ManagedCareSupplement3

GENERATIONS – Journal of the American Society on Aging

Successful Chronic Disease Programming : The Important Role of Community Health Workers By Carl H. Rush

CHWs can help people achieve health equity, improve their clinical outcomes, and reduce the community-wide burden of chronic disease.

I ntegrating community health workers (CHW) into public health and healthcare programs and services has become more common in recent years, and is now a recognized strategy for payers and providers to achieve health equity, improve clinical outcomes, and reduce the personal and financial burden of chronic conditions. Findings in this area show there are expanding opportuni- ties for CHWs to serve the health needs of Ameri- ca’s aging population (Rush, 2015). This article profiles three promising models that illustrate a range of successful approaches to CHW integra- tion in the domain of chronic disease. Definition and Role of the Community Health Worker The American Public Health Association (2018) defines a CHWas “a frontline public health worker who is a trustedmember of and/or has an unusu-

ally 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 facili- tate access to services and improve the quality and cultural competence of service delivery.” For ten or more years, researchers have noted growing CHW roles in chronic disease preven- tion and management for poverty populations and communities of color (Bodenheimer, Chen, and Bennett, 2009; Shah, Kaselitz, and Heisler, 2013). As early as 2003, the American Associa- tion of Diabetes Educators (AADE) concluded that CHWs “play a unique, important role in the care and support of people with and at risk for diabetes within their communities; . . . [and CHWs should] teach diabetes educators and other healthcare team members about commu- nity needs . . .” (AADE, 2003).

abstract Integrating community health workers into public health and healthcare programs and services is a recognized strategy to achieve health equity, improve clinical outcomes, and reduce the personal and financial burden of chronic conditions. This article profiles three promising models illustrating a range of approaches to such integration in the domain of chronic disease: an ongoing effort in a regional healthcare provider system; a state policy taskforce associated with a statewide demon- stration of Accountable Health Communities; and a culturally specific health promotion research project. | key words : community health workers, Spectrum Health, Washington Community Health Worker Task Force, Healthy Fit Initiative

36 | Spring 2019

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