Community Health Worker Roles, Regulation and Growth in Rural America

Research center:
Lead researcher:
Project funded:
September 2018
Anticipated completion date:
November 2019

Growing bodies of research in public health point to Community Health Workers (CHWs) as vital figures in ensuring access to care in a cost-effective manner. By engaging with patients to bridge the gap between the public and needed services, CHWs are positioned to help enhance patient knowledge and improve individual responsibility for care.

Critically, the number of CHWs working throughout the U.S. has increased dramatically in recent years. Understanding this growth and its impact on our health system is an important area of inquiry that we propose to study in depth. Specifically, our research will first work to understand the impact that the growing number of CHWs nationwide has had on healthcare in the U.S. Through a series of focus groups in rural and urban environments nationwide, we intend to better understand the variety of roles that CHWs play, the ways in which they help individuals access care, and their recommendations for improving patient engagement and responsibility. We are particularly interested in how these factors vary across rural and urban environments. In addition, we plan to take what we learn from these focus groups as we develop a survey on health access to be administered to CHWs nationwide.

Through this survey and the focus groups, we will gain important insight into the varied roles of CHWs in health access in rural and urban environments across the U.S. Furthermore, we intend to use a legal analysis to study the growing regulatory frameworks states are developing that relate to CHWs and the relationship between these regulations and the increasing numbers of CHWs in states across the country. Some states have established regulations related to CHW infrastructure, professional identity, workforce development, and financing. We intend to investigate how states have differentially treated each of these regulatory components and how this relates to trends in CHW employment. In particular, we intend to analyze this relationship across metropolitan and non- metropolitan areas.