hands for hundreds of years: community health workers.
Also known as community outreach workers, patient navigators, health educators, community health representatives and promotores de salud, community health workers deliver a variety of health and social services to people where they live, learn, work and play. They are trusted members of their community, sharing a common ethnicity, language, culture and life experiences.
They connect individuals to resources, and improve quality and cultural competency of care. They build individual and community capacity to increase health knowledge, health behaviors and, ultimately, better health outcomes.
More than 60 years of evidence in primary care, maternal health, chronic disease interventions, immunizations, oral health and HIV care proves community health workers play a crucial role in improving the health of our country.
In Texas, there are more than 5,000 certified community health workers, along with many others working without certification. All are on the front lines of health care to serve our most vulnerable populations.
Unfortunately, community health workers remain on the fringes of public health. With less than 3% of U.S. health care expenditures going to public health and disease prevention, these positions are often grant-funded, contributing to a lack of sustainable recruitment, training, professional development and career pathways.
The good news is the U.S. government has significantly invested in building the community health workforce, an interest renewed in part by COVID-19.
In 2022, the Health Resources and Service Administration granted over $225 million to train community health workers. Three San Antonio organizations received $9 million of these funds. We represent one of these programs, a community-academic collaborative led by the University of Texas Health Science Center at San Antonio (UT Health San Antonio). As part of our efforts, we bring together training centers and employers in an apprentice program to elevate the community health workforce in South Texas.
Like apprenticeships for trades and professions such as plumbing and electrical, a community health worker apprenticeship is a structured training program that combines on-the-job learning with classroom instruction.
Through registered apprenticeships, employers can learn how to optimally integrate community health workers into their organization and mold future leaders to meet the needs of the populations they serve.
As a cross-sector workforce, community health workers work beyond inpatient and outpatient health care. They also work in schools, government agencies, faith-based organizations, neighborhood centers, on the street, and in libraries, pharmacies, affordable housing purveyors and other trusted organizations.
These organizations already face a demand among patrons for linkages to health and social services. A community health worker can alleviate these tasks and allow other team members to focus on other responsibilities.
From the standpoint of an employer, there is no better time to train future health professionals through a registered apprenticeship program. The city of San Antonio’s Ready to Work program and Alamo Workforce Solutions have funds to support the salaries of new and current workers in apprenticeship programs. Our community health worker training program also provides technical expertise in designing job descriptions, executing on-the-job training and mentorship.
One of the most influential actions a South Texas employer can take this year is hiring a community health worker to prioritize health and well-being. By pulling community health workers from the fringes and into a formalized apprenticeship pathway, we can strengthen the entire public health ecosystem.
Shayanne Martin is a senior project manager with the Charles E. Cheever Jr. Center for Medical Humanities and Ethics at UT Health San Antonio. Dr. Jason Rosenfeld is an associate professor of medicine at UT Health San Antonio and co-director of Health Confianza.