Community Health Worker Practice: Jurisdictional Differences and Rural Health Impact

Rural communities in the United States face pronounced barriers to accessing health care, resulting in higher rates of under- or uninsurance, facility closures, and preventable morbidity and mortality. Community health workers (CHWs) represent a promising strategy for bridging these gaps by providing culturally competent education, navigation support, and resource linkage. Although CHW programs have demonstrated improvements in chronic disease management, health behaviors, and healthcare utilization, there is insufficient evidence linking specific policy provisions to rural health outcomes due to wide variation in program structure and policy context.

This project will use two large data sets for outcomes and relevant state-level CHW policy information from 2016 – present to estimate the relationship between state-level CHW policy provisions and rural health outcomes. Outcomes of interest include mortality and emergency department utilization for the leading causes of death among children, adults, and older adults.

Findings will fill critical gaps in the understanding of how CHW-related policies influence rural health, supporting the development of evidence-based policy frameworks to optimize rural health outcomes.