Community Health Worker Roles and Responsibilities in Rural and Urban America


Growing bodies of research in public health point to community health workers (CHWs) as vital figures in ensuring cost-effective access to needed services. By engaging with patients to bridge the gap between the public and needed services, CHWs are positioned to enhance patient knowledge and improve individual responsibility for care. They are uniquely situated, often armed with cultural competence and a personal understanding of the challenges their clients face, to help clients navigate barriers and address social determinants of health.

To investigate the CHW field in rural and urban environments, this research relied on a series of focus groups conducted with CHWs in four states. Our findings suggest that there is not a "typical" CHW. Despite this, our results show that CHWs in rural and urban areas share two commonalities—their role as bridge figures between communities and needed resources and their unique position in helping the healthcare industry address social determinants of health. An important difference we observed is that rural CHWs took on a more "generalist" role due to lack of resources, programs, and services, whereas urban CHWs took on a more "specialist" role because of the sometimes substantial amount of available resources, programs, and services.

Southwest Rural Health Research Center
Timothy Callaghan, David Washburn, Cason Schmit, Denise Martinez, Emily Thompson, Megan LaFleur, Zuleyma Ruiz